Quality of life of patients with gastric cancer in Taiwan: validation and clinical application of the Taiwan Chinese version of the EORTC QLQ-C30 and EORTC QLQ-STO22

The relatively high incidence of gastric cancer in Taiwan warranted the need of a disease-specific quality of life (QOL) instrument. We translated the EORTC QLQ-C30 and QLQ-STO22 according to the guidelines from the EORTC. A total of 100 patients were interviewed. Convergent and discriminant validity, Cronbach's alpha coefficient and known-groups comparisons were used to examine the reliability and validity. We found good reliability for multi-item subscales of the QLQ-C30 and QLQ-STO22 (Cronbach's alpha coefficient: 0.70-0.94) except cognitive functioning of the QLQ-C30 and eating restriction of the QLQ-STO22. Patients in the active treatment group experienced compromised functional status and worse treatment-associated symptoms than those in the follow-up group. Similar results were found in comparisons based on Eastern Cooperative Oncology Group (ECOG) Performance Status and dysphagia grades. The study has ascertained the cross-cultural validity, reliability and clinical applicability of the Taiwan Chinese version of the EORTC QLQ-C30 and QLQ-STO22.     

Psychometric Validation of the Malaysian Chinese Version of the EORTC QLQ-C30 in Colorectal Cancer Patients

Background and Aims: Colorectal cancer is the second most frequent cancer in Malaysia. We aimed to assess the validity and reliability of the Malaysian Chinese version of European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire core (QLQ-C30) in patients with colorectal cancer. Materials and Methods: Translated versions of the QLQ-C30 were obtained from the EORTC. A cross sectional study design was used to obtain data from patients receiving treatment at two teaching hospitals in Kuala Lumpur, Malaysia. The Malaysian Chinese version of QLQ-C30 was self administered in 96 patients while the Karnofsky Performance Scales (KPS) was generated by attending surgeons. Statistical analysis included reliability, convergent, discriminate validity, and known-groups comparisons. Statistical significance was based on p value ≤0.05. Results: The internal consistencies of the Malaysian Chinese version were acceptable [Cronbach’s alpha (α≥ 0.70)] in the global health status/overall quality of life (GHS/QOL), functioning scales except cognitive scale (α≤0.32) in all levels of analysis, and social/family functioning scale ( =0.63) in patients without a stoma. All questionnaire items fulfilled the criteria for convergent and discriminant validity except question number 5, with correlation with role (r = 0.62) and social/family (r = 0.41) functioning higher than with physical functioning scales (r = 0.34). The test-retest coefficients in the GHS/QOL, functioning scales and in most of the symptoms scales were moderate to high (r = 0.58 to 1.00). Patients with a stoma reported statistically significant lower physical functioning (p=0.015), social/family functioning (p=0.013), and higher constipation (p=0.010) and financial difficulty (p=0.037) compared to patients without stoma. There was no significant difference between patients with high and low KPS scores. Conclusions:Malaysian Chinese version of the QLQ-C30 is a valid and reliable measure of HRQOL in patients with colorectal cancer.     

Psychometric properties of the simplified Chinese version of the EORTC QLQ-BR53 for measuring quality of life for breast cancer patients

A Simplified Chinese version of the EORTC QLQ-BR53 was evaluated using responses from 233 patients with breast cancer in China by assessing the construct and criterion-related validity, internal consistency and test–retest reliability, and responsiveness as measured by score changes of the scales. Internal consistency reliability measured by Cronbach’s coefficient α is greater than 0.75 for most multi-item scales except cognitive functioning (0.41) and breast symptoms (0.71). Test–retest reliability coefficients for all domains are greater than 0.80 with the exception of physical functioning (0.65), social functioning (0.75), appetite loss (0.75), diarrhea (0.72), and body image (0.72). Correlation and factor analysis among domains and items showed good construct validity for both QLQ-C30 and QLQ-BR23. Score changes over time were observed in most domains except emotional functioning, global health status/QOL, dyspnoea, constipation, diarrhea, financial difficulties, sexual functioning, sexual enjoyment, and breast symptoms. Therefore, the Simplified Chinese version of QLQ-BR53 shows reasonable validity, reliability, and responsiveness and can be used to measure QOL for Chinese patients with breast cancer.     

