Replication and validation of higher order models demonstrated that a summary score for the EORTC QLQ-C30 is robust

AbstractBackgroundLung cancer treatment can lead to negative health consequences. We analyzed the effects of curative-intent lung cancer treatment on functional exercise capacity (EC) and patient-reported outcomes (PROs).MethodsWe performed a prospective-observational cohort study of consecutive patients with stage I-IIIA lung cancer undergoing curative-intent therapy and assessed functional EC [primary outcome, six-minute walk distance (6MWD)], cancer-specific quality of life (QoL) [secondary outcome, European Organization for Research and Treatment of Cancer QoL Questionnaire Core 30 (EORTC-QLQ-C30) summary score], and exploratory outcomes including dyspnea [University of California San Diego Shortness of Breath Questionnaire (UCSD-SOBQ)] and fatigue [Brief Fatigue Inventory (BFI)] symptoms before and at 1 to 3 months post-treatment. We analyzed the time effect of treatment on outcomes using multivariable generalized estimating equations.ResultsIn 35 enrolled participants, treatment was borderline-significantly associated with a clinically-meaningful decline in functional EC [(mean change, 95% CI) 6MWD = −25.4m (−55.3, +4.47), p=0.10], non-significant change in cancer-specific QoL [EORTC-QLQ-C30 summary score = − 3.4 (−9.8, +3.0), p=0.30], and statistically-significant and clinically-meaningful higher dyspnea [UCSD-SOBQ = +13.1 (+5.7, +20.6), p=0.001] and increased fatigue [BFI = +10.0 (+2.9, +17.0), p=0.006].ConclusionsAmong the first prospective analysis of the effect of curative-intent lung cancer treatment on functional EC and PROs, we observed worsening dyspnea and fatigue, and possibly a decline in functional EC but not cancer-specific QoL at 1 to 3 months post-treatment. Interventions to reduce treatment-related morbidities and improve lung cancer survivorship may need to focus on reducing dyspnea, fatigue, and/or improving functional EC.Consent and ApprovalWritten informed consent was obtained from each participant included in this study. All human investigations were performed after approval by the VA San Diego Healthcare System institutional review board and in accord with an assurance filed with and approved by the U.S. Department of Health and Human Services.

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The EORTC QLQ‐C30 Summary Score as Prognostic Factor for Survival of Patients with Cancer in the “Real‐World”: Results from the Population‐Based PROFILES Registry

The Oncologist ◽

10.1634/theoncologist.2019-0348 ◽

2019 ◽

Vol 25 (4) ◽

Cited By ~ 6

Author(s):

Olga Husson ◽

Belle H. Rooij ◽

Jacobien Kieffer ◽

Simone Oerlemans ◽

Floortje Mols ◽

...

Keyword(s):

Prognostic Factor ◽

Real World ◽

Population Based ◽

Summary Score ◽

The Real ◽

Patients With Cancer ◽

Eortc Qlq C30 ◽

Eortc Qlq

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One-Year Morbidity Following Videoscopic Inguinal Lymphadenectomy for Stage III Melanoma

Cancers ◽

10.3390/cancers13061450 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1450

Author(s):

Marnix R. Jansen ◽

Otis M. Vrielink ◽

Marloes Faut ◽

Eric A. Deckers ◽

Lukas B. Been ◽

...

Keyword(s):

Quality Of Life ◽

Summary Score ◽

Stage Iii ◽

Inguinal Lymphadenectomy ◽

Eortc Qlq C30 ◽

Melanoma Patients ◽

Stage Iii Melanoma ◽

One Year ◽

Eortc Qlq

Purpose: We aimed to elucidate morbidity following videoscopic inguinal lymphadenectomy for stage III melanoma. Methods: Melanoma patients who underwent a videoscopic inguinal lymphadenectomy between November 2015 and May 2019 were included. The measured outcomes were lymphedema and quality of life. Patients were reviewed one day prior to surgery and postoperatively every 3 months for one year. Results: A total number of 34 patients were included for participation; 19 (55.9%) patients underwent a concomitant iliac lymphadenectomy. Lymphedema incidence was 40% at 3 months and 50% at 12 months after surgery. Mean interlimb volume difference increased steadily from 1.8% at baseline to 6.9% at 12 months (p = 0.041). Median Lymph-ICF-LL total score increased from 0.0 at baseline to 12.0 at 3 months, and declined to 8.5 at 12 months (p = 0.007). Twelve months after surgery, Lymph-ICF-LL scores were higher for females (p = 0.021) and patients that received adjuvant radiotherapy (p = 0.013). The Median Distress Thermometer and EORTC QLQ-C30 summary score recovered to baseline at 12 months postoperatively (p = 0.747 and p = 0.203, respectively). Conclusions: The onset of lymphedema is rapid and continues to increase up to one year after videoscopic inguinal lymphadenectomy. Quality of life recovers to the baseline value.

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Investigating the response scale of the EORTC QLQ-C30 in German cancer patients and a population survey

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01866-x ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Michael Koller ◽

Karolina Müller ◽

Sandra Nolte ◽

Heike Schmidt ◽

Christina Harvey ◽

...

