Tito R. Mendoza, PhD, MS, MEd
Department of Symptom Research, Division of Internal Medicine
About Dr. Mendoza
Tito Mendoza spends most of his time doing collaborative work that utilizes his quantitative background in psychometrics and statistics to develop and evaluate the measurement properties of patient-reported outcomes (PRO)-based measurement questionnaires in the substantive area of cancer symptom research. As a psychometrician, he was instrumental in the development of single-symptom (Brief Fatigue Inventory) and multiple-symptom (MD Anderson Symptom Inventory, MDASI) assessment tools. His collaborations with clinicians at MD Anderson have resulted in the development of several disease-specific and cancer-site-specific modules of the MDASI, including the MDASI-Brain Tumor, the MDASI-Head and Neck, the MDASI-Thyroid, the MDASI-Gastrointestinal Cancer, the MDASI-Heart Failure, and others. He also works with our international collaborators to provide the necessary theoretical measurement framework to conduct foreign-language validation of our assessment tools.
Dr. Mendoza was involved in a number of aspects of the development and validation of the patient-reported outcomes version of the Common Terminology Criteria Adverse Event (PRO-CTCAE) funded by the National Cancer Institute. Currently, he is involved in the psychometric validation of fit-for-purpose PRO assessment tools that are intended to meet the US Food and Drug Administration’s requirement for the use of patient report in labeling claims.
Dr. Mendoza applies his statistical expertise to the design, analysis, and interpretation of studies with PROs. An integral aspect of his research is the application of advanced statistical models in understanding symptom outcomes. He is interested in determining how PROs can be use to define and develop responder-type analyses. Currently, he is investigating the symptom burden of patients receiving immune checkpoint inhibitor combined with other cancer therapies.
Present Title & Affiliation
Primary Appointment
Professor, Department of Symptom Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
Research Interests
My primary research interest is in applying psychometrics to develop and evaluate symptom assessment tools. I was instrumental in the development of single-symptom (Brief Fatigue Inventory, BFI) and multiple-symptom (M. D. Anderson Symptom Inventory, MDASI) assessment tools. My collaboration with clinicians at M. D. Anderson have resulted in the development of several disease-specific and cancer-site-specific modules of the MDASI, including the MDASI-Brain Tumor, the MDASI-Head and Neck, the MDASI-Thyroid, the MDASI-Gastrointestinal Cancer, and the MDASI-Heart Failure, and others. I have provided our international collaborators with the necessary theoretic measurement framework to conduct foreign-language validation of our assessment tools.
An integral aspect of my research is the application of advanced statistical models in understanding symptom outcomes. I am interested in determining how patient-reported outcome can be use to define and develop responder type analysis.
Education & Training
Degree-Granting Education
| 1999 | University of Wisconsin, Madison, WI, USA, PHD, Quantitative Methods |
| 1995 | University of Wisconsin, Madison, WI, USA, MS, Statistics |
| 1991 | University of Toledo, Toledo, OH, USA, MEd, Research and Measurement |
| 1987 | University of the Philippines, Los Baños, PHL, BS, Statistics |
Experience & Service
Academic Appointments
Associate Professor, Department of Symptom Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 2010 - 2018
Assistant Professor, Department of Symptom Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 2004 - 2010
Selected Publications
Peer-Reviewed Articles
- Shi Q, Mendoza TR, Dueck AC, Ma H, Zhang J, Qian Y, Bhowmik D, Cleeland CS. Determination of mild, moderate, and severe pain interference in patients with cancer. Pain 158(6):1108-1112, 2017. PMID: 28267060.
- Basch E, Pugh SL, Dueck AC, Mitchell SA, Berk L, Fogh S, Rogak LJ, Gatewood M, Reeve BB, Mendoza TR, O'Mara AM, Denicoff AM, Minasian LM, Bennett AV, Setser A, Schrag D, Roof K, Moore JK, Gergel T, Stephans K, Rimner A, DeNittis A, Bruner DW. Feasibility of patient reporting of symptomatic adverse events via the patient-reported outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) in a chemoradiotherapy cooperative group multicenter clinical trial. Int J Radiat Oncol Biol Phys 98(2):409-418, 2017. e-Pub 2017. PMID: 28463161.