Cultural Adaptation and Validation of the Moroccan Version of the EORTC QLQ-CR29 in Patients with Colorectal Cancer

The increasing incidence of colorectal cancer in Morocco has generated a need for a disease-specific quality-of-life measuring instrument. The present study aims to translate and evaluate the reliability and validity of the Moroccan Arabic version of the EORTC QLQ-C29 measure in Moroccan subjects with colorectal cancer (CRC). Methods: Following translation to Moroccan Arabic, The QLQ-C30 and QLQ-C29 were administered to 135 patients treated for colorectal cancer (CRC) at the national oncology institute of Rabat, in the period from February 2016 to June 2018. Statistical analysis included reliability, convergent, and discriminant validity as well as known-groups comparisons. Results: (89 %) patients completed the questionnaires of the EORTC QLQ C-29 and EORTC QLQ C-30. The test –retest, administered to 25 patients and the ICCs for each item ranged from 0.61 to 0.93 indicating good to excellent reproducibility. The internal consistency coefficients for body image, urinary frequency, stool frequency scales were acceptable (Cronbach’s alpha ≥ 0.70), while the blood and mucus in the stool dimensions had lower reliability (0.65).  Multi-trait scaling analysis showed that multi-item scales met standards of convergent and discriminate validity. All Correlations between the EORTC QLQ C-29 and EORTC QLQ C-30 scores were low (r < 40). The known- group comparisons showed differences between group of patients based on tumor location and with/ without a stoma. Conclusion: The Moroccan Arabic Dialectal version of the QLQ-C 29 is a valid and reliable measure of health related quality of life (HRQOL) in patients with colorectal cancer.     

The European Organization for Research and Treatment of Cancer QLQ-C30: an examination into the cultural validity and reliability of the Turkish version of the EORTC QLQ-C30

The Turkish version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire version 2.0 (EORTC QLQ-C30 v.2.0) has started to be used in clinical trials recently. The objective of the study was to evaluate the validity and reliability of the Turkish version of the EORTC QLQ-C30 v.2.0 and the correlation between the Karnofsky Performance Scale (KPS) and the EORTC QLQ-C30. Two hundred and two lung cancer patients were included in the study between January and March 2000. All the subscales met the minimal standards of reliability (Cronbach's alpha ≥ 0.70). Only the role functioning scale differed among the three disease stages of patients (local, locoregional and metastatic). There was no statistically significant difference among therapy types. All interscale correlations were statistically significant ( P  < 0.01). The strongest correlations were found among the physical functioning, role functioning and fatigue scales. Social functioning was closely related with physical, role, emotional and cognitive functioning. The weakest correlations were between nausea/vomiting and the other scales. Global quality of life (QOL) was substantially correlated with most of the scales except cognitive functioning. The coefficients for the correlation between the items differed between 0.12 and 0.97 and all the subscales were strongly correlated with the scales which they formed. The highest correlation between the EORTC QLQ-C30 and KPS was for physical functioning ( r  = 0.62, P  < 0.05). The Turkish version of the EORTC QLQ-C30 is a valid (by means of interscales validity) and reliable instrument for Turkish lung cancer patients and can be used in clinical studies but needs supporting by the reference data on the QOL of the Turkish population.     

Understanding the reliability and validity of the EORTC QLQ-C30 in Turkish cancer patients

Quality of life (QOL) has become an important area to address. The most commonly used QOL tool in oncology is the European Organization for Research and Treatment of Cancer QOL measure (EORTC QLQ-C30). The aim of this study is to examine the reliability and validity of this widely used questionnaire in Turkish language. A total of 114 cancer patients were recruited in this study. The internal consistency of the subscales, concurrent validity between EORTC QLQ-C30 version 3.0 and Short Form-36 (SF-36), the correlations between the subscales of EORTC QLQ-C30 and Hospital Anxiety and Depression scale-Anxiety (HADS-A), and Hospital Anxiety and Depression scale-Depression (HADS-D) were also evaluated. Cronbach's alpha-coefficient for multi-item scales ranged from 0.56 to 0.85, with emotional functioning having the highest Cronbach's alpha-coefficient. General health/QOL subscale was correlated significantly with all other subscales. Modest correlations were found between relevant subscales of SF-36 and EORTC QLQ-C30 scales indicating good convergent validity. Although score of emotional functioning subscale was significantly correlated with HADS-A, no correlation was found with HADS-D. The correlations between general health/QOL and HADS-A and HADS-D were significant though Pearson's coefficients were below 0.4. The EORTC QLQ-C30 version 3.0 is a reliable and valid instrument and suitable for measuring the QOL in cancer patients in Turkey.     

