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Rothmund M, Pilz MJ, Schlosser L, Arraras JI, Groenvold M, Holzner B, van Leeuwen M, Petersen MA, Schmidt H, Young T, Rose M, Cella D, Giesinger JM. Equipercentile equating of scores from common patient-reported outcome measures of physical function in patients with cancer. J Clin Epidemiol 2024; 165:111203. [PMID: 37918641 DOI: 10.1016/j.jclinepi.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To provide equipercentile equating of physical function (PF) scores from frequently used patient-reported outcome measures (PROMs) in cancer patients to facilitate data pooling and comparisons. STUDY DESIGN AND SETTING Adult cancer patients from five European countries completed the European Organization for Research and Treatment of Cancer (EORTC) computer adaptive test (CAT) Core, EORTC Quality of Life Questionnaire Version 3.0 (QLQ-C30), Functional Assessment of Cancer Therapy - General (FACT-G), 36-item Short Form Health Survey (SF-36), and the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function 20a short form. The R package "equate" was used to establish conversion tables of PF scores on those measures with a bivariate rank correlation of at least 0.75. RESULTS In total, 953 patients with cancer (mean age 58.9 years, 54.7% men) participated. Bivariate rank correlations between PF scores from the EORTC CAT Core, EORTC QLQ-C30, SF-36, and PROMIS were all above 0.85, but below 0.69 for the FACT-G. Conversion tables were established for all measures but the FACT-G. These tables indicate which score from one PROM best matches the score from another PROM and provide standard errors of converted scores. CONCLUSION Our analysis indicates that linking of PF scores from both EORTC measures (CAT and QLQ-C30) with PROMIS and SF-36 is possible, whereas the physical domain of the FACT-G seems to be different. The established conversion tables may be used for comparing results or pooling data from clinical studies using different PROMs.
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Affiliation(s)
- Maria Rothmund
- Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical Psychology, University Clinic of Psychiatry II, Innsbruck Medical University, Anichstraße 35, A-6020 Innsbruck, Austria; Institute of Psychology, University of Innsbruck, Innrain 52, A-6020 Innsbruck, Austria
| | - Micha J Pilz
- Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical Psychology, University Clinic of Psychiatry II, Innsbruck Medical University, Anichstraße 35, A-6020 Innsbruck, Austria
| | - Lisa Schlosser
- Data Lab Hell GmbH, Europastraße 2a, A-6170 Zirl, Austria
| | - Juan I Arraras
- Oncology Department, Hospital Universitario de Navarra, C/Irunlarrea 3, ES-31008 Pamplona, Spain
| | - Mogens Groenvold
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, Bispebjerg bakke 23B, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, DK-1353 Copenhagen, Denmark
| | - Bernhard Holzner
- Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical Psychology, University Clinic of Psychiatry I, Innsbruck Medical University, Anichstraße 35, A-6020 Innsbruck, Austria
| | - Marieke van Leeuwen
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Morten Aa Petersen
- Palliative Care Research Unit, Department of Geriatrics and Palliative Medicine GP, Bispebjerg & Frederiksberg Hospital, University of Copenhagen, Bispebjerg bakke 23B, Copenhagen, Denmark
| | - Heike Schmidt
- University Clinic and Outpatient Clinic for Radiotherapy and Institute of Health and Nursing Science, Medical Faculty of Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Teresa Young
- Supportive Oncology Research Team, East & North Hertfordshire NHS Trust incorporating Mount Vernon Cancer Centre, Northwood, Middlesex HA6 2RN, United Kingdom
| | - Matthias Rose
- Center for Patient-Centered Outcomes Research (CPCOR), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Johannes M Giesinger
- Department of Psychiatry, Psychotherapy, Psychosomatics, and Medical Psychology, University Clinic of Psychiatry II, Innsbruck Medical University, Anichstraße 35, A-6020 Innsbruck, Austria.
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Marte C, George LS, Rutherford SC, Ouyang DJ, Martin P, Leonard JP, Trevino KM. Unmet mental health needs in patients with advanced B-cell lymphomas. Palliat Support Care 2022; 20:328-333. [PMID: 35713350 PMCID: PMC9843817 DOI: 10.1017/s1478951521001164] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
CONTEXT Existing research on psychological distress and mental health service utilization has focused on common types of solid tumor cancers, leaving significant gaps in our understanding of patients experiencing rare forms of hematologic cancers. OBJECTIVE To examine distress, quality of life, and mental health service utilization among patients with aggressive, refractory B-cell lymphomas. METHOD Patients (n = 26) with B-cell lymphomas that relapsed after first- or second-line treatment completed self-report measures of distress (Hospital Anxiety and Depression Scale) and quality of life (Short-Form Health Survey, SF-12). Patients also reported whether they had utilized mental health treatment since their cancer diagnosis. RESULTS Approximately 42% (n = 11) of patients reported elevated levels of psychological distress. Of patients with elevated distress, only one quarter (27.2%; n = 3) received mental health treatment, while more than half did not receive mental health treatment (54.5%; n = 6), and 18.1% (n = 2) did not want treatment. Patients with elevated distress reported lower mental quality of life than patients without elevated distress [F (1, 25) = 15.32, p = 0.001]. SIGNIFICANCE OF THE RESULTS A significant proportion of patients with advanced, progressive, B-cell lymphomas may experience elevated levels of distress. Yet, few of these distressed patients receive mental health treatment. Findings highlight the need to better identify and address barriers to mental health service utilization among patients with B-cell lymphoma, including among distressed patients who decline treatment.
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Affiliation(s)
| | | | | | | | - Peter Martin
- Weill Cornell Medicine, New York, NY
- New York Presbyterian, New York, NY
| | - John P Leonard
- Weill Cornell Medicine, New York, NY
- New York Presbyterian, New York, NY
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Association between prognostic awareness and quality of life in patients with advanced cancer. Qual Life Res 2022; 31:2367-2374. [PMID: 35119564 DOI: 10.1007/s11136-022-03097-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE Despite the current guidelines supporting open communication about serious news, the evidence about the impact of prognostic awareness on the quality of life in cancer patients is not clear. The aim of this study was to assess the association between quality of life and prognostic awareness in patients with advanced cancer. METHODS This was a cross-sectional study which involved patients (n = 129) with incurable advanced cancer (estimated by oncologist using 12-month surprise question). Data were collected at oncology departments at 3 hospitals using structured interview in which patients were asked about their quality of life (using Integrated Palliative Outcome Scale-IPOS and a single-item global measure), prognostic awareness, information needs and demographics. RESULTS Only 16% of the sample was completely aware of prognosis and 57% was partially aware. Accurate prognostic awareness was significantly associated (p = 0.02) with lower level of quality of life between (when measured by both the IPOS and the single-item scale) patients with accurate prognostic awareness (M = 37.1; 10.4) and partially aware (M = 31.9; 9.1) and unaware patients (M = 30; 7.4). Detailed analysis showed that significant difference between groups was found only for physical symptoms subscales (p = 0.002), not for emotional and communication subscales. CONCLUSION Prognostic awareness was found to be negatively associated with physical domain of quality of life, but not with emotional and communication domains. More research is needed on personality factors that might influence the development of prognostic awareness and quality of life.