- Shi Q, Mendoza TR, Wang XS, Cleeland CS. Using a symptom-specific instrument to measure patient-reported daily functioning in patients with cancer. Eur J Cancer 67:83-90, 2016. e-Pub 2016. PMID: 27620946.
- Sio TT, Lin HK, Shi Q, Gunn GB, Cleeland CS, Lee JJ, Hernandez M, Blanchard P, Thaker NG, Phan J, Rosenthal DI, Garden AS, Morrison WH, Fuller CD, Mendoza TR, Mohan R, Wang XS, Frank SJ. Intensity modulated proton therapy versus intensity modulated photon radiation therapy for oropharyngeal cancer: first comparative results of patient-reported outcomes. Int J Radiat Oncol Biol Phys 95(4):1107-14, 2016. e-Pub 2016. PMID: 27354125.
- Armstrong TS, Vera-Bolanos E, Acquaye AA, Gilbert MR, Ladha H, Mendoza T. The symptom burden of primary brain tumors: evidence for a core set of tumor and treatment-related symptoms. Neuro Oncol 18(2):252-260, 2016. e-Pub 2015. PMID: 26289592.
- Bennett AV, Dueck AC, Mitchell SA, Mendoza TR, Reeve BB, Atkinson TM, Castro KM, Denicoff A, Rogak LJ, Harness JK, Bearden JD, Bryant D, Siegel RD, Schrag D, Basch E, National Cancer Institute PRO-CTCAE Study Group. Mode equivalence and acceptability of tablet computer-, interactive voice response system-, and paper-based administration of the U.S. National Cancer Institute's Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). Health Qual Life Outcomes 14:24, 2016. e-Pub 2016. PMID: 26892667.
- Shah JJ, Feng L, Thomas SK, Berkova Z, Weber DM, Wang M, Qazilbash MH, Champlin RE, Mendoza TR, Cleeland C, Orlowski RZ. Siltuximab (CNTO 328) with lenalidomide, bortezomib and dexamethasone in newly-diagnosed, previously untreated multiple myeloma: an open-label phase I trial. Blood Cancer J 6:e396, 2016. e-Pub 2016. PMID: 26871714.
- Dueck AC, Mendoza TR, Mitchell SA, Reeve BB, Castro KM, Rogak LJ, Atkinson TM, Bennett AV, Denicoff AM, O'Mara AM, Li Y, Clauser SB, Bryant DM, Bearden JD, Gillis TA, Harness JK, Siegel RD, Paul DB, Cleeland CS, Schrag D, Sloan JA, Abernethy AP, Bruner DW, Minasian LM, Basch E, National Cancer Institute PRO-CTCAE Study Group. Validity and Reliability of the US National Cancer Institute's Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). JAMA Oncol 1(8):1051-9, 2015. PMID: 26270597.
- Shi Q, Wang XS, Li G, Shah ND, Orlowski RZ, Williams LA, Mendoza TR, Cleeland CS. Racial/ethnic disparities in inflammatory gene single-nucleotide polymorphisms as predictors of a high risk for symptom burden in patients with multiple myeloma 1 year after diagnosis. Cancer 121(7):1138-46, 2015. e-Pub 2014. PMID: 25469832.
- Wang XS, Shi Q, Shah ND, Heijnen CJ, Cohen EN, Reuben JM, Orlowski RZ, Qazilbash MH, Johnson VE, Williams LA, Mendoza TR, Cleeland CS. Inflammatory markers and development of symptom burden in patients with multiple myeloma during autologous stem cell transplantation. Clin Cancer Res 20(5):1366-74, 2014. e-Pub 2014. PMID: 24423611.
