Quality of Life Research

, Volume 20, Issue 4, pp 479–490 | Cite as

Development of computerized adaptive testing (CAT) for the EORTC QLQ-C30 physical functioning dimension

  • Morten Aa. PetersenEmail author
  • Mogens Groenvold
  • Neil K. Aaronson
  • Wei-Chu Chie
  • Thierry Conroy
  • Anna Costantini
  • Peter Fayers
  • Jorunn Helbostad
  • Bernhard Holzner
  • Stein Kaasa
  • Susanne Singer
  • Galina Velikova
  • Teresa Young



Computerized adaptive test (CAT) methods, based on item response theory (IRT), enable a patient-reported outcome instrument to be adapted to the individual patient while maintaining direct comparability of scores. The EORTC Quality of Life Group is developing a CAT version of the widely used EORTC QLQ-C30. We present the development and psychometric validation of the item pool for the first of the scales, physical functioning (PF).


Initial developments (including literature search and patient and expert evaluations) resulted in 56 candidate items. Responses to these items were collected from 1,176 patients with cancer from Denmark, France, Germany, Italy, Taiwan, and the United Kingdom. The items were evaluated with regard to psychometric properties.


Evaluations showed that 31 of the items could be included in a unidimensional IRT model with acceptable fit and good content coverage, although the pool may lack items at the upper extreme (good PF). There were several findings of significant differential item functioning (DIF). However, the DIF findings appeared to have little impact on the PF estimation.


We have established an item pool for CAT measurement of PF and believe that this CAT instrument will clearly improve the EORTC measurement of PF.


Computerized adaptive test EORTC QLQ-C30 Item banking Item response theory Physical functioning Quality of life 



The study was funded by grants from the EORTC Quality of Life Group. National Taiwan University, grant National Science Council, Taiwan, No. 95-2314-B-002-266-MY2, 97-2314-B-002-020-MY3.


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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Morten Aa. Petersen
    • 1
    Email author
  • Mogens Groenvold
    • 1
    • 2
  • Neil K. Aaronson
    • 3
  • Wei-Chu Chie
    • 4
  • Thierry Conroy
    • 5
  • Anna Costantini
    • 6
  • Peter Fayers
    • 7
    • 8
  • Jorunn Helbostad
    • 9
  • Bernhard Holzner
    • 10
  • Stein Kaasa
    • 11
  • Susanne Singer
    • 12
  • Galina Velikova
    • 13
  • Teresa Young
    • 14
  1. 1.The Research Unit, Department of Palliative MedicineBispebjerg HospitalCopenhagen NVDenmark
  2. 2.Institute of Public HealthUniversity of CopenhagenCopenhagenDenmark
  3. 3.Division of Psychosocial Research and EpidemiologyThe Netherlands Cancer InstituteAmsterdamThe Netherlands
  4. 4.Graduate Institute of Preventive Medicine and Department of Public Health, College of Public HealthNational Taiwan UniversityTaipeiTaiwan
  5. 5.Medical Oncology DepartmentCentre Alexis VautrinVandoeuvre-lès-NancyFrance
  6. 6.Psychoncology Unit, Sant’Andrea Hospital, 2nd Faculty of MedicineSapienza University of RomeRomeItaly
  7. 7.Department of Public HealthUniversity of AberdeenAberdeenUK
  8. 8.Department of Cancer Research and Molecular MedicineNorwegian University of Science and TechnologyTrondheimNorway
  9. 9.Department of NeuroscienceNorwegian University of Science and Technology and St. Olav University HospitalTrondheimNorway
  10. 10.Department of Psychiatry and PsychotherapyMedical University InnsbruckInnsbruckAustria
  11. 11.Palliative Medicine UnitUniversity Hospital of TrondheimTrondheimNorway
  12. 12.Department Medical Psychology and Medical SociologyUniversity of LeipzigLeipzigGermany
  13. 13.Cancer Research UK CentreUniversity of LeedsLeedsUK
  14. 14.Lynda Jackson Macmillan CentreMount Vernon Cancer CentreNorthwoodUK

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