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Crawford H, North K, Wilson MJ, Berman Y, McKelvey-Martin V, Morrison PJ, Fleming J, Barton B. Development and Preliminary Evaluation of a Quality-of-Life Questionnaire for Adults with Neurofibromatosis Type 1 (NF1-AdQOL). Clin Exp Dermatol 2021; 47:271-281. [PMID: 34342021 DOI: 10.1111/ced.14867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 07/24/2021] [Accepted: 07/26/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is a variable and unpredictable multisystem genetic disorder which predisposes to medical complications, cognitive impairment and disfigurement, of all which can impact negatively upon the health related quality of life (HRQOL) of affected adults. OBJECTIVES To develop and validate a disease specific HRQOL adult questionnaire to evaluate effects of NF1 from the patient's viewpoint. METHODS The NF1 adult HRQOL questionnaire (NF1-AdQOL) was developed based on patient interviews (n=8), survey of clinicians and piloting of the questionnaire. Adults with NF1 (n=114, 18-40 years) were recruited from three Australian genetics clinics and completed the NF1-AdQOL, Skindex-29 and Short Form-36v2 (SF-36v2) questionnaires. An exploratory factor analysis of the NF1-AdQOL was conducted to assess construct validity. Convergent and discriminant validity of the NF1-AdQOL was determined by using the multi-trait multi-method with Skindex-29 and SF-36v2 scores. RESULTS Factor analysis indicated that 62.7% of the common variance could be explained by three factors labelled as 'emotions associated with cosmetic appearance' (12 items), 'social functioning and learning' (11 items) and 'physical symptoms' (8 items). NF1-AdQOL had good internal consistency (Cronbach's α = 0.96). Convergent validity was confirmed by moderate associations with similarly named scales of the Skindex-29 and SF-36v2. Results from all HRQOL questionnaires indicated overall healthy HRQOL for young adults with NF1. CONCLUSIONS NF1-AdQOL is a relatively valid, feasible and fairly easy to read tool to measure QOL in adults with NF1. Further evaluation is required to determine its test-retest reliability, responsiveness and validity in larger adult NF1 cohorts.
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Affiliation(s)
- H Crawford
- Faculty of Medicine and Child Health, University of Sydney, Sydney, NSW, Australia.,Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - K North
- Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Genetic Medicine, Westmead Hospital, Sydney, NSW, Australia.,Discipline of Genomic Medicine, University of Sydney, Sydney, NSW, Australia
| | - M J Wilson
- Department of Genetic Medicine, Westmead Hospital, Sydney, NSW, Australia.,Discipline of Genomic Medicine, University of Sydney, Sydney, NSW, Australia
| | - Y Berman
- Discipline of Genomic Medicine, University of Sydney, Sydney, NSW, Australia.,Department of Clinical Genetics, Royal North Shore Hospital, Sydney, Australia
| | - V McKelvey-Martin
- School of Pharmacy and Pharmaceutical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - P J Morrison
- School of Pharmacy and Pharmaceutical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom.,Department of Medical Genetics, Belfast City Hospital, Belfast, Northern Ireland, United Kingdom
| | - J Fleming
- Department of Clinical Genetics, Royal North Shore Hospital, Sydney, Australia
| | - B Barton
- Faculty of Medicine and Child Health, University of Sydney, Sydney, NSW, Australia.,Kids Neuroscience Centre, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Children's Hospital Education Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
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Davda J, Kibet H, Achieng E, Atundo L, Komen T. Assessing the acceptability, reliability, and validity of the EORTC Quality of Life Questionnaire (QLQ-C30) in Kenyan cancer patients: a cross-sectional study. J Patient Rep Outcomes 2021; 5:4. [PMID: 33415528 PMCID: PMC7790948 DOI: 10.1186/s41687-020-00275-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/15/2020] [Indexed: 03/28/2023] Open
Abstract
BACKGROUND In oncology practice, eliciting the patient's perspective on their quality of life (QOL) adds important information and value to their treatment and care. The European Organization for Research and Treatment of Cancer QOL questionnaire (EORTC QLQ-C30) is the most commonly used tool for this purpose but has not been validated in Kenya. The present study aimed to conduct a preliminary assessment of the QOL among Kenyan cancer patients and examine the psychometric properties of the tool in this population. One hundred patients with heterogeneous types of cancer were enrolled in this cross-sectional study between July and August 2019. The EORTC QLQ-C30 questionnaire was administered to patients using either the English or Kiswahili official version. Descriptive statistics were used to assess patient demographics and clinical characteristics. The psychometric properties of the EORTC QLQ-C30 were evaluated in terms of acceptability, internal consistency, and construct validity using statistical software packages, STATA and SPSS. RESULTS The EORTC QLQ-C30 was found to be acceptable for use in our patient population as indicated by high compliance and low missing responses. Of the 100 patients, 66 were able to self-administer the questionnaire. The average time for completion was 13 min. Preliminary QOL assessment indicated an average QOL in Kenyan cancer patients (53 ± 27). Among the function scales, participants scored the lowest on the social function scale (51 ± 36) whereas among the symptom scales, participants scored the highest on the financial difficulties scale (79 ± 31). Cronbach's alpha coefficient values ranged from 0.72-0.95, illustrating the reliability of the scales measured. Interscale correlations were statistically significant (p < 0.05), indicating clinical validity of the data collected. The magnitudes of the correlations between the physical functioning scale and the role functioning, pain, and fatigue scales were consistent with the values published in other studies across different geographical populations, further cross-validating the results from our study. CONCLUSION The results from this study provide important first insights into using EORTC QLQ-C30 in the Kenyan population. We conclude that the questionnaire is an acceptable, reliable, and valid instrument for measuring the QOL in cancer patients in Kenya and recommend its use in clinical practice.
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Feghali J, Pennington Z, Ehresman J, Lubelski D, Cottrill E, Ahmed AK, Schilling A, Sciubba DM. Predicting postoperative quality-of-life outcomes in patients with metastatic spine disease: who benefits? J Neurosurg Spine 2020:1-7. [PMID: 33338994 DOI: 10.3171/2020.7.spine201136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 07/21/2020] [Indexed: 01/09/2023]
Abstract
Symptomatic spinal metastasis occurs in around 10% of all cancer patients, 5%-10% of whom will require operative management. While postoperative survival has been extensively evaluated, postoperative health-related quality-of-life (HRQOL) outcomes have remained relatively understudied. Available tools that measure HRQOL are heterogeneous and may emphasize different aspects of HRQOL. The authors of this paper recommend the use of the EQ-5D and Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ), given their extensive validation, to capture the QOL effects of systemic disease and spine metastases. Recent studies have identified preoperative QOL, baseline functional status, and neurological function as potential predictors of postoperative QOL outcomes, but heterogeneity across studies limits the ability to derive meaningful conclusions from the data. Future development of a valid and reliable prognostic model will likely require the application of a standardized protocol in the context of a multicenter study design.
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Abstract
Radical and palliative treatments for non-small cell lung cancer (NSCLC) have faced a significant evolution during last decades, which in turn has modified their effects on the patient quality of life (QoL). QoL data collection is becoming methodologically rigorous, with published recommendations and societal statements. In lung cancer surgery, there is no standardization in collecting and analyzing this outcome yet. However, to face the evolution in lung cancer therapies, few initiatives like the European Organization for the Research and Treatment of Cancer (EORTC) lung cancer module update project or the Patient-Reported Outcomes Measurement Information System (PROMIS), have now the potential to help thoracic surgeons to collect QoL data with validated dynamic instruments to make this outcome comparable to the clinical ones. This review aims to give an overview of the available and most commonly used QoL questionnaires in lung cancer surgery in order to facilitate future research and practical implementation.