- Hay JL, Atkinson TM, Reeve BB, Mitchell SA, Mendoza TR, Willis G, Minasian LM, Clauser SB, Denicoff A, O'Mara A, Chen A, Bennett AV, Paul DB, Gagne J, Rogak L, Sit L, Viswanath V, Schrag D, Basch E, NCI PRO-CTCAE Study Group. Cognitive interviewing of the U.S. National Cancer Institute's Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). Qual Life Res 23(1):257-69, 2014. e-Pub 2013. PMID: 23868457.
- Jones D, Zhao F, Fisch MJ, Wagner LI, Patrick-Miller LJ, Cleeland CS, Mendoza TR. The validity and utility of the MD Anderson Symptom Inventory in patients with prostate cancer: evidence from the Symptom Outcomes and Practice Patterns (SOAPP) data from the Eastern Cooperative Oncology Group. Clin Genitourin Cancer 12(1):41-9, 2014. e-Pub 2013. PMID: 24126238.
- Escalante CP, Meyers C, Reuben JM, Wang X, Qiao W, Manzullo E, Alvarez RH, Morrow PK, Gonzalez-Angulo AM, Wang XS, Mendoza T, Liu W, Holmes H, Hwang J, Pisters K, Overman M, Cleeland C. A randomized, double-blind, 2-period, placebo-controlled crossover trial of a sustained-release methylphenidate in the treatment of fatigue in cancer patients. Cancer J 20(1):8-14, 2014. PMID: 24445757.
- Shi Q, Duvic M, Osei JS, Hordinsky MK, Norris DA, Price VH, Amos CI, Christiano AM, Mendoza TR. Health-related quality of life (HRQoL) in alopecia areata patients-a secondary analysis of the National Alopecia Areata Registry data. J Investig Dermatol Symp Proc 16(1):S49-50, 2013. PMID: 24326555.
- Mendoza TR, Osei JS, Shi Q, Duvic M. Development of the alopecia areata symptom impact scale. J Investig Dermatol Symp Proc 16(1):S51-2, 2013. PMID: 24326557.
- Cleeland CS, Zhao F, Chang VT, Sloan JA, O'Mara AM, Gilman PB, Weiss M, Mendoza TR, Lee JW, Fisch MJ. The symptom burden of cancer: Evidence for a core set of cancer-related and treatment-related symptoms from the Eastern Cooperative Oncology Group Symptom Outcomes and Practice Patterns study. Cancer 119(24):4333-40, 2013. e-Pub 2013. PMID: 24114037.
- Armstrong TS, Wefel JS, Wang M, Gilbert MR, Won M, Bottomley A, Mendoza TR, Coens C, Werner-Wasik M, Brachman DG, Choucair AK, Mehta M. Net clinical benefit analysis of radiation therapy oncology group 0525: a phase III trial comparing conventional adjuvant temozolomide with dose-intensive temozolomide in patients with newly diagnosed glioblastoma. J Clin Oncol 31(32):4076-84, 2013. e-Pub 2013. PMID: 24101048.
- Gunn GB, Mendoza TR, Fuller CD, Gning I, Frank SJ, Beadle BM, Hanna EY, Lu C, Cleeland CS, Rosenthal DI. High symptom burden prior to radiation therapy for head and neck cancer: A patient-reported outcomes study. Head Neck 35(10):1490-8, 2013. e-Pub 2012. PMID: 23169304.
- Barney BJ, Wang XS, Lu C, Liao Z, Johnson VE, Cleeland CS, Mendoza TR. Prognostic value of patient-reported symptom interference in patients with late-stage lung cancer. Qual Life Res 22(8):2143-50, 2013. e-Pub 2013. PMID: 23371797.
- Mendoza TR, Zhao F, Cleeland CS, Wagner LI, Patrick-Miller LJ, Fisch MJ. The validity and utility of the M. D. Anderson Symptom Inventory in patients with breast cancer: evidence from the Symptom Outcomes and Practice Patterns (SOAPP) data from the Eastern Cooperative Oncology Group. Clin Breast Cancer 13(5):325-34, 2013. e-Pub 2013. PMID: 23816985.