The EORTC Quality of Life Questionnaire for patients with prostate cancer: EORTC QLQ-PR25. Validation study for Spanish patients

Objectives  The EORTC Quality of Life (QL) Group has developed a questionnaire, the EORTC QLQ-PR25, for evaluating QL in prostate cancer. The aim of this study is to assess the psychometric properties of the EORTC QLQPR25 when applied to a sample of Spanish patients. Materials and methods  One hundred and thirty-seven prostate cancer patients with localised disease who started radiotherapy with radical intention combined with or without hormonotherapy prospectively completed the EORTC QLQ-C30 and EORTC QLQ-PR25 questionnaires three times: on the first and last day of radiotherapy and in the follow-up period. Psychometric evaluation of the questionnaires’ structure, reliability and validity was conducted. Results  Multitrait scaling analysis showed that many of the item-scale correlation coefficients met the standards of convergent and discriminant validity. Exceptions appeared mainly in the scales for bowel symptoms and for hormonal-treatment-related symptoms. Cronbach’s coefficients of the scales were good (0.72–0.86) for the urinary symptoms and sexual function scales but they were lower (<0.70) for the bowel and hormonal treatment scales. Most scales of the EORTC QLQ-PR25 had low to moderate intercorrelations. Correlations between the scales of the QLQ-C30 and the module were generally low. Group comparison analyses showed better QL in patients with higher Performance Status. Changes in QL appeared throughout the measurements. These were in line with the treatment process. Conclusions  The EORTC QLQ-PR25 was a reliable and valid instrument when applied to a sample of Spanish prostate cancer patients. These results are in line with those of the EORTC validation study.     

The EORTC QLQ-C30 (version 3.0) Quality of Life questionnaire: validation study for Spain with head and neck cancer patients

The EORTC Quality of Life Study Group has developed a questionnaire for evaluating Quality of Life in international clinical trials: QLQ-C30. The purpose of the present work is to validate the third version of this questionnaire (3.0) for use in Spain.Two hundred and one head and neck cancer patients completed the QLQ-C30 at one or two time points during the treatment and follow-up periods, and a subsample completed the questionnaire on three occasions. Psychometric evaluation of the structure, reliability and validity of the questionnaire was undertaken.The data support the structure and the reliability of the scales. Validity was confirmed in three ways: the interscale correlations are statistically significant and moderate, several scales and items discriminate among groups of patients with different scores on the clinical variables, and some scales reflect significant changes during treatment and the follow-up period.The EORTC QLQ-C30 (version 3.0) is a reliable and valid questionnaire when applied to a sample of Spanish head and neck cancer patients. These results are in line with previous studies.     

The EORTC cancer in-patient satisfaction with care questionnaire: EORTC IN-PATSAT32

Objectives  The EORTC Quality of Life (QL) Group has developed a questionnaire (the EORTC IN-PATSAT32) to assess the satisfaction of cancer inpatients with hospital-based care. In this study we assess the psychometric properties of the EORTC IN-PATSAT32 applied to a sample of Spanish patients. Materials and methods  Eighty cancer patients with different tumour sites completed the EORTC QLQ-C30 and EORTC IN-PATSAT32 questionnaires. Psychometric evaluation of the structure, reliability and validity was conducted. Results  Multitrait scaling analysis showed that most itemscale correlation coefficients met the standards of convergent and discriminant validity. Cronbach’s coefficients were good (0.77–0.97) for all scales except hospital access. Correlations between the scales and single items of the QLQ-C30 and EORTC IN-PATSAT32 were generally low. Correlations between the Oberst scales and an item on intention to recommend the hospital or ward to others with the EORTC IN-PATSAT32 were moderate. Patients with higher scores on the Oberst scales and the item on intention to recommend the hospital or ward showed higher satisfaction with care levels in all EORTC IN-PATSAT32 areas but one. Conclusions  The EORTC IN-PATSAT32 appears to be a reliable and valid instrument when applied to a sample of Spanish cancer patients. These results are in line with those of the EORTC validation study.     