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Affiliation(s)
- Cecilia Pompili
- Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research at St. James's, University of Leeds, Leeds, UK.,Division of Thoracic Surgery, St. James's University Hospital, Leeds, UK
| | - Michael Koller
- Center for Clinical Studies Regensburg, University of Regensburg, Regensburg, Germany
| | - Galina Velikova
- Section of Patient Centred Outcomes Research, Leeds Institute for Medical Research at St. James's, University of Leeds, Leeds, UK
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Validity and Reliability of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 - Tagalog among Adult Filipinos with Differentiated Thyroid Cancer. J ASEAN Fed Endocr Soc 2018; 33:174-180. [PMID: 33442124 PMCID: PMC7784208 DOI: 10.15605/jafes.033.02.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 07/31/2018] [Indexed: 11/17/2022] Open
Abstract
Objective This study aims to determine the convergent and discriminant validity and internal consistent reliability of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) Tagalog among adult Filipinos with differentiated thyroid cancer (DTC). Methodology 104 adult Filipinos with DTC at various disease stages self-administered the EORTC QLQ-C30 version 3 Tagalog and Short Form-36 (SF-36) version 2 Tagalog. Concurrent validity between conceptually-related scales from both tools was determined. Convergent and discriminant validity of multi-item scales of the EORTC QLQ-C30 Tagalog were assessed by Spearman’s correlation. Cronbach's α was computed. Results The EORTC QLQ-C30 Tagalog showed moderate correlation with similar scales in the SF-36 Tagalog particulary for physical, role and social functioning, pain, and global health (r=0.42-0.48, p<0.001). It showed satisfactory item-domain convergent and discriminant validity for all scales except pain, fatigue, physical and cognitive functioning. Internal consistent reliability was good with cronbachs α ranging from 0.77 to 0.88 for global health, emotional and role functioning and symptom scale of nausea/vomiting. Conclusion The EORTC QLQ-C30 Tagalog had acceptable convergent and discriminant validity and internal consistent reliability for the scales of global health, role, social and emotional functioning and nausea/vomiting when applied among adult Filipinos with DTC.
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Questionnaire to assess quality of life in patients with breast cancer – Validation of the Chinese version of the EORTC QLQ-BR 53. Breast 2017; 32:87-92. [DOI: 10.1016/j.breast.2016.12.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 12/18/2016] [Accepted: 12/26/2016] [Indexed: 11/24/2022] Open
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Health-related Quality of Life as Studied by EORTC QLQ and Voice Handicap Index Among Various Patients With Laryngeal Disease. J Voice 2017; 31:251.e17-251.e26. [DOI: 10.1016/j.jvoice.2016.07.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/08/2016] [Accepted: 07/15/2016] [Indexed: 11/19/2022]
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Hamel JF, Pe M, Coens C, Martinelli F, Eggermont AM, Brandberg Y, Bottomley A. A systematic review examining factors influencing health related quality of life among melanoma cancer survivors. Eur J Cancer 2016; 69:189-198. [DOI: 10.1016/j.ejca.2016.10.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 10/05/2016] [Indexed: 11/28/2022]
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Baker PD, Bambrough J, Fox JRE, Kyle SD. Health-related quality of life and psychological functioning in patients with primary malignant brain tumors: a systematic review of clinical, demographic and mental health factors. Neurooncol Pract 2015; 3:211-221. [PMID: 31386034 DOI: 10.1093/nop/npv042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Indexed: 12/18/2022] Open
Abstract
Background The impact of primary malignant brain tumors on patient quality of life and psychological functioning is poorly understood, limiting the development of an evidence base for supportive interventions. We conducted a thorough systematic review and quality appraisal of the relevant literature to identify correlates of health-related quality of life (HRQoL) and psychological functioning (depression, anxiety and distress) in adults with primary malignant brain tumors. Method Twenty-three articles met predefined inclusion criteria from a pool of peer-reviewed literature published between January 1984 and July 2015 (N = 2407). Methodological quality of included studies was assessed using an adapted version of the Newcastle-Ottawa Scale. Results The overall methodological quality of the literature was moderate. Factors relating consistently with HRQoL and/or psychological functioning were cognitive impairment, corticosteroid use, current or previous mental health difficulties, fatigue, functional impairment, performance status and motor impairment. Conclusions Practitioners should remain alert to the presence of these factors as they may indicate patients at greater risk of poor HRQoL and psychological functioning. Attention should be directed towards improving patients' psychological functioning and maximizing functional independence to promote HRQoL. We outline several areas of future research with emphasis on improved methodological rigor.
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Affiliation(s)
- Paul D Baker
- Section for Clinical and Health Psychology, University of Manchester, Manchester, UK (P.D.B.); Department of Neuropsychology, Salford Royal NHS Foundation Trust, Salford, UK (J.B.); Department of Psychology, Royal Holloway, University of London, Surrey, UK (J.R.E.F.); Enfield Complex Care Team, Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK (J.R.E.F.); Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK (S.D.K.)
| | - Jacki Bambrough
- Section for Clinical and Health Psychology, University of Manchester, Manchester, UK (P.D.B.); Department of Neuropsychology, Salford Royal NHS Foundation Trust, Salford, UK (J.B.); Department of Psychology, Royal Holloway, University of London, Surrey, UK (J.R.E.F.); Enfield Complex Care Team, Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK (J.R.E.F.); Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK (S.D.K.)
| | - John R E Fox
- Section for Clinical and Health Psychology, University of Manchester, Manchester, UK (P.D.B.); Department of Neuropsychology, Salford Royal NHS Foundation Trust, Salford, UK (J.B.); Department of Psychology, Royal Holloway, University of London, Surrey, UK (J.R.E.F.); Enfield Complex Care Team, Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK (J.R.E.F.); Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK (S.D.K.)
| | - Simon D Kyle
- Section for Clinical and Health Psychology, University of Manchester, Manchester, UK (P.D.B.); Department of Neuropsychology, Salford Royal NHS Foundation Trust, Salford, UK (J.B.); Department of Psychology, Royal Holloway, University of London, Surrey, UK (J.R.E.F.); Enfield Complex Care Team, Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK (J.R.E.F.); Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK (S.D.K.)
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Koutoukidis DA, Knobf MT, Lanceley A. Obesity, diet, physical activity, and health-related quality of life in endometrial cancer survivors. Nutr Rev 2015; 73:399-408. [PMID: 26011914 PMCID: PMC4477700 DOI: 10.1093/nutrit/nuu063] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Obesity, low-quality diet, and inactivity are all prevalent among survivors of endometrial cancer. The present review was conducted to assess whether these characteristics are associated with health-related quality of life (HRQoL). Electronic databases, conference abstracts, and reference lists were searched, and researchers were contacted for preliminary results of ongoing studies. The quality of the methodology and reporting was evaluated using appropriate checklists. Standardized mean differences were calculated, and data were synthesized narratively. Eight of the 4385 reports retrieved from the literature were included in the analysis. Four of the 8 studies were cross-sectional, 1 was retrospective, 1 was prospective, and 2 were randomized controlled trials. Obesity was negatively associated with overall HRQoL in 4 of 4 studies and with physical well-being in 6 of 6 studies, while it was positively associated with fatigue in 2 of 4 studies. Meeting the recommendations for being physically active, eating a diet high in fruit and vegetables, and abstaining from smoking were positively associated with overall HRQoL in 2 of 2 studies, with physical well-being in 2 of 3 studies, and with fatigue in 1 of 3 studies. Improvements in fatigue and physical well-being were evident after lifestyle interventions. The findings indicate a healthy lifestyle is positively associated with HRQoL in this population, but the number of studies is limited. Additional randomized controlled trials to test effective and practical interventions promoting a healthy lifestyle in survivors of endometrial cancer are warranted.