- Haines D, Martin M, Carson S, Oliveros O, Green S, Coates T, Eile J, Schilling L, Dinu B, Mendoza T, Gerstenberger E, Trachtenberg F, Vichinsky E, Thalassemia Clinical Research Network. Pain in thalassaemia: the effects of age on pain frequency and severity. Br J Haematol 160(5):680-7, 2013. e-Pub 2012. PMID: 23278768.
- Armstrong TS, Wefel JS, Gning I, Acquaye A, Vera-Bolanos E, Gilbert MR, Cleeland CS, Mendoza T. Congruence of primary brain tumor patient and caregiver symptom report. Cancer 118(20):5026-37, 2012. e-Pub 2012. PMID: 22415423.
- Fisch MJ, Lee JW, Weiss M, Wagner LI, Chang VT, Cella D, Manola JB, Minasian LM, McCaskill-Stevens W, Mendoza TR, Cleeland CS. Prospective, observational study of pain and analgesic prescribing in medical oncology outpatients with breast, colorectal, lung, or prostate cancer. J Clin Oncol 30(16):1980-8, 2012. e-Pub 2012. PMID: 22508819.
- Mendoza TR, Koyyalagunta D, Burton AW, Thomas SK, Phan MH, Giralt SA, Shah JJ, Cleeland CS. Changes in pain and other symptoms in patients with painful multiple myeloma-related vertebral fracture treated with kyphoplasty or vertebroplasty. J Pain 13(6):564-70, 2012. e-Pub 2012. PMID: 22543044.
- Burton AW, Mendoza T, Gebhardt R, Hamid B, Nouri K, Perez-Toro M, Ting J, Koyyalagunta D. Vertebral compression fracture treatment with vertebroplasty and kyphoplasty: experience in 407 patients with 1,156 fractures in a tertiary cancer center. Pain Med 12(12):1750-7, 2011. e-Pub 2011. PMID: 22123171.
- Swartz RJ, Schwartz C, Basch E, Cai L, Fairclough DL, McLeod L, Mendoza TR, Rapkin B, SAMSI Psychometric Program Longitudinal Assessment of Patient-Reported Outcomes Working Group. The king's foot of patient-reported outcomes: current practices and new developments for the measurement of change. Qual Life Res 20(8):1159-1167, 2011. e-Pub 2011. PMID: 21336659.
- Armstrong TS, Vera-Bolanos E, Gning I, Acquaye A, Gilbert MR, Cleeland C, Mendoza T. The impact of symptom interference using the M.D. Anderson Symptom Inventory-Brain Tumor Module (MDASI-BT) on prediction of recurrence in primary brain tumor patients. Cancer 117(14):3222-8, 2011. e-Pub 2011. PMID: 21264841.
- Cleeland CS, Mendoza TR, Wang XS, Woodruff JF, Palos GR, Richman SP, Nazario A, Lynch GR, Liao KP, Mobley GM, Lu C. Levels of symptom burden during chemotherapy for advanced lung cancer: differences between public hospitals and a tertiary cancer center. J Clin Oncol 29(21):2859-65, 2011. e-Pub 2011. PMID: 21690477.
- Ferreira KA, Teixeira MJ, Mendoza TR, Cleeland CS. Validation of Brief Pain Inventory to Brazilian patients with pain. Support Care Cancer 19(4):505-11, 2011. e-Pub 2010. PMID: 20221641.
- Cleeland CS, Wang XS, Shi Q, Mendoza TR, Wright SL, Berry MD, Malveaux D, Shah PK, Gning I, Hofstetter WL, Putnam JB, Vaporciyan AA. Automated symptom alerts reduce postoperative symptom severity after cancer surgery: a randomized controlled clinical trial. J Clin Oncol 29(8):994-1000, 2011. e-Pub 2011. PMID: 21282546.