Validation of the Turkish Versions of EORTC QLQ-C30 and BR23 Modules in Breast Cancer Patients

Purpose: To test the validity and reliability of The European Organization for Research and Treatment ofCancer (EORTC) core (QLQ-C30) and breast cancer module (QLQ-BR23) for Turkish breast cancer patients.Patients and Methods: A total of 127 patients treated with radiotherapy (RT) enrolled to this prospective study.EORTC QLQ-C30 and QLQ-BR23 modules applied to patients before initiation of RT and at follow-up period.Statistical analyses were performed by SPSS 13.0. Results: Questionnaires’ were found reliable and valid forTurkish breast cancer patients. Six of the 8 multi-item scales of QLQ-C30 had a high reliability (Cronbach’s α>0.7); where physical functioning and pain scores were less reliable (Cronbach’s α of 0.66 and 0.68 respectively).In the QLQ-BR23, 3 of 5 multi-item scales were reliable; less reliable were breast and arm symptoms scale(Cronbach’s α of 0.65 and 0.61 respectively). In our analysis the most determinative subscales of QLQ-C30on global health was emotional functioning followed by fatigue, role functioning and appetite loss (respectivelyp=0.002, p=0.01; p=0.03 and p=0.08). Among QLQ-BR23 scales systemic therapy side effects, future perspectiveand upset by hair loss subscales had high impact on global health status (respectively p=0.006; p=0.01 and p=0.03).Conclusions: The Turkish version of EORTC QLQ-C30 and QLQ-BR23 modules are reliable and valid tools toassess quality of life of Turkish breast cancer patients.     

Validation of the simplified Chinese version of EORTC QLQ-C30 from the measurements of five types of inpatients with cancer

Background: European Organization for Research and Treatment quality of life (QOL) questionnaire (QLQ-C30) has been used frequently and many language versions have been developed, including the simplified Chinese version. It is important to study psychometric properties of the simplified Chinese version from the clinical standpoint.Patients and methods: The simplified Chinese version of the QLQ-C30 was used in a longitudinal study of 600 patients with five types of cancer: lung, breast, head and neck, colorectal, and stomach. The psychometric properties of the scale were evaluated by indicators of validity and reliability coefficients such as Cronbach's α and Pearson's correlation coefficient r, standardized response mean (SRM), correlational analysis, t-tests, and structural equation models.Results: Correlation and structural equation model analyses confirmed good construct validity with root mean square error of approximation 0.054, standardized root mean square residual 0.037, non-normed fit index 0.972, and comparative fit index 0.980. The α coefficients for all domains are >0.7 except for cognitive functioning (0.49). The test–retest reliability coefficients for most domains are >0.80 except for appetite loss (0.77) and diarrhea (0.75). The QOL score changes after treatments were of statistical significance with higher or moderate SRM in most domains.Conclusion: The simplified Chinese version of QLQ-C30 has good validity, reliability, and responsiveness and can be used to measure QOL for Chinese cancer patients.     

A 12 country field study of the EORTC QLQ-C30 (version 3.0) and the head and neck cancer specific module (EORTC QLQ-H&N35) in head and neck patients. EORTC Quality of Life Group

This study tests the reliability and validity of the European Organization for Research and Treatment of Cancer (EORTC) head and neck cancer module (QLQ-H&N35) and version 3.0 of the EORTC Core Questionnaire (QLQ-C30) in 622 head and neck cancer patients from 12 countries. The patients completed the QLQ-C30, the QLQ-H&N35 and a debriefing questionnaire before antineoplastic treatment or at a follow-up. 232 patients receiving treatment completed a second questionnaire after treatment. Compliance was high and the questionnaire was well accepted by the patients. Multitrait scaling analysis confirmed the proposed scale structure of the QLQ-H&N35. The QLQ-H&N35 was responsive to differences between disease status, site and patients with different Karnofsky performance status, and to changes over time. The new physical functioning scale (with a four-point response format) of version 3.0 of the QLQ-C30 was shown to be more reliable than previous versions. Thus, the QLQ-H&N35, in conjunction with the QLQ-C30, appears to be reliable, valid and applicable to broad multicultural samples of head and neck cancer patients.     

