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Validation of EQ-5D in patients with cervical cancer in Taiwan

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Abstract

Purpose

The survival rate of cervical cancer is increasing due to early diagnosis and timely treatment. As a result, the availability of a valid and reliable general HRQoL is important. The purpose of this study was to evaluate the psychometric properties of the EuroQol questionnaire (EQ-5D) in patients with cervical cancer in Taiwan.

Method

Outpatients with cervical cancer were recruited from three medical centers across Taiwan. Test–retest reliability and ceiling effect were evaluated. Construct validity including convergent and discriminate validities were examined using the EORTC QLQ C-30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire) and the clinical indicators of the functional performance assessment using the Karnofsky Performance Scale (KPS) and disease status.

Results

A total of 530 patients completed the questionnaire. The intraclass correlation coefficient for the EQ-5D index was 0.83, and the Cohen's kappa values for the EQ-5D dimensions ranged from 0.54 to 0.73. The EQ-5D index and VAS scores were higher for patients with a higher KPS score and disease-free status. The EQ-5D index was strongly correlated with all EORTC QLQ-C30 functioning scales.

Conclusion

The EQ-5D questionnaire is reliable and valid for the assessment of health-related quality of life in patients with cervical cancer in Taiwan.

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References

  1. Division of Statistics DOH (2005) Statistics of causes of death, health and vital statistical. In: Editor ED (ed) Book of statistics of causes of death, health and vital statistical. Department of Health, Executive Yuan, R.O.C. Taipei

    Google Scholar 

  2. Anttila A, Ronco G, Clifford G, Bray F, Hakama M, Arbyn M, Weiderpass E (2004) Cervical cancer screening programmes and policies in 18 European countries. Br J Cancer 91:935–941

    CAS  PubMed  Google Scholar 

  3. Hou SI, Fernandez ME, Baumler E, Parcel GS, Chen PH (2003) Correlates of cervical cancer screening among women in Taiwan. Health Care Women Int 24:384–398

    PubMed  Google Scholar 

  4. Liao CC, Wang HY, Lin RS, Hsieh CY, Sung FC (2006) Addressing Taiwan's high incidence of cervical cancer: factors associated with the Nation's low compliance with Papanicolaou screening in Taiwan. Public Health 120:1170–1176

    Article  PubMed  Google Scholar 

  5. Nayfield SG, Ganz PA, Moinpour CM, Cella DF, Hailey BJ (1992) Report from a National Cancer Institute (USA) workshop on quality of life assessment in cancer clinical trials. Qual Life Res 1:203–210

    Article  CAS  PubMed  Google Scholar 

  6. Osoba D (1992) The quality of life committee of the clinical trials group of the national cancer institute of Canada: organization and functions. Qual Life Res 1:211–218

    Article  CAS  PubMed  Google Scholar 

  7. Wiebe S, Guyatt G, Weaver B, Matijevic S, Sidwell C (2003) Comparative responsiveness of generic and specific quality-of-life instruments. J Clin Epidemiol 56:52–60

    Article  PubMed  Google Scholar 

  8. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European organization for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    Article  CAS  PubMed  Google Scholar 

  9. Gold MR, Patrick DL, Torrance DG (1996) Identifying and valuing outcomes. In: Gold MR (ed) Cost-effectiveness in health and medicine. Oxford University Press, New York, pp 82–134

    Google Scholar 

  10. Patrick DL, Deyo RA (1989) Generic and disease-specific measures in assessing health status and quality of life. Med Care 27:S217–S232

    Article  CAS  PubMed  Google Scholar 

  11. Rabin R, de Charro F (2001) EQ-5D: a measure of health status from the EuroQol Group. Ann Med 33:337–343

    Article  CAS  PubMed  Google Scholar 

  12. Badia X, Schiaffino A, Alonso J, Herdman M (1998) Using the EuroQoI 5-D in the Catalan general population: feasibility and construct validity. Qual Life Res 7:311–322

    Article  CAS  PubMed  Google Scholar 

  13. Kind P, Dolan P, Gudex C, Williams A (1998) Variations in population health status: results from a United Kingdom national questionnaire survey. BMJ 316:736–741

    CAS  PubMed  Google Scholar 

  14. Drummond M (2001) Introducing economic and quality of life measurements into clinical studies. Ann Med 33:344–349

    Article  CAS  PubMed  Google Scholar 

  15. Krabbe PF, Peerenboom L, Langenhoff BS, Ruers TJ (2004) Responsiveness of the generic EQ-5D summary measure compared to the disease-specific EORTC QLQ C-30. Qual Life Res 13:1247–1253

    Article  PubMed  Google Scholar 

  16. Anderson H, Palmer MK (1998) Measuring quality of life: impact of chemotherapy for advanced colorectal cancer. Experience from two recent large phase III trials. Br J Cancer 77(Suppl 2):9–14

    CAS  PubMed  Google Scholar 

  17. Essink-Bot ML, de Koning HJ, Nijs HG, Kirkels WJ, van der Maas PJ, Schroder FH (1998) Short-term effects of population-based screening for prostate cancer on health-related quality of life. J Natl Cancer Inst 90:925–931

    Article  CAS  PubMed  Google Scholar 

  18. Polsky D, Keating NL, Weeks JC, Schulman KA (2002) Patient choice of breast cancer treatment: impact on health state preferences. Med Care 40:1068–1079

    Article  PubMed  Google Scholar 

  19. Trippoli S, Vaiani M, Lucioni C, Messori A (2001) Quality of life and utility in patients with non-small cell lung cancer. Quality-of-life study group of the master 2 project in pharmacoeconomics. Pharmacoeconomics 19:855–863

    Article  CAS  PubMed  Google Scholar 

  20. van den Hout WB, van der Linden YM, Steenland E, Wiggenraad RG, Kievit J, de Haes H, Leer JW (2003) Single- versus multiple-fraction radiotherapy in patients with painful bone metastases: cost-utility analysis based on a randomized trial. J Natl Cancer Inst 95:222–229

    Article  PubMed  Google Scholar 

  21. Chen CJ, You SL, Lin LH, Hsu WL, Yang YW (2002) Cancer epidemiology and control in Taiwan: a brief review. Jpn J Clin Oncol 32(Suppl):S66–S81

    Article  PubMed  Google Scholar 

  22. Brooks R (1996) EuroQol: the current state of play. Health Policy 37:53–72

    Article  CAS  PubMed  Google Scholar 

  23. Essink-Bot ML, Stouthard ME, Bonsel GJ (1993) Generalizability of valuations on health states collected with the EuroQolc-questionnaire. Health Econ 2:237–246

    Article  CAS  PubMed  Google Scholar 

  24. Kind P (1996) The EuroQol instrument: an index of health-related quality of life. In: Spiker B (ed) Quality of life and pharmacoeconomics in clinical trials. Lippincott-Raven Publishers, Philadelphia, pp 191–201

    Google Scholar 

  25. Dolan P (1997) Modeling valuations for EuroQol health states. Med Care 35:1095–1108

    Article  CAS  PubMed  Google Scholar 

  26. Apolone G, Filiberti A, Cifani S, Ruggiata R, Mosconi P (1998) Evaluation of the EORTC QLQ-C30 questionnaire: a comparison with SF-36 Health Survey in a cohort of Italian long-survival cancer patients. Ann Oncol 9:549–557

    Article  CAS  PubMed  Google Scholar 

  27. Kaasa S, Bjordal K, Aaronson N, Moum T, Wist E, Hagen S, Kvikstad A (1995) The EORTC core quality of life questionnaire (QLQ-C30): validity and reliability when