Identifying changes in scores on the EORTC-QLQ-C30 representing a change in patients’ supportive care needs
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Using health-related quality-of-life measures for patient management requires knowing what changes in scores require clinical attention. We estimated changes on the European Organization for Research and Treatment of Cancer Quality-of-Life-Questionnaire-Core-30 (EORTC-QLQ-C30), representing important changes by comparing to patient-reported changes in supportive care needs.
This secondary analysis used data from 193 newly diagnosed cancer patients (63 % breast, 37 % colorectal; mean age 60 years; 20 % male) from 28 Canadian surgical practices. Participants completed the Supportive Care Needs Survey-Short Form-34 (SCNS-SF34) and EORTC-QLQ-C30 at baseline, 3, and 8 weeks. We calculated mean changes in EORTC-QLQ-C30 scores associated with improvement, worsening, and no change in supportive care needs based on the SCNS-SF34. Mean changes in the EORTC-QLQ-C30 scores associated with the SCNS-SF34 improved and worsened categories were used to estimate clinically important changes, and the ‘no change’ category to estimate insignificant changes.
EORTC-QLQ-C30 score changes ranged from 6 to 32 points for patients reporting improved supportive care needs; statistically significant changes were 10–32 points. EORTC-QLQ-C30 score changes ranged from 21-point worsening to 21-point improvement for patients reporting worsening supportive care needs; statistically significant changes were 9–21 points in the hypothesized direction and a 21-point statistically significant change in the opposite direction. EORTC-QLQ-C30 score changes ranged from a 1-point worsening to 16-point improvement for patients reporting stable supportive care needs.
These data suggest 10-point EORTC-QLQ-C30 score changes represent changes in supportive care needs. When using the EORTC-QLQ-C30 in clinical practice, scores changing ≥10 points should be highlighted for clinical attention.
KeywordsEORTC-QLQ-C30 Supportive care needs Patient-reported outcomes Clinical practice Cancer Clinically important differences
Area under the curve
European Organization for the Research and Treatment of Cancer Quality-of-Life-Questionnaire-Core-30
Generalized estimating equation
Health-related quality of life
Minimal important difference
Randomized controlled trial
Receiver operating characteristic
Supportive Care Needs Survey-Short Form-34
This analysis was funded by the American Cancer Society (# MRSG-08-011-01-CPPB). The original data collection was supported by the Canadian Health Services Research Foundation, Ontario Ministry of Health and Long-term Care. Dr Snyder and Dr Carducci are members of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins (P30 CA 006973).
Conflict of interest
The authors report no conflict of interest.
- 10.McLachlan, S.-A., Allenby, A., Matthews, J., et al. (2001). Randomized trial of coordinated psychosocial interventions based on patient self-assessments versus standard care to improve the psychosocial functioning of patients with cancer. Journal of Clinical Oncology, 19, 4117–4125.PubMedGoogle Scholar
- 13.Jensen, R. E., Snyder, C. F., Abernethy, A. P., et al. (2013). A review of electronic patient reported outcomes systems used in cancer clinical care. Journal of Oncology Practice, 10, e215–e222.Google Scholar
- 14.Brundage, M. D., Bantug, E. T., Little, E. A., Smith, K. A., Snyder, C. F., PRO data presentation stakeholder advisory board. (2014). Which formats for communicating patient-reported outcomes (PROs) work best? Journal of Clinical Oncology, 32, 5s (suppl; abstr 6616).Google Scholar
- 15.Snyder, C. F., Blackford, A. L., Brahmer, J. R., et al. (2010). Needs assessments can identify scores on HRQOL questionnaires that represent problems for patients: an illustration with the Supportive Care Needs Survey and the QLQ-C30. Quality of Life Research, 19, 837–845.CrossRefPubMedGoogle Scholar
- 18.Sussman, J., Howell, D., Bainbridge, D., et al. (2012). Results of a cluster randomized trial to evaluate a nursing lead supportive care intervention in newly diagnosed breast and colorectal cancer patients. Journal of Clinical Oncology, 30 (suppl), Abstract 6035.Google Scholar
- 20.Lipscomb, J., Gotay, C. C., & Snyder, C. (Eds.). (2005). Outcomes assessment in cancer: Measures, methods, and applications. Cambridge: Cambridge University Press.Google Scholar
- 24.National Cancer Institute. Grid-Enabled Measures Database: Supportive Care Needs Survey-Short Form (SCNS-SF34). https://www.gem-beta.org/Public/MeasureDetail.aspx?mid=1592&cat=2.
- 26.International Society for Quality of Life Research. User’s Guide to Implementing Patient‐Reported Outcomes Assessment in Clinical Practice, Version: November 11, 2011. http://www.isoqol.org/research/isoqol-publications.
- 30.Maringwa, J. T., Quinten, C., King, M., et al. (2011). Minimal important differences for interpreting health-related quality of life scores from the EORTC QLQ-C30 in lung cancer patients participating in randomized controlled trials. Supportive Care in Cancer, 19, 1753–1760.CrossRefPubMedGoogle Scholar