- Palos GR, Mendoza TR, Liao KP, Anderson KO, Garcia-Gonzalez A, Hahn K, Nazario A, Ramondetta LM, Valero V, Lynch GR, Jibaja-Weiss ML, Cleeland CS. Caregiver symptom burden: the risk of caring for an underserved patient with advanced cancer. Cancer 117(5):1070-9, 2011. e-Pub 2010. PMID: 20960510.
- Atkinson TM, Rosenfeld BD, Sit L, Mendoza TR, Fruscione M, Lavene D, Shaw M, Li Y, Hay J, Cleeland CS, Scher HI, Breitbart WS, Basch E. Using confirmatory factor analysis to evaluate construct validity of the Brief Pain Inventory (BPI). J Pain Symptom Manage 41(3):558-65, 2011. e-Pub 2010. PMID: 21131166.
- Bruner DW, Hanisch LJ, Reeve BB, Trotti AM, Schrag D, Sit L, Mendoza TR, Minasian L, O'Mara A, Denicoff AM, Rowland JH, Montello M, Geoghegan C, Abernethy AP, Clauser SB, Castro K, Mitchell SA, Burke L, Trentacosti AM, Basch EM. Stakeholder perpectives on implementing the National Cancer Institute's patient-reported outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). Translational Behavioral Medicine 1(1):110-22, 2011.
- Mendoza TR, Wang XS, Lu C, Palos GR, Liao Z, Mobley GM, Kapoor S, Cleeland CS. Measuring the symptom burden of lung cancer: the validity and utility of the lung cancer module of the M. D. Anderson Symptom Inventory. Oncologist 16(2):217-27, 2011. e-Pub 2011. PMID: 21285393.
- Shi Q, Trask PC, Wang XS, Mendoza TR, Apraku WA, Malekifar M, Cleeland CS. Does recall period have an effect on cancer patients' ratings of the severity of multiple symptoms?. J Pain Symptom Manage 40(2):191-9, 2010. e-Pub 2010. PMID: 20579835.
- Wang XS, Cleeland CS, Mendoza TR, Yun YH, Wang Y, Okuyama T, Johnson VE. Impact of cultural and linguistic factors on symptom reporting by patients with cancer. J Natl Cancer Inst 102(10):732-38, 2010. e-Pub 2010. PMID: 20348233.
- Wang XS, Williams LA, Eng C, Mendoza TR, Shah NA, Kirkendoll KJ, Shah PK, Trask PC, Palos GR, Cleeland CS. Validation and application of a module of the M. D. Anderson Symptom Inventory for measuring multiple symptoms in patients with gastrointestinal cancer (the MDASI-GI). Cancer 116(8):2053-63, 2010. e-Pub 2010. PMID: 20166216.
- Armstrong TS, Gning I, Mendoza TR, Vera-Bolanos E, Gilbert MR, Rhines LD, Weinberg JS, Sanchez-Williams G, Levin V, Burton AW, Cleeland C. Reliability and validity of the M. D. Anderson Symptom Inventory-Spine Tumor Module. J Neurosurg Spine 12(4):421-30, 2010. PMID: 20367379.
- Atkinson TM, Mendoza TR, Sit L, Passik S, Scher HI, Cleeland C, Basch E. The Brief Pain Inventory and its "Pain at its worst in the last 24 hours" item: clinical trial endpoint considerations. Pain Med 11(3):337-46, 2010. e-Pub 2010. PMID: 20030743.
- Wang XS, Shi Q, Lu C, Basch EM, Johnson VE, Mendoza TR, Mobley GM, Cleeland CS. Prognostic value of symptom burden for overall survival in patients receiving chemotherapy for advanced non-small cell lung cancer. Cancer 116(1):137-45, 2010. e-Pub 2009. PMID: 19852033.
- Mendoza TR, Laudico AV, Wang XS, Guo H, Matsuda ML, Yosuico VD, Fragante EP, Cleeland CS. Assessment of fatigue in cancer patients and community dwellers: validation study of the Filipino version of the Brief Fatigue Inventory. Oncology 79(1-2):112-7, 2010. e-Pub 2010. PMID: 21088437.