The construction and testing of the EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR38)

The objectives of the current study were to construct a colorectal cancer-specific quality of life (QL) questionnaire module to be used in conjunction with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and to test its reliability and validity in The Netherlands. Module construction took place following the EORTC guidelines for module development. The module—the QLQ-CR38—consists of 38 items covering symptoms and side-effects related to different treatment modalities, body image, sexuality and future perspective. This module was tested among 117 colorectal cancer patients on several occasions. The timing was prior to treatment with radiotherapy or chemotherapy, during treatment and 3 months following the second assessment. For purposes of test–retest reliability, a subsample of patients completed the QLQ-CR38 1 week following the third assessment. Multitrait scaling analysis confirmed the hypothesised scale structure of the function scales but not of the symptom scales. Cronbach’s alpha coefficients for seven of the nine scales exceeded the 0.70 criterion at one or both assessments. The test–retest reliability for all scales and one single item was 0.78 or higher. The stability of the two remaining single items was lower. On the basis of known-groups comparisons, selective scales distinguished clearly between patients differing in disease stage, initial and on-treatment performance status and the presence of a stoma. Additionally, selective scales detected change over time as a function of change in performance status and treatment-induced change. These results lend support to the clinical validity of the QLQ-CR38 as a supplementary questionnaire for assessing specific QL issues relevant to patients with colorectal cancer. Additional efforts to test the module’s cross-cultural validity are needed.     

Quality of life of patients with ovarian cancer in Taiwan: validation and application of the Taiwan Chinese version of the EORTC QLQ‐OV28

Objective: The aim of this study was to examine the reliability and validity of the Taiwan Chinese Version of the EORTC QLQ‐OV28. Methods: The authors translated the questionnaire according to the guideline of the EORTC. A total of 96 patients with ovarian cancer in National Taiwan University Hospital were interviewed with the questionnaire and the EORTC QLQ‐C30 between September 2004 and September 2007. Answer distribution and psychometric properties of the EORTC QLQ‐OV28 were examined. Results: The mean age of the patients was 54 (standard deviation 12 years). Most of the patients were in FIGO stages III or IV. Two thirds were on‐treatment (chemotherapy). Items for gastrointestinal (GI) symptoms, menopausal symptoms, and sexuality showed more flooring effects than others. Missing values were frequent in further questions about sexual activity. After excluding conditional questions, the Cronbach's alpha coefficients of most scales were satisfactory (0.74–0.89), except other chemotherapy side effects (0.63) and menopausal symptoms (0.39). The item‐to‐own and item‐to‐other scales correlation showed satisfactory results. Patients who were on‐treatment had significantly poorer quality of life (QoL) scores in most symptom scales. Conclusions: The EORTC QLQ‐OV28 is a valid instrument to assess QoL issues of patients with ovarian cancer in Taiwan, a country of a different culture. Copyright © 2009 John Wiley & Sons, Ltd.     

Translation and validation of the EORTC QLQ-C30 for use among Turkish and Moroccan ethnic minority cancer patients in the Netherlands

The purpose of this study was to validate the core EORTC quality of life questionnaire, the QLQ-C30 (version 3.0), for use among Turkish and Moroccan cancer patients in the Netherlands. The questionnaire was translated into two oral Moroccan languages , and the existing Turkish version was culturally adapted for use in the Netherlands. Ninety Turkish and 79 Moroccan patients completed the questionnaire. Administration of the questionnaire proved feasible, with low levels of missing questionnaires (4%) and missing items (on average, 1.5-2.4%). With one minor exception, the evidence of convergent validity was strong for all multi-item scales. Internal consistency reliability was above 0.70 for all scales except the cognitive functioning scale in the Turkish sample. The questionnaire was able to distinguish clearly between subgroups formed on the basis of performance status and comorbidity, and was moderately responsive to change over time in performance status. These data support the use of the QLQ-C30 among Turkish and Moroccan cancer patients residing in the Netherlands. Additional studies are needed to confirm the psychometrics of the questionnaire when used among these ethnic minority groups residing in other Western European countries.     