Keyword(s):

Summary Score ◽

Life Questionnaire ◽

Response Scale ◽

European Organization ◽

Response Option ◽

Health Burden ◽

Reference Number ◽

German Speaking ◽

Eortc Qlq C30 ◽

Eortc Qlq

Abstract Background The European Organization for research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) scales are scored on a 4-point response scale, ranging from not at all to very much. Previous studies have shown that the German translation of the response option quite a bit as mäßig violates interval scale assumptions, and that ziemlich is a more appropriate translation. The present studies investigated differences between the two questionnaire versions. Methods The first study employed a balanced cross-over design and included 450 patients with different types of cancer from three German-speaking countries. The second study was a representative survey in Germany including 2033 respondents. The main analyses included compared the ziemlich and mäßig version of the questionnaire using analyses of covariance adjusted for sex, age, and health burden. Results In accordance with our hypothesis, the adjusted summary score was lower in the mäßig than in the ziemlich version; Study 1: − 4.5 (95% CI − 7.8 to − 1.3), p = 0.006, Study 2: − 3.1 (95% CI − 4.6 to − 1.5), p < 0.001. In both studies, this effect was pronounced in respondents with a higher health burden; Study 1: − 6.8 (95% CI − 12.2 to − 1.4), p = 0.013; Study 2: − 4.5 (95% CI − 7.3 to − 1.7), p = 0.002. Conclusions We found subtle but consistent differences between the two questionnaire versions. We recommend to use the optimized response option for the EORTC QLQ-C30 as well as for all other German modules. Trial registration: The study was retrospectively registered on the German Registry for Clinical Studies (reference number DRKS00012759, 04th August 2017, https://www.drks.de/DRKS00012759).

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Mid-Upper Arm Circumference as an Indicator of Quality of Life of Patients with Advanced Cancer

10.21203/rs.3.rs-1005909/v1 ◽

2021 ◽

Author(s):

Seon-Hye Won ◽

Yusuke Hiratsuka ◽

Sang-Yeon Suh ◽

Hayoung Bae ◽

Sung-Eun Choi ◽

...

Keyword(s):

Quality Of Life ◽

Health Status ◽

Advanced Cancer ◽

Summary Score ◽

Upper Arm ◽

Arm Circumference ◽

Eortc Qlq C30 ◽

Eortc Qlq ◽

Mid Upper Arm Circumference

Abstract Purpose Mid-upper arm circumference (MUAC) has been used to assess malnutrition and health status across various disease groups. However, it is unclear whether MUAC is associated with quality of life (QOL) of patients with advanced cancer. Our goal was to investigate the relationship between MUAC and QOL in ambulatory out-patients with advanced cancer. Method This was a cross-sectional study conducted in a tertiary cancer center in South Korea. A total of 200 patients with advanced cancer at oncology clinics of Seoul National University Bundang Hospital from March 2016 to January 2019 were enrolled. Out-patients with advanced cancer whose survival was expected to be less than one year by their oncologists were enrolled. QOL of patients was evaluated using the European Organization for Research and Treatment of Cancer quality of life questionnaire core 30 (EORTC QLQ-C30). Associations of QOL with MUAC and nutritional parameters were examined with generalized linear models. Results The most common cancer sites were the lung, colon or rectum, and genitourinary tract. In univariate analyses, significant factors associated with higher summary score of EORTC QLQ-C30 were higher MUAC (≥ 26.5 cm, p < 0.001), higher body mass index (BMI) (≥ 22 kg/m2, p < 0.001), higher serum albumin (≥ 3.7 g/dL, p = 0.004), higher creatinine (≥ 0.8 mg/dL, p = 0.023), and higher uric acid (≥ 5 mg/dL, p = 0.001). In multivariate analysis, higher serum albumin (≥ 3.7 g/dL, p < 0.01) and higher MUAC (≥ 26.5 cm, p = 0.03) were independently associated with better summary score of EORTC QLQ-C-30. Conclusion MUAC was highly associated with QOL in terms of summary score and overall health status. Thus, MUAC, with its simplicity, can be a useful tool to reflect QOL in patients with advanced cancer.

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Investigating the Response Scale of the Eortc Qlq-C30 in German Cancer Patients and a Population Survey – A Case of Quality Control in Patient-Reported Outcomes Research

10.21203/rs.3.rs-533959/v1 ◽

2021 ◽

Author(s):

Michael Koller ◽

Karolina Müller ◽

Sandra Nolte ◽

Heike Schmidt ◽

Christina Harvey ◽

...

Keyword(s):

Summary Score ◽

Life Questionnaire ◽

Response Scale ◽

European Organization ◽

Response Option ◽

Health Burden ◽

Patient Reported ◽

Symptom Ratings ◽

Eortc Qlq C30 ◽

Eortc Qlq

Abstract Background: The European Organization for research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) scales are scored on a 4-point response scale, ranging from not at all to very much. Previous studies have shown that the German translation of the response option quite a bit as mäßig violates interval scale assumptions, and that ziemlich is a more appropriate translation. The present studies investigated differences between the two questionnaire versions and were based on the hypothesis that the conventional version yielded lower functioning and higher symptom ratings than the optimized version, particularly in respondents with a higher health burden.Methods: The first study employed a balanced cross-over design and included 450 patients with different types of cancer from three German-speaking countries. The second study was a representative survey in Germany including 2033 respondents. Half of the participants filled in the mäßig, the other half the ziemlich version of the questionnaire.Results: In accordance with our hypothesis, the adjusted summary score was lower in the mäßig than in the ziemlich version; Study 1: -4.5 (95% CI -7.8 to -1.3), p = 0.006, Study 2: -3.1 (95% CI - 4.6 to -1.5), p < 0.001. In both studies, this effect was pronounced in respondents with a higher health burden; Study 1: -6.8 (95% CI -12.2 to -1.4), p = 0.013; Study 2: -4.5 (95% CI -7.3 to -1.7), p = 0.002.Conclusions: We found subtle but consistent differences between the two questionnaire versions. The optimized response option should be used for the EORTC QLQ-C30 as well as for all other German modules.Trial registration: The study was retrospectively registered on the German Registry for Clinical Studies (reference number DRKS00012759, 04th August 2017, https://www.drks.de/DRKS00012759).

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