- Park HC, Janjan NA, Mendoza TR, Lin EH, Vadhan-Raj S, Hundal M, Zhang Y, Delclos ME, Crane CH, Das P, Wang XS, Cleeland CS, Krishnan S. Temporal patterns of fatigue predict pathologic response in patients treated with preoperative chemoradiation therapy for rectal cancer. Int J Radiat Oncol Biol Phys 75(3):775-81, 2009. e-Pub 2009. PMID: 19231100.
- Armstrong TS, Gning I, Mendoza TR, Weinberg JS, Gilbert MR, Tortorice ML, Cleeland CS. Clinical utility of the MDASI-BT in patients with brain metastases. J Pain Symptom Manage 37(3):331-40, 2009. e-Pub 2008. PMID: 18676120.
- Shi Q, Wang XS, Mendoza TR, Pandya KJ, Cleeland CS. Assessing persistent cancer pain: a comparison of current-pain ratings and pain recalled from the past week. J Pain Symptom Manage 37(2):168-74, 2009. e-Pub 2008. PMID: 18676116.
- Gning I, Trask PC, Mendoza TR, Harle MT, Gutierrez KA, Kitaka SA, Sherman SI, Cleeland CS. Development and initial validation of the thyroid cancer module of the M. D. Anderson Symptom Inventory. Oncology 76(1):59-68, 2009. e-Pub 2008. PMID: 19052478.
- Cella D, Viswanathan HN, Hays RD, Mendoza TR, Stein KD, Pasta DJ, Foreman AJ, Vadhan-Raj S, Kallich JD. Development of a fatigue and functional impact scale in anemic cancer patients receiving chemotherapy. Cancer 113(6):1480-8, 2008. PMID: 18642348.
- Fadol A, Mendoza T, Gning I, Kernicki J, Symes L, Cleeland CS, Lenihan D. Psychometric testing of the MDASI-HF: a symptom assessment instrument for patients with cancer and concurrent heart failure. J Card Fail 14(6):497-507, 2008. PMID: 18672198.
- Rosenthal DI, Mendoza TR, Chambers MS, Burkett VS, Garden AS, Hessell AC, Lewin JS, Ang KK, Kies MS, Gning I, Wang XS, Cleeland CS. The M. D. Anderson symptom inventory-head and neck module, a patient-reported outcome instrument, accurately predicts the severity of radiation-induced mucositis. Int J Radiat Oncol Biol Phys 72(5):1355-61, 2007. e-Pub 2008. PMID: 18501527.
- Mendoza T, Mayne T, Rublee D, Cleeland C. Reliability and validity of a modified Brief Pain Inventory short form in patients with osteoarthritis. Eur J Pain 10(4):353-61, 2006. PMID: 16051509.
- Mendoza TR, Wang XS, Cleeland CS, Morrissey M, Johnson BA, Wendt JK, Huber SL. The rapid assessment of fatigue severity in cancer patients: use of the Brief Fatigue Inventory. Cancer 85(5):1186-96, 1999. PMID: 10091805.
Abstracts
- Mendoza T, Rosenthal D, Wang X, Mobley G, Cleeland C. Measuring the symptom burden of head and neck cancer patients undergoing concurrent chemotherapy and radiation therapy using area under the curve. American Society of Clinical Oncology 2009 Annual Meeting, Orlando FL, May 29 - June 2, 2009. J Clin Oncol 27(15 Suppl), 2009.
Book Chapters
- Johnson VE, Mendoza TR. Bayesian adaptive design: a novel approach to test the effectiveness of symptom-reducing agents using patient-reported outcomes. In: Cancer Symptom Science: Measurement, Mechanisms, and Management. Cambridge University Press: Cambridge UK, 293-303, 2011.
- Cleeland CS, Mendoza TR. Symptom measurement by patient report. In: Cancer Symptom Science: Measurement, Mechanisms, and Management. Cambridge University Press: Cambridge UK, 268-84, 2011.