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Affiliation(s)
- Dimitrios A Koutoukidis
- D.A. Koutoukidis, A. Lanceley, and M.T. Knobf are with the Department of Women's Cancer, UCL EGA Institute for Women's Health, University College London, London, UK. M.T. Knobf is with the Acute Care/Health Systems Division, Yale University School of Nursing, New Haven, Connecticut, USA.
| | - M Tish Knobf
- D.A. Koutoukidis, A. Lanceley, and M.T. Knobf are with the Department of Women's Cancer, UCL EGA Institute for Women's Health, University College London, London, UK. M.T. Knobf is with the Acute Care/Health Systems Division, Yale University School of Nursing, New Haven, Connecticut, USA
| | - Anne Lanceley
- D.A. Koutoukidis, A. Lanceley, and M.T. Knobf are with the Department of Women's Cancer, UCL EGA Institute for Women's Health, University College London, London, UK. M.T. Knobf is with the Acute Care/Health Systems Division, Yale University School of Nursing, New Haven, Connecticut, USA
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Breast Cancer EDGE Task Force Outcomes: Clinical Measures of Health Related Quality of Life. REHABILITATION ONCOLOGY 2015. [DOI: 10.1097/01893697-201533010-00003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Paiva CE, Carneseca EC, Barroso EM, de Camargos MG, Alfano ACC, Rugno FC, Paiva BSR. Further evaluation of the EORTC QLQ-C30 psychometric properties in a large Brazilian cancer patient cohort as a function of their educational status. Support Care Cancer 2014; 22:2151-60. [PMID: 24652051 DOI: 10.1007/s00520-014-2206-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 03/09/2014] [Indexed: 01/04/2023]
Abstract
PURPOSE The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) is considered a valid instrument for use in Brazil. However, the previous Brazilian validation study included only 30 lung cancer patients and only measured test-retest reliability. The aim of this study was to evaluate the psychometric properties of the EORTC QLQ-C30 in a sample of cancer patients at different educational levels who completed the instrument administered by an interviewer. METHODS Data from six prospective studies conducted by the same group of researchers were combined in this study (N = 986). RESULTS Reliability was assessed using Cronbach's alpha coefficient, all values of which were >0.7, with the exception of cognitive functioning, social functioning, and nausea and vomiting (α = 0.57, α = 0.69, and α = 0.68, respectively). In multi-trait scaling analysis, convergent and divergent validity were considered adequate (validity indices were 91.6 and 97.4%). In general, moderate to strong correlations were found between the subscales of the EORTC QLQ-C30 and its respective dimensions from the WHOQOL-bref, the hospital anxiety and depression scale, and the Edmonton Symptom Assessment System (ESAS) instruments. In addition, the EORTC QLQ-C30 was able to differentiate groups of patients with distinct performance statuses and types of treatment (known-group validation). Statistical analyses were also performed on educational status, yielding similar results. CONCLUSIONS Detailed psychometric property data using the EORTC QLQ-C30 in Brazil are added by this study. In addition, we demonstrated that this instrument is in general reliable and valid regardless of the patient educational level.
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Affiliation(s)
- Carlos Eduardo Paiva
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil,
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Yang X, Li Q, Zhao H, Li J, Duan J, Wang D, Fang N, Zhu P, Fu J. Quality of life in rectal cancer patients with permanent colostomy in Xi'an. Afr Health Sci 2014; 14:28-36. [PMID: 26060455 DOI: 10.4314/ahs.v14i1.6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To observe the quality of life (QOL) in rectal cancer patients with permanent colostomy in different periods after operation. METHODS A 1-,3-,6-month prospective study of QOL in 51 rectal cancer patients with permanent colostomy and 50 without permanent colostomy was assessed using European Organization for Research and Treatment of Cancer (EORTC) QOL-30 and CR38 questionnaires. RESULTS The variation of QOL in different periods was "v" type. In the 1st postoperative month, these patients had the lowest quality of life scores, accompanied significantly varied functions and severe symptoms. Almost of all indexes of these patients had improved consistently in the postoperative period. The scores of global QOL even better than pre-operative level at 6th months post-operation, but the social function, body image, chemotherapy side effects and financial difficulties had not restored to the baseline level. Patients without permanent colostomy had a better score in most of categories of QOL-30 and CR38. CONCLUSIONS The 1st postoperative month was crucial for patients' recovery, in which we should pay great attention to these problems which relate to the recovery of rectal cancer patients with permanent colostomy.
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Affiliation(s)
- Xiuxiu Yang
- Department of infection management Xijing Hospital, Fourth Military Medical University
| | - Qin Li
- Department of infection management Xijing Hospital, Fourth Military Medical University
| | - Haihong Zhao
- Department of infection management Xijing Hospital, Fourth Military Medical University
| | - Junhua Li
- Department of infection management Xijing Hospital, Fourth Military Medical University
| | - Jiaobo Duan
- Department of infection management Xijing Hospital, Fourth Military Medical University
| | - Dandan Wang
- Department of infection management Xijing Hospital, Fourth Military Medical University
| | - Ningning Fang
- Department of infection management Xijing Hospital, Fourth Military Medical University
| | - Ping Zhu
- Department of infection management Xijing Hospital, Fourth Military Medical University
| | - Jufang Fu
- Department of infection management Xijing Hospital, Fourth Military Medical University
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Bleakley K, Stinson M. Complementary and alternative therapies: do they improve quality of life for women with breast cancer? PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x11y.0000000022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Pitfalls in the interpretation of standardised quality of life instruments for individual patients? A qualitative study in colorectal cancer. Qual Life Res 2012; 22:1879-88. [DOI: 10.1007/s11136-012-0303-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2012] [Indexed: 01/22/2023]
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Kontodimopoulos N, Samartzis A, Papadopoulos AA, Niakas D. Reliability and validity of the Greek QLQ-C30 and QLQ-MY20 for measuring quality of life in patients with multiple myeloma. ScientificWorldJournal 2012; 2012:842867. [PMID: 22919356 PMCID: PMC3419404 DOI: 10.1100/2012/842867] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 06/10/2012] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the psychometric properties of the Greek EORTC QLQ-C30 and QLQ-MY20 instruments. METHOD A sample of myeloma patients (N = 89) from two tertiary hospitals were surveyed with the QLQ-C30, QLQ-MY20 and various demographic and disease related questions. The previously validated Greek SF-36 instrument was used as a "gold standard" for health-related quality of life (HRQoL) comparisons. Hypothesized scale structure, internal consistency reliability (Cronbach's alpha) and various forms of construct validity (convergent, discriminative, concurrent and known-groups) were assessed. RESULTS Multitrait scaling confirmed scale structure of the QLQ-C30 and QLQ-MY20, with good item convergence (96% and 72%) and discrimination (78% and 58%) rates. Cronbach's α was >0.70 for all but one scale (cognitive functioning). Spearman's correlations between similar QLQ-C30 and SF-36 scales ranged between 0.35-0.80 (P < 0.001). Expected interscale correlations and known-groups comparisons supported construct validity. QLQ-MY20 scales showed comparatively lower correlations with QLQ-C30 functional scales, and higher correlations with conceptually related symptom scales. CONCLUSIONS The observed psychometric properties of the two instruments imply suitability for assessing myeloma HRQoL in Greece. Future studies should focus on generalizability of the results, as well as on specific issues such as longitudinal validity and responsiveness.