The European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life questionnaire cervical cancer module: EORTC QLQ-CX24

BACKGROUND: The authors report on the development and validation of a cervical cancer module for the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life (QoL) questionnaire (QLQ), which was designed to assess disease-specific and treatment-specific aspects of QoL in patients with cervical cancer. METHODS: The cervical cancer module (EORTC QLQ-CX24) was developed in a multicultural, multidisciplinary setting to supplement the EORTC QLQ-C30 core questionnaire. The QLQ-C30 and the cervical cancer module were administered to 346 patients with cervical cancer who underwent radical hysterectomy and received radiotherapy and chemotherapy. Psychometric analyses were performed by using data from 2 independent samples. RESULTS: The QLQ-CX24 consists of 3 multiitem scales and 5 single-item scales. Multitrait scaling analyses revealed high internal consistencies for the subscales with Cronbach alpha coefficients ranging from .72 to .87 (Symptom Experience, .72; Body Image, .86; Sexual/Vaginal Functioning, .87). Convergent and discriminant validity were fulfilled with scaling errors below 3%. The QLQ-CX24 was capable of discriminating between clinical subgroups. All items exhibited good compliance with <3% missing values. Most patients completed the EORTC QLQ-C30 and the QLQ-CX24 in <15 minutes (86%), and many did not require any assistance to complete the questionnaires (65%). CONCLUSIONS: The current psychometric analyses supported the content and construct validity and the reliability of the EORTC QLQ-CX24 module. This newly developed module is a useful instrument for assessing the QoL of patients who are treated for cervical cancer both in clinical trials and in clinical practice.     

International validation of two EORTC questionnaires for assessment of health-related quality of life for patients with high-grade non-Hodgkin lymphoma (QLQ-NHL-HG29) and low-grade non-Hodgkin lymphoma (QLQ-NHL-LG20)

Background

Health-related quality of life (HRQOL) is a critical aspect to consider when making treatment decisions for patients with non-Hodgkin-lymphoma (NHL). This international study by the European Organisation for Research and Treatment of Cancer (EORTC) tested the psychometric properties of two newly developed measures for patients with high-grade (HG)- and low-grade (LG)-NHL: the EORTC QLQ-NHL-HG29 and the EORTC QLQ-NHL-LG20 to supplement the core questionnaire (EORTC QLQ-C30).

Methods

Overall, 768 patients with HG-NHL (N = 423) and LG-NHL (N = 345) from 12 countries completed the QLQ-C30, QLQ-NHL-HG29/QLQ-NHL-LG20 and a debriefing questionnaire at baseline, and a subset at follow-up for either retest (N = 125/124) or responsiveness to change (RCA; N = 98/49).

Results

Confirmatory factor analysis showed an acceptable to good fit of the 29 items of the QLQ-NHL-HG29 on its five scales (symptom burden [SB], neuropathy, physical condition/fatigue [PF], emotional impact [EI], and worries about health/functioning [WH]), and of the 20 items of the QLQ-NHL-LG20 on its four scales (SB, PF, EI, and WH). Completion took on average 10 minutes. Test–retest reliability, convergent validity, known-group comparisons, and RCA find satisfactory results of both measures. A total of 31%–78% of patients with HG-NHL and 22%–73% of patients with LG-NHL reported symptoms and/or worries (e.g., tingling in hands/feet, lack of energy, and worries about recurrence). Patients reporting symptoms/worries had substantially lower HRQOL compared to those without.

Discussion

The use of the EORTC QLQ-NHL-HG29 and QLQ-NHL-LG20 questionnaires in clinical research and practice will provide clinically relevant data to better inform treatment decision-making.

