Table 1. Scoring Algorithm for the modified 7-day Lee Chronic GVHD Symptom Scale.
The modified 7 day Lee Chronic GVHD Symptom Scale (mLSS) is a 28 item instrument with 7 subscales (skin, eyes, mouth, lung, nutrition, energy and psych) containing 2–7 items which allow calculation of a summary score. Response options for “Please let us know if you have been bothered by any of the following problems in the past 7 days” range from 0–4 (Not at all, Slightly, Moderately, Quite a bit, Extremely). A clinically meaningful difference is considered 5–6 points on the summary score. Bolded items are scored under a different subscale than where they are located under the headers in the survey. Items p and k were deleted from the original 30 item scale.
| Subscale Name | Number of items | Items |
|---|---|---|
| Skin | 5 | a. Abnormal skin color |
| b. Rashes | ||
| c. Thickened skin | ||
| d. Sores on skin | ||
| e. Itchy skin | ||
| Eye | 3 | f. Dry eyes |
| g. Need to use eyedrops frequently | ||
| h. Difficulty seeing clearly | ||
| Mouth | 2 | i. Need to avoid certain foods due to mouth pain |
| j. Ulcers in mouth | ||
| Lung | 4 | l. Frequent cough |
| m. Colored sputum | ||
| o. Shortness of breath at rest | ||
 |
||
| aa. Fevers | ||
| Nutrition | 4 |  |
| q. Difficulty swallowing solid foods | ||
| r. Difficulty swallowing liquids | ||
| s. Vomiting | ||
| t. Weight loss | ||
| Energy | 7 | n. Shortness of breath with exercise |
| u. Joint and muscle aches | ||
| v. Limited joint movement | ||
| w. Muscle cramps | ||
| x. Weak muscles | ||
| y. Loss of energy | ||
| z. Need to sleep more/take naps | ||
| Psych | 3 | bb. Depression |
| cc. Anxiety | ||
| dd. Difficulty sleeping | ||
Scoring rules:
Note that the subscales do not conform exactly to the headers in the patient survey.
Items p and k are deleted from the 7 day version.
Subscales may be scored if 50% of more of the items in the subscale are completed.
Scores are linearly transformed to a 0–100 scale where 0 means all answered items were a “0” and “100” means that all answered items were a “4”
Missing items are not included in the scoring.
The summary score is the average of the subscale scores, as long as 4 or more subscales are available.
Higher scores indicate more severe symptoms.