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Affiliation(s)
- Nick Kontodimopoulos
- School of Social Sciences, Hellenic Open University, Bouboulinas 57-59, 26222 Patras, Greece.
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Huang IC, Quinn GP, Wen PS, Shenkman EA, Revicki DA, Krull K, Li Z, Shearer PD. Using three legacy measures to develop a health-related quality of life tool for young adult survivors of childhood cancer. Qual Life Res 2011; 21:1437-50. [PMID: 22101901 DOI: 10.1007/s11136-011-0055-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2011] [Indexed: 11/25/2022]
Abstract
BACKGROUND Little attention has been paid to selecting and developing health-related quality of life (HRQOL) measurement tools for young adult survivors of childhood cancer (YASCC). The primary purpose of this study was to develop a HRQOL tool for YASCC based on three legacy instruments. METHODS Data collected from 151 YASCC were analyzed. HRQOL was measured using the Medical Outcomes Study SF-36, Quality of Life in Adult Cancer Survivors, and Quality of Life-Cancer Survivor. We used the following stages to develop our HRQOL tool: mapping items from three instruments into a common HRQOL construct, checking dimensionality using confirmatory factor analyses (CFA), and equating items using Rasch modeling. RESULTS We assigned 123 items to a HRQOL construct comprised of six generic and eight survivor-specific domains. CFA retained 107 items that meet the assumptions of unidimensionality and local independence. Rasch analysis retained 68 items that satisfied the indices of information-weighted/outlier-sensitive fit statistic mean square. However, items in most domains possess relatively easy measurement properties, whereas YASCC's underlying HRQOL was on the middle to higher levels. CONCLUSIONS Psychometric properties of the established tool for measuring HRQOL of YASCC were not satisfied. Future studies need to refine this tool, especially adding more challenging items.
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Affiliation(s)
- I-Chan Huang
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL, USA.
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Prospective external convergence evaluation of two different quality-of-life instruments in lung resection patients. Eur J Cardiothorac Surg 2011; 40:99-105. [DOI: 10.1016/j.ejcts.2010.10.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Revised: 09/27/2010] [Accepted: 10/11/2010] [Indexed: 11/21/2022] Open
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Davenport TE, Stevens SR, Baroni K, Mark Van Ness J, Snell CR. Reliability and validity of Short Form 36 Version 2 to measure health perceptions in a sub-group of individuals with fatigue. Disabil Rehabil 2011; 33:2596-604. [DOI: 10.3109/09638288.2011.582925] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kontodimopoulos N, Ntinoulis K, Niakas D. Validity of the Greek EORTC QLQ-C30 and QLQ-BR23 for measuring health-related quality of life in breast cancer patients. Eur J Cancer Care (Engl) 2011; 20:354-61. [PMID: 20345453 DOI: 10.1111/j.1365-2354.2009.01170.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to assess construct validity and internal consistency reliability of the Greek EORTC QLQ-C30 and QLQ-BR23 instruments. A sample of female breast cancer patients (n= 105) were self-administered the QLQ-C30, QLQ-BR23 and SF-36 and questions on treatment and socio-demographic status. Hypothesised scale structure, reliability (Cronbach's α) and construct validity (convergent, discriminative, concurrent and known-groups) were assessed. Multitrait scaling confirmed scale structure of the QLQ-C30 and QLQ-BR23 with good item convergence (92% and 85%), and discrimination (87% and 84%) rates. Cronbach's α was >0.70 for all but one scale (cognitive functioning). Strength of Spearman's correlations between the QLQ-C30 and SF-36 scales assessing similar health-related quality of life dimensions ranged from 0.25 to 0.64 (P < 0.01). Construct validity was confirmed with satisfactory results for interscale correlations and known-groups comparisons. QLQ-BR23 scales showed comparatively low (<0.40) correlations with QLQ-C30 functional scales, and higher correlations with conceptually related symptom scales. Most QLQ-C30 and QLQ-BR23 scales discriminated between pre-treatment and current treatment patients. The overall psychometric results for the Greek version of the QLQ-C30 and QLQ-BR23 confirmed it as a reliable and valid questionnaire for assessing breast cancer-specific HRQoL in Greece.
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Affiliation(s)
- N Kontodimopoulos
- Faculty Of Social Sciences, Hellenic Open University, Bouboulinas 57-59, Patras, Greece.
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Perwitasari DA, Atthobari J, Dwiprahasto I, Hakimi M, Gelderblom H, Putter H, Nortier JWR, Guchelaar HJ, Kaptein AA. Translation and Validation of EORTC QLQ-C30 into Indonesian Version for Cancer Patients in Indonesia. Jpn J Clin Oncol 2011; 41:519-29. [DOI: 10.1093/jjco/hyq243] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Introducing a new health-related quality of life outcome tool for metastatic disease of the spine: content validation using the International Classification of Functioning, Disability, and Health; on behalf of the Spine Oncology Study Group. Spine (Phila Pa 1976) 2010; 35:1377-86. [PMID: 20505561 DOI: 10.1097/brs.0b013e3181db96a5] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A systematic review of Health Related-Quality of Life Outcomes (HRQOL) in metastatic disease of the spine and content validation of a new Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ). OBJECTIVE To identify HRQOL questionnaires previously reported for spinal metastases and to validate the content of the new SOSGOQ based on the International Classification of Function and Disability (ICF). SUMMARY OF BACKGROUND DATA Literature on metastatic tumors of the spine and clinical outcomes is limited and generally of poor quality. The SOSG has developed a "quality of life" outcome tool specific for patients with metastatic of the spine. The ICF is a universal framework allowing content exploration, comparison, and validation of all questionnaires relating to HRQOL. METHODS A systematic review identified 141 studies. Reported outcome tools were enumerated. The most commonly used (ESAS, Karnofsky Scale, and Oswestry Disability Index) and the SOSGOQ were linked to the ICF. Descriptive statistics examined the frequency and specificity of the ICF linkage. Linkage reliability was evaluated by interinvestigator percentage agreement. RESULTS The SOSGOQ contains 56 concepts, with all 4 domains of the ICF represented. Four concepts could not be linked. There was 100% interobserver agreement (IOA) for total number of concepts and for those "not covered." Hundred percent of concepts had "First and Second" level linkage. Hundred percent IOA exists at both "Component" and "First Level" linkage. There was 96.1% IOA at "Second Level". Thirty-three concepts linked to Third Level with 96.9% IOA. Ten concepts linked at the Fourth Level with 100% IOA. CONCLUSION The SOSGOQ includes all domains relevant for measurement of function and disability and its content validity is confirmed by linkage with the ICF. This new questionnaire has superior content capacity to measure disease burden of patients with metastatic disease of the spine than any instruments previously identified in the literature.