Plain language summary

• The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group developed two questionnaires.
• These questionnaires measure health-related quality of life.
• The questionnaires are for patients with high-grade or low-grade non-Hodgkin lymphoma.
• They are called the EORTC QLQ-NHL-HG29 and QLQ-NHL-LG20.
• The questionnaires are now internationally validated.
• This study demonstrates that the questionnaires are reliably and valid, which are important aspects of a questionnaire.
• The questionnaires can now be used in clinical trials and practice.
• With the information gathered from the questionnaires, patients and clinicians can better evaluate treatments and discuss the best choice for a patient.

     

The development of the EORTC QLQ-C15-PAL: a shortened questionnaire for cancer patients in palliative care

This study aimed at developing a shortened version of the EORTC QLQ-C30, one of the most widely used health-related quality of life questionnaires in oncology, for palliative care research. The study included interviews with 41 patients and 66 health care professionals in palliative care to determine the appropriateness, relevance and importance of the various domains of the QLQ-C30. Item response theory methods were used to shorten scales. Patients and health care professionals rated pain, physical function, emotional function, fatigue, global health status/quality of life, nausea/vomiting, appetite, dyspnoea, constipation, and sleep as most important. Therefore, these scales/items were retained in the questionnaire. Four scales were shortened without reducing measurement precision. Important dimensions not covered by the questionnaire were identified. The resulting 15-item EORTC QLQ-C15-PAL is a 'core questionnaire' for palliative care. Depending on the research questions, it may be supplemented by additional items, modules or questionnaires.     

An international validation study of the EORTC QLQ-INFO25 questionnaire: An instrument to assess the information given to cancer patients

AimThe EORTC Quality of Life (QOL) Group has developed an instrument to evaluate the information received by cancer patients. This study assessed the psychometric characteristics of the EORTC INFO module in a large international/multi-cultural sample of cancer patients.MethodsThe provisional 26-item information module (EORTC INFO26) was administered with the EORTC QLQ-C30 and the information scales of the inpatient satisfaction module EORTC IN-PATSAT32 on two occasions during the patients’ treatment and follow-up period. Questionnaire-hypothesised scale structure, reliability, validity and responsiveness to changes were evaluated through standard psychometric analyses. Patient acceptability was assessed with a debriefing questionnaire.ResultsThe study comprised 509 patients from 8 countries (7 European countries and Taiwan) with different cancers and disease stages. Multi-trait scaling analysis led to the deletion of one item but confirmed the hypothesised 4 multi-item scales (information about disease, medical tests, treatment and other services) and eight single items. Internal consistency for all scales was good (α > 0.70), as was test–retest reliability (intraclass correlations > 0.70). All items can be combined to generate a single score (α > 0.90). Convergent validity was supported by significant correlations with related areas of IN-PATSAT32 (r > 0.40). Low correlations with EORTC QLQ-C30 scales confirmed divergent validity (r < 0.30) The EORTC INFO-25 module discriminated among groups based on gender, age, education, levels of anxiety and depression, information wishes and satisfaction. Only one scale captured changes over time.ConclusionsThe EORTC QLQ-INFO 25 is a reliable and valid self-reported instrument. The module can be used in cross-cultural observational and intervention studies.     

The EORTC Core Quality of Life questionnaire (QLQ-C30): validity and reliability when analysed with patients treated with palliative radiotherapy

The EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) is designed to measure cancer patients' physical, psychological and social functions. The questionnaire is composed of multi-item scales and single items. 247 patients completed the EORTC QLQ-C30 before palliative radiotherapy and 181 after palliative radiotherapy. The questionnaire was well accepted with a high completion rate in the present patient population consisting of advanced cancer patients with short life expectancy. In addition, the questionnaire was found to be useful to detect the effect of palliative radiotherapy over time. The scale reliability was excellent for all scales except the role functioning scale. Excellent criterion validity was found for the emotional functioning scale where it was correlated with GHQ-20. Performance of the questionnaire was improved after the second evaluation as compared with the first. The present study shows that the EORTC QLQ-C30 is found to be practical and valid in measuring quality of life in patients with advanced disease.