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Wallwiener M, Matthies L, Simoes E, Keilmann L, Hartkopf AD, Sokolov AN, Walter CB, Sickenberger N, Wallwiener S, Feisst M, Gass P, Fasching PA, Lux MP, Wallwiener D, Taran FA, Rom J, Schneeweiss A, Graf J, Brucker SY. Reliability of an e-PRO Tool of EORTC QLQ-C30 for Measurement of Health-Related Quality of Life in Patients With Breast Cancer: Prospective Randomized Trial. J Med Internet Res 2017; 19:e322. [PMID: 28912116 PMCID: PMC5620457 DOI: 10.2196/jmir.8210] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/08/2017] [Accepted: 08/14/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Breast cancer represents the most common malignant disease in women worldwide. As currently systematic palliative treatment only has a limited effect on survival rates, the concept of health-related quality of life (HRQoL) is gaining more and more importance in the therapy setting of metastatic breast cancer. One of the major patient-reported outcomes (PROs) for measuring HRQoL in patients with breast cancer is provided by the European Organization for Research and Treatment of Cancer (EORTC). Currently, paper-based surveys still predominate, as only a few reliable and validated electronic-based questionnaires are available. Facing the possibilities associated with evolving digitalization in medicine, validation of electronic versions of well-established PRO is essential in order to contribute to comprehensive and holistic oncological care and to ensure high quality in cancer research. OBJECTIVE The aim of this study was to analyze the reliability of a tablet-based measuring application for EORTC QLQ-C30 in German language in patients with adjuvant and (curative) metastatic breast cancer. METHODS Paper- and tablet-based questionnaires were completed by a total of 106 female patients with adjuvant and metastatic breast cancer recruited as part of the e-PROCOM study. All patients were required to complete the electronic- (e-PRO) and paper-based versions of the HRQoL EORTC QLQ-C30 questionnaire. A frequency analysis was performed to determine descriptive sociodemographic characteristics. Both dimensions of reliability (parallel forms reliability [Wilcoxon test] and test of internal consistency [Spearman rho and agreement rates for single items, Pearson correlation and Kendall tau for each scale]) were analyzed. RESULTS High correlations were shown for both dimensions of reliability (parallel forms reliability and internal consistency) in the patient's response behavior between paper- and electronic-based questionnaires. Regarding the test of parallel forms reliability, no significant differences were found in 27 of 30 single items and in 14 of 15 scales, whereas a statistically significant correlation in the test of consistency was found in all 30 single items and all 15 scales. CONCLUSIONS The evaluated e-PRO version of the EORTC QLQ-C30 is reliable for patients with both adjuvant and metastatic breast cancer, showing a high correlation in almost all questions (and in many scales). Thus, we conclude that the validated paper-based PRO assessment and the e-PRO tool are equally valid. However, the reliability should also be analyzed in other prospective trials to ensure that usability is reliable in all patient groups. TRIAL REGISTRATION ClinicalTrials.gov NCT03132506; https://clinicaltrials.gov/ct2/show/NCT03132506 (Archived by WebCite at http://www.webcitation.org/6tRcgQuou).
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Affiliation(s)
- Markus Wallwiener
- Gynecologic Oncology, National Center for Tumor Diseases, Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - Lina Matthies
- Gynecologic Oncology, National Center for Tumor Diseases, Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - Elisabeth Simoes
- Research Institute for Women's Health, Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany
| | - Lucia Keilmann
- Gynecologic Oncology, National Center for Tumor Diseases, Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas D Hartkopf
- Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany
| | - Alexander N Sokolov
- Research Institute for Women's Health, Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany
| | - Christina B Walter
- Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany
| | - Nina Sickenberger
- Gynecologic Oncology, National Center for Tumor Diseases, Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - Stephanie Wallwiener
- Gynecologic Oncology, National Center for Tumor Diseases, Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - Manuel Feisst
- Institute for Medical Biometry and Informatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Paul Gass
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany
| | - Michael P Lux
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany
| | - Diethelm Wallwiener
- Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany
| | - Florin-Andrei Taran
- Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany
| | - Joachim Rom
- Gynecologic Oncology, National Center for Tumor Diseases, Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas Schneeweiss
- Gynecologic Oncology, National Center for Tumor Diseases, Hospital for General Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - Joachim Graf
- Research Institute for Women's Health, Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany
| | - Sara Y Brucker
- Research Institute for Women's Health, Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany
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