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Health related quality of life assessment in metastatic disease of the spine: a systematic review. Spine (Phila Pa 1976) 2009; 34:S128-34. [PMID: 19829272 DOI: 10.1097/brs.0b013e3181b778b2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Systematic literature review. OBJECTIVES To examine the available literature on health related quality of life (HRQOL) assessment in metastatic disease of the spine and identify the optimal functional outcome scales to be used in developing a disease-specific tool. SUMMARY OF BACKGROUND DATA There is a lack of consensus in the use of HRQOL measures in patients with metastatic spine disease. METHODS A systematic review was conducted using MEDLINE, EMBASE, the Science Citation Index (ISI), the Cumulative Index to Nursing and Allied Health Literature, the PsycINFO, the Allied and Complementary Medicine (AMED), Cochrane Reviews and Global Health databases for clinical studies addressing metastatic spine disease from 1966 through 2008. The validity of outcome tools was established by linkage analysis with the International Classification of Functioning Disability and Health (ICF). RESULTS One hundred forty-one clinical studies met inclusion criteria including 10,347 patients. Only 5 moderate grade and 1 high grade study were identified. Thirty- four studies used a patient self-assessment instrument to assess health status. None of the instruments were validated for metastatic spine patients. The most commonly used Pi-by-no tools were SF-36, SIP 5, and the ADL. None of the studies defined health related quality of life (HRQOL) or justified the choice of instrument. The most commonly used cancer-specific tools were ECOG, EORTC QCQ-C30, and EUROQOL 5D. Based on frequency of citation and on correlation with the International Classification of Functioning Disability and Health, the ECOG and SF36 were judged as most valid and reliable. CONCLUSION A systematic review of the available evidence suggests that valid and reliable health related quality of life measures exist for the assessment of oncology patients; however, a disease-specific tool for metastatic spine disease awaits development. Until such time as a disease-specific tool is available, we recommend that the ECOG and SF-36 be considered for use in studies addressing the outcome assessment of patients with metastatic spine disease.
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Abstract
AbstractPalliative care aims at improving the patient’s quality of life. The assessment of this quality of life (QoL) is crucial for the evaluation of palliative care outcome. Many patients require hospital admissions for symptom control during their cancer journey and most of them die in hospitals, although they would like to stay at home until the end of their lives. In 1986, the European Organization for Research and Treatment (EORTC) initiated a research programme to develop an integrated, modular approach for evaluating the quality of life of patients participating in international clinical trials. This questionnaire measures cancer patients’ physical, psychological and social functions and was used in a wide range of clinical cancer trials with large numbers of research groups and also in various other non-trial studies. The aim of this study was to evaluate the psychometric properties, especially the reliability, validity and applicability of the EORTC QLQ-C30 in a German sample of terminally ill cancer patients receiving palliative care in different settings. The questionnaire was well accepted in the present patient population. Scale reliability was good (pre-treatment 0.80) especially for the functional scale. The results support the reliability and validity of the QLQ-C30 (version 3.0) as a measure of the health-related quality of life in German cancer patients receiving palliative care treatment.
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Franceschini J, Santos AAD, El Mouallem I, Jamnik S, Uehara C, Fernandes ALG, Santoro IL. [Assessment of the quality of life of patients with lung cancer using the Medical Outcomes Study 36-item Short-Form Health Survey]. J Bras Pneumol 2009; 34:387-93. [PMID: 18622506 DOI: 10.1590/s1806-37132008000600009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Accepted: 08/30/2007] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To assess the quality of life of patients with lung cancer and to compare it with that of individuals without cancer. METHODS The Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) was administered to 57 patients diagnosed with lung cancer, treated at the Lung Cancer Outpatient Clinic of the Hospital São Paulo, and to a control group of 57 individuals recruited from the Extra Penha workout group. The Mann-Whitney test was used to compare the groups, domain by domain. The first model of logistic regression was adjusted for male gender, nonsurgical treatment, Karnofsky performance status and smoking, which were included as predictors. The second model was adjusted for each SF-36 domain in order to identify increases in the proportions of patients in stage IIIB or IV. RESULTS The lung cancer group and the control group presented the following mean scores, respectively, for the SF-36 domains: role limitations due to physical health problems, 29.39 +/- 36.94 and 82.89 +/- 28.80; role limitations due to emotional problems, 42.78 +/- 44.78 and 86.55 +/- 28.77; physical function, 56.49 +/- 28.39 and 89.00 +/- 13.80; vitality, 61.61 +/- 23.82 and 79.12 +/- 17.68; bodily pain, 62.72 +/- 28.72 and 81.54 +/- 19.07; general health, 62.51 +/- 25.57 and 84.47 +/- 13.47; emotional well-being, 68.28 +/- 23.46 and 82.63 +/- 17.44; and social functioning, 72.87 +/- 29.20 and 91.67 +/- 17.44. The logistic regression model showed that role limitations due to physical health problems, physical function and emotional well-being were predictors of stages IIIB and IV. CONCLUSIONS The patients with lung cancer had a poorer quality of life, especially regarding physical aspects, than did the control subjects.
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Cankurtaran ES, Ozalp E, Soygur H, Ozer S, Akbiyik DI, Bottomley A. Understanding the reliability and validity of the EORTC QLQ-C30 in Turkish cancer patients. Eur J Cancer Care (Engl) 2008; 17:98-104. [PMID: 18181898 DOI: 10.1111/j.1365-2354.2007.00827.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
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.
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Affiliation(s)
- E S Cankurtaran
- Ankara Oncology Training and Research Hospital, Psychiatry Clinic, Ankara, Turkey.
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Fredheim OMS, Borchgrevink PC, Saltnes T, Kaasa S. Validation and comparison of the health-related quality-of-life instruments EORTC QLQ-C30 and SF-36 in assessment of patients with chronic nonmalignant pain. J Pain Symptom Manage 2007; 34:657-65. [PMID: 17618079 DOI: 10.1016/j.jpainsymman.2007.01.011] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2006] [Revised: 01/12/2007] [Accepted: 01/13/2007] [Indexed: 11/12/2022]
Abstract
The EORTC QLQ-C30 health-related quality of life (HRQoL) questionnaire was developed for use in clinical cancer trials. It has also been applied in studies of patients with chronic nonmalignant pain in spite of nondocumented validity. Validation of the EORTC QLQ-C30 in this patient population and comparison with the traditional first choice HRQoL instrument in chronic nonmalignant pain, the SF-36, are, therefore, required. Two hundred eighty-six patients admitted to the tertiary multidisciplinary pain center at St. Olavs University Hospital in Trondheim, Norway, completed both the EORTC QLQ-C30 and the SF-36 at admittance. Correlations between EORTC QLQ-C30 and SF-36 measures of the same concept were between 0.70 and 0.81 for all five domains covered by both instruments. Internal consistency was below 0.70 for the EORTC QLQ-C30 scales physical functioning (0.57), pain (0.68), role functioning (0.43), cognitive functioning (0.66), and nausea/vomiting (0.53), as well as the SF-36 scale role emotional functioning (0.66). Large floor or ceiling effects were seen for several EORTC QLQ-C30 scales. While SF-36 addresses no other symptoms than pain and fatigue, the EORTC QLQ-C30 also includes sleep, financial difficulties, nausea/vomiting, dyspnea, appetite loss, constipation, and diarrhea. Even though some EORTC QLQ-C30 scales have unsatisfactory internal consistency, EORTC QLQ-C30, similar to SF-36, has overall acceptable psychometric properties. The EORTC QLQ-C30 is a valid alternative to the SF-36 when a broader assessment of symptoms is desired.
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Affiliation(s)
- Olav Magnus S Fredheim
- Pain and Palliation Research Group, Norwegian University of Science and Technology, Trondheim, Norway.
