Testing the measurement equivalence of paper and interactive voice response system versions of the EORTC QLQ-C30
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The objective of this study was to evaluate the measurement equivalence of an interactive voice response system (IVRS) version and the original paper-based version of the EORTC QLQ-C30.
The QLQ-C30 is a cancer-specific, health-related quality of life questionnaire consisting of nine multi-item scales (physical, role, emotional, cognitive and social functioning, fatigue, nausea/vomiting, pain, and quality of life) and six single item measures (dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial problems). This study utilized a crossover design with subjects randomly assigned to one of two assessment orders: (1) paper then IVRS or (2) IVRS then paper. Equivalence between the two administration modes was established by comparing the 95 % lower confidence interval (CI) of the intraclass correlation coefficients (ICCs) for each scale, with a critical value of 0.70.
The ICCs for the nine multi-item scales were all above 0.79, ranging from 0.791 to 0.899 (ICC 95 % lower CI range 0.726–0.865) and significantly different from our threshold reliability of 0.70. The ICCs for the six single items ranged from 0.689 to 0.896 (ICC 95 % lower CI range 0.611–0.888). Two of the items, insomnia and appetite loss, were not statistically different from 0.70. When considered together, the per-protocol analysis results support the equivalence of the paper and IVRS versions of the QLQ-C30 for 13 of the 15 scores.
This analysis provides evidence that the scores obtained from the IVRS version of the QLQ-C30 are equivalent to those obtained with the original paper version except for the insomnia and appetite loss items.
KeywordsPatient-reported outcomes EORTC QLQ-C30 Interactive voice response Measurement equivalence
The data used for this research were collected as part of a study funded by ClinPhone Plc (now Perceptive Informatics). Additional support was provided by the University of Arizona Cancer Center Support Grant CA023074 from the National Cancer Institute. The authors gratefully acknowledge the staff and facility support provided by the University of Arizona College of Pharmacy and the University of Arizona Cancer Center’s Behavioral Measurements Shared Service. JJL and SJC were employed by the University of Arizona at the time this study was conducted. The authors have no financial interest in Perceptive Informatics or ClinPhone PLC.
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