The EORTC CAT Core-The computer adaptive version of the EORTC QLQ-C30 questionnaire

Morten Aa Petersen; Neil K Aaronson; Juan I Arraras; Wei-Chu Chie; Thierry Conroy; Anna Costantini; Linda Dirven; Peter Fayers; Eva-Maria Gamper; Johannes M Giesinger; Esther J J Habets; Eva Hammerlid; Jorunn Helbostad; Marianne J Hjermstad; Bernhard Holzner; Colin Johnson; Georg Kemmler; Madeleine T King; Stein Kaasa; Jon H Loge; Jaap C Reijneveld; Susanne Singer; Martin J B Taphoorn; Lise H Thamsborg; Krzysztof A Tomaszewski; Galina Velikova; Irma M Verdonck-de Leeuw; Teresa Young; Mogens Groenvold; European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group

doi:10.1016/j.ejca.2018.04.016

The EORTC CAT Core-The computer adaptive version of the EORTC QLQ-C30 questionnaire

Eur J Cancer. 2018 Sep:100:8-16. doi: 10.1016/j.ejca.2018.04.016. Epub 2018 Jun 21.

Authors

Morten Aa Petersen¹, Neil K Aaronson², Juan I Arraras³, Wei-Chu Chie⁴, Thierry Conroy⁵, Anna Costantini⁶, Linda Dirven⁷, Peter Fayers⁸, Eva-Maria Gamper⁹, Johannes M Giesinger⁹, Esther J J Habets¹⁰, Eva Hammerlid¹¹, Jorunn Helbostad¹², Marianne J Hjermstad¹³, Bernhard Holzner⁹, Colin Johnson¹⁴, Georg Kemmler⁹, Madeleine T King¹⁵, Stein Kaasa¹⁶, Jon H Loge¹⁷, Jaap C Reijneveld¹⁸, Susanne Singer¹⁹, Martin J B Taphoorn⁷, Lise H Thamsborg²⁰, Krzysztof A Tomaszewski²¹, Galina Velikova²², Irma M Verdonck-de Leeuw²³, Teresa Young²⁴, Mogens Groenvold²⁵; European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group

Affiliations

¹ The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark. Electronic address: Morten.Aagaard.Petersen@regionh.dk.
² Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
³ Medical Oncology Department, Hospital of Navarre, Pamplona, Spain.
⁴ Institute of Epidemiology and Preventive Medicine, Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
⁵ Medical Oncology Department, Institut de cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France.
⁶ Psychoncology Unit, Sant'Andrea Hospital, Faculty of Medicine, Psychology Sapienza University, Rome, Italy.
⁷ Department of Neurology, Haaglanden Medical Center, PO Box 432, 2501 CK The Hague, The Netherlands; Department of Neurology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
⁸ Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
⁹ Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Innsbruck Medical University, Innsbruck, Austria.
¹⁰ Department of Neurology, Haaglanden Medical Center, PO Box 432, 2501 CK The Hague, The Netherlands.
¹¹ Department of Otolaryngology Head and Neck Surgery, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden.
¹² Department of Neuroscience, Norwegian University of Science and Technology, St. Olav University Hospital, Trondheim, Norway.
¹³ European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
¹⁴ Surgical Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
¹⁵ School of Psychology and Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
¹⁶ Oslo University Hospital, University of Oslo, Norway and European Palliative Care Research Centre (PRC), Norwegian University of Science and Technology, Oslo, Norway.
¹⁷ Palliative Medicine Unit, University Hospital of Trondheim, Trondheim, Norway.
¹⁸ Department of Neurology, Brain Tumor Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands; Department of Neurology, Brain Tumor Center Amsterdam, Academic Medical Center, Amsterdam, The Netherlands.
¹⁹ Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Mainz, Germany.
²⁰ The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
²¹ Health Outcomes Research Unit, Department of Gerontology, Geriatrics, and Social Work, Faculty of Education, Ignatianum Academy, Krakow, Poland.
²² Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
²³ Department of Otolaryngology - Head & Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
²⁴ East & North Hertfordshire NHS Trust Incorporating Mount Vernon Cancer Centre, Northwood, Middlesex, UK.
²⁵ The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.

PMID: 29936066
DOI: 10.1016/j.ejca.2018.04.016

Abstract

Background: To optimise measurement precision, relevance to patients and flexibility, patient-reported outcome measures (PROMs) should ideally be adapted to the individual patient/study while retaining direct comparability of scores across patients/studies. This is achievable using item banks and computerised adaptive tests (CATs). The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) is one of the most widely used PROMs in cancer research and clinical practice. Here we provide an overview of the research program to develop CAT versions of the QLQ-C30's 14 functional and symptom domains.

Methods: The EORTC Quality of Life Group's strategy for developing CAT item banks consists of: literature search to identify potential candidate items; formulation of new items compatible with the QLQ-C30 item style; expert evaluations and patient interviews; field-testing and psychometric analyses, including factor analysis, item response theory calibration and simulation of measurement properties. In addition, software for setting up, running and scoring CAT has been developed.

Results: Across eight rounds of data collections, 9782 patients were recruited from 12 countries for the field-testing. The four phases of development resulted in a total of 260 unique items across the 14 domains. Each item bank consists of 7-34 items. Psychometric evaluations indicated higher measurement precision and increased statistical power of the CAT measures compared to the QLQ-C30 scales. Using CAT, sample size requirements may be reduced by approximately 20-35% on average without loss of power.

Conclusions: The EORTC CAT Core represents a more precise, powerful and flexible measurement system than the QLQ-C30. It is currently being validated in a large independent, international sample of cancer patients.

Keywords: Computerized adaptive test; EORTC QLQ-C30; Health related quality of life; Item banking; Item development; Item response theory; Patient-reported outcome.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Activities of Daily Living
Cost of Illness
Europe
Female
Health Status
Health Status Indicators*
Humans
Male
Middle Aged
Neoplasms / diagnosis
Neoplasms / pathology
Neoplasms / physiopathology
Neoplasms / psychology*
Patient Reported Outcome Measures*
Psychometrics
Quality of Life*
Software Design*
Taiwan