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Marín Caro MM, Laviano A, Pichard C. Nutritional intervention and quality of life in adult oncology patients. Clin Nutr 2007; 26:289-301. [PMID: 17368656 DOI: 10.1016/j.clnu.2007.01.005] [Citation(s) in RCA: 164] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2006] [Revised: 01/10/2007] [Accepted: 01/17/2007] [Indexed: 12/26/2022]
Abstract
The evaluation of quality of life (QoL) assesses patients' well-being by taking into account physical, psychological and social conditions. Cancer and its treatment result in severe biochemical and physiological alterations associated with a deterioration of QoL. These metabolic changes lead to decreased food intake and promote wasting. Cancer-related malnutrition can evolve to cancer cachexia due to complex interactions between pro-inflammatory cytokines and host metabolism. Beside and beyond the physical and the metabolic effects of cancer, patients often suffer as well from psychological distress, including depression. Depending on the type of cancer treatment (either curative or palliative) and on patients' clinical conditions and nutritional status, adequate and patient-tailored nutritional intervention should be prescribed (diet counselling, oral supplementation, enteral or total parenteral nutrition). Such an approach, which should be started as early as possible, can reduce or even reverse their poor nutritional status, improve their performance status and consequently their QoL. Nutritional intervention accompanying curative treatment has an additional and specific role, which is to increase the tolerance and response to the oncology treatment, decrease the rate of complications and possibly reduce morbidity by optimizing the balance between energy expenditure and food intake. In palliative care, nutritional support aims at improving patient's QoL by controlling symptoms such as nausea, vomiting and pain related to food intake and postponing loss of autonomy. The literature review supports that nutritional care should be integrated into the global oncology care because of its significant contribution to QoL. Furthermore, the assessment of QoL should be part of the evaluation of any nutritional support to optimize its adequacy to the patient's needs and expectations.
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Abstract
Approximately 20% of adults worldwide report persistent fatigue. Physical activity is a healthful behaviour that has promise for combating feelings of fatigue and low energy. This article summarises the epidemiological literature that examined the association between physical activity and feelings of energy and fatigue. Twelve population-based studies conducted between January 1945 and February 2005 that concurrently measured physical activity and feelings of energy and fatigue were located. All of the studies suggested that there was an association between physical activity and a reduced risk of experiencing feelings of low energy and fatigue when active adults were compared with sedentary peers (odds ratio = 0.61; 95% CI 0.52, 0.72). The effect was heterogeneous and varied according to study design and the energy/fatigue measure used in the study. Because epidemiological comparisons cannot establish direction of causality, standard criteria for evaluating strength of evidence in epidemiological studies (i.e. strength of association, temporal sequence, consistency, dose response and biological plausibility) were used to judge whether the observed association between physical activity and feelings of energy and fatigue suggest causality in the absence of adequate experimental evidence. There was agreement among the studies suggesting a strong, consistent, temporally appropriate dose-response relationship between physical activity and feelings of energy and fatigue. No compelling evidence has confirmed any plausible biological mechanisms that explain the apparent protective effect of physical activity against feelings of low energy and fatigue. Nonetheless, the epidemiological evidence is sufficiently strong to justify better controlled prospective cohort studies and randomised controlled trials.
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Affiliation(s)
- Timothy W Puetz
- Department of Kinesiology, University of Georgia, Athens, GA 30602-6554, USA.
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Cheung YB, Goh C, Thumboo J, Khoo KS, Wee J. Quality of life scores differed according to mode of administration in a review of three major oncology questionnaires. J Clin Epidemiol 2006; 59:185-91. [PMID: 16426954 DOI: 10.1016/j.jclinepi.2005.06.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2004] [Revised: 05/26/2005] [Accepted: 06/16/2005] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess whether scores on the three major quality-of-life questionnaires in oncology (FACT-G, FLIC, and EORTC QLQ-C30) are associated with modes of administration in a realistic clinical research setting. STUDY DESIGN AND SETTING A heterogeneous sample of 1,265 cancer patients was recruited in Singapore. About one-fourth of the patients chose to have the interview administered by research staff; the rest self-completed the questionnaires. Multiple regression was used to adjust for differences in demographic and clinical characteristics between patients. An equivalence margin was defined as 0.25 standard deviations. RESULTS Apart from one exception (the EORTC QLQ-C30 global functioning scale), all scales showed higher mean values in patients who were interviewed than patients who self-administered the questionnaires. For the physical and functional well-being scales of FACT-G and the physical and social functioning scales of EORTC QLQ-C30, the differences were small and the confidence intervals fell totally within the equivalence zone. The emotional well-being score of the FACT-G was different across modes of administration and the confidence interval fell outside the equivalence zones. There was no interaction between modes of administration and respondents' education level. CONCLUSION The physical aspect of quality-of-life is not sensitive to interviewer administration but the psychological aspect is. Statistical adjustment for some scales is recommended.
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Affiliation(s)
- Yin Bun Cheung
- MRC Tropical Epidemiology Group, Room 305a, IDEU, ITD, London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom.
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Cooley ME, McCorkle R, Knafl GJ, Rimar J, Barbieri MJ, Davies M, Murren J. Comparison of health-related quality of life questionnaires in ambulatory oncology. Qual Life Res 2005; 14:1239-49. [PMID: 16047500 DOI: 10.1007/s11136-004-5534-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The purpose of this study is to compare three commonly used health-related quality of life (HR-QOL) questionnaires for their ease of use, accuracy, and patient preference; identify factors related to patient preference; identify differences in patient completion rates; and to identify factors associated with patient completion of these questionnaires. Three psychometrically sound measures, the Symptom Distress Scale (SDS), Medical Outcome Study Short Form-36 (SF-36), and Functional Assessment of Cancer Therapy (FACT), were tested. Seventy-nine patients completed questionnaires in the ambulatory oncology setting. No significant differences in patient ratings were found in ease of use and accuracy among the questionnaires. All of the questionnaires were rated as easy to use and accurate. Patient ratings on preference were marginally significant (p = 0.07). Forty-six percent of participants indicated that they preferred the SDS, whereas 27% and 39% preferred the SF-36 and the FACT. No significant differences in patient completion rates were found among the questionnaires. One hundred percent completion rates ranged from 88.6% for the SDS to 78.5% for the SF-36, and 80% completion rates ranged from 98.7% for the SDS to 94.9% for the SF-36. Administration of standardized HR-QOL questionnaires is feasible in the clinical setting.
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Affiliation(s)
- Mary E Cooley
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
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Talbot M, Turcotte RE, Isler M, Normandin D, Iannuzzi D, Downer P. Function and health status in surgically treated bone metastases. Clin Orthop Relat Res 2005; 438:215-20. [PMID: 16131894 DOI: 10.1097/01.blo.0000170721.07088.2e] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
UNLABELLED In a prospective study, we evaluated if surgery substantially improved functional and quality of life outcomes in patients with nonspinal bone metastases. Sixty-seven patients were followed up prospectively. The Short Form-36, the Musculoskeletal Tumor Society 1987 form, the Musculoskeletal Tumor Society 1993 form, and the Toronto Extremity Salvage Score were administered preoperatively and 6 weeks and 3 months postoperatively. Fifty percent of the patients had pathologic fractures. Intramedullary nailing was done in 36 patients, prosthetic replacement was done in 24 patients, and plating was done in five patients. The average postoperative survival was 8 months. At 6 weeks, 13 patients had died and seven were lost to followup. Twenty-one percent of patients had complications, although only 4.5% needed additional surgery. The patients' Musculoskeletal Tumor Society 1987 form, Musculoskeletal Tumor Society 1993 form, and Toronto Extremity Salvage Score scores improved at 6 weeks and 3 months postoperatively. There were no improvements in the Short Form-36 mental and physical summary scales of the patients. The number of patients using pain medication did not decrease. Patients had functional improvements after surgical treatment of bone metastases, even patients with a limited life expectancy. Future prospective studies should anticipate a high rate of attrition with this population from death and loss to followup. LEVEL OF EVIDENCE Prognostic study, Level I (high quality prospective study-all patients were enrolled at the same point in their disease with > or = 80% followup of enrolled patients). See the Guidelines for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Max Talbot
- Division of Orthopaedic Surgery, Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada
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Luo N, Fones CSL, Lim SE, Xie F, Thumboo J, Li SC. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-c30): validation of English version in Singapore. Qual Life Res 2005; 14:1181-6. [PMID: 16041912 DOI: 10.1007/s11136-004-4782-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE This study aimed to validate the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, English version 3.0) in Singaporean cancer patients. METHODS In a cross-sectional study, a heterogeneous sample of cancer patients (n = 57) self-administered a questionnaire containing the QLQ-C30, the Short Form 36 Health Survey (SF-36) and assessing health and sociodemographic status. Construct validity was assessed by testing a priori hypotheses that QLQ-C30 scales would be moderately or strongly correlated with SF-36 scales measuring similar dimensions of health-related quality of life (HRQoL) and that subjects reporting mild symptoms would have better HRQoL scores than those reporting severe symptoms. Internal consistency reliability was assessed using Cronbach's alpha. RESULTS Strength of Spearman's correlations between the QLQ-C30 and SF-36 scales assessing similar dimensions of HRQoL ranged from 0.35 to 0.67. Subjects with mild symptoms had better scores than those with severe symptoms for all six QLQ-C30 HRQoL scales (p < 0.05 for five scales, Mann-Whitney U tests). Cronbach's alpha ranged from 0.19 for the cognitive functioning scale to 0.91 for the global QoL scale. CONCLUSION This study provides preliminary evidence for the validity and reliability of the EORTC QLQ-C30 in English-speaking Singaporean cancer patients.
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Affiliation(s)
- N Luo
- Department of Pharmacy, National University of Singapore, Singapore
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Cheung YB, Goh C, Thumboo J, Khoo KS, Wee J. Variability and Sample Size Requirements of Quality-of-Life Measures: A Randomized Study of Three Major Questionnaires. J Clin Oncol 2005; 23:4936-44. [PMID: 16051946 DOI: 10.1200/jco.2005.07.141] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PurposeTo compare the variability and sample size requirements of the global quality-of-life (QOL) scores of the following three major QOL instruments: the Functional Assessment of Cancer Therapy–General (FACT-G), Functional Living Index–Cancer (FLIC), and European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire C30 (EORTC QLQ-C30).Patients and MethodsCancer patients were randomly assigned to answer two of the three instruments using an incomplete block design (n = 1,268). The instruments were compared in terms of coefficient of variation, effect size in detecting a difference between patients with different performance status, and correlation coefficient between scores at baseline and follow-up.ResultsThe FACT-G and FLIC had significantly smaller coefficients of variation than the EORTC QLQ-C30 (both P < .05). The FLIC also had significantly larger correlation coefficients between scores at baseline and follow-up than the EORTC QLQ-C30 (P < .05). The FACT-G and the FLIC had a larger effect size in a cross-sectional and longitudinal setting, respectively, than the EORTC QLQ-C30 in differentiating patients with different performance status (both P < .05).ConclusionIn some aspects, the FACT-G and FLIC global QOL scores had smaller variability and larger discriminative ability than the EORTC QLQ-C30. Further research using other criteria to compare the three instruments is recommended.
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Affiliation(s)
- Yin-Bun Cheung
- Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore 169610.
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Wittink H, Turk DC, Carr DB, Sukiennik A, Rogers W. Comparison of the Redundancy, Reliability, and Responsiveness to Change Among SF-36, Oswestry Disability Index, and Multidimensional Pain Inventory. Clin J Pain 2004; 20:133-42. [PMID: 15100588 DOI: 10.1097/00002508-200405000-00002] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the Medical Outcomes Trust Short-Form-36 (SF-36), the Multidimensional Pain Inventory (MPI), and the Oswestry Disability Index (ODI) measures on internal consistency, domain overlap, and responsiveness in detecting changes following multidisciplinary pain treatment. METHODS 424 patients with chronic pain referred to a multidisciplinary pain center were assessed. Of these, 87 patients were assessed prior to and following treatment. Cronbach's alphas were calculated for each SF-36 and MPI domain, and for the ODI. Canonical correlation and regression analyses (R2) described overlap. Responsiveness to change was computed from treatment effect size and significance. RESULTS Cronbach's alpha ranged from 0.69-0.92 for MPI domains, from 0.79-0.91 for SF-36 domains, and was 0.86 for the ODI. Three domains overlapped but several were unique (eg, the MPI "significant other" domains; R2 range 0.03-0.16). Significant changes following treatment were observed for the MPI Pain Severity, Interference and Outdoor Work Activities, the SF-36 Physical and Social Functioning, Bodily Pain, and the ODI. CONCLUSION The MPI, SF-36, and ODI each have good psychometric properties. Three domains overlapped between the MPI and the SF-36: pain, Interference/Social functioning, and mental health. The MPI and the SF-36 each contributed unique domains such as the SF-36 General Health and Vitality domains and the MPI "significant other" and physical activity domains. Several of the MPI domains were among the most sensitive to change. Because of its large normative sample and samples of patients with diverse medical disorders, the SF-36 may be particularly useful to compare chronic pain patients to those with other medical conditions. The ODI has the lowest respondent burden. The MPI and SF-36, although containing much overlapping information, both make unique and complementary contributions to assessing patients with chronic pain.
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Affiliation(s)
- Harriët Wittink
- Pain Management Program, Tufts-New England Medical Center, Boston, MA 02111, USA.
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Chie WC, Chang KJ, Huang CS, Kuo WH. Quality of life of breast cancer patients in Taiwan: Validation of the Taiwan Chinese version of the EORTC QLQ-C30 and EORTC QLQ-BR23. Psychooncology 2003; 12:729-35. [PMID: 14502597 DOI: 10.1002/pon.727] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The objective of this study was to test the reliability and validity of the Taiwan Chinese version of the EORTC QLQ-C30 (version 3) and EORTC QLQ-BR23. The authors followed the guidelines of translation and pilot testing of the questionnaires. The questionnaires were given to 35 breast cancer patients under active treatment and 54 under follow-up at the National Taiwan University Hospital from November 2000 to October 2001. A retest was conducted one to two weeks after the first interview/form completion for the follow-up group. The intraclass correlation coefficients of the two questionnaires were moderate to high in the follow-up group. The Cronbach's alpha coefficients of most scales of the two questionnaires were > or = 0.70 except that of physical functioning (0.68), cognitive functioning (0.53), and arm symptoms (0.59). Correlations of scales measuring similar dimensions of the EORTC QLQ-C30 and the SF-36 were moderate. Patients in the active treatment group had more serious QOL problems due to disease and treatment. Results of this study showed that the Taiwan Chinese version of the two questionnaires had good test/retest reliability, high internal consistency in most scales, and could show the expected differences between patients in active chemotherapy and follow-up group.
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Affiliation(s)
- Wei-Chu Chie
- School of Public Health and Graduate Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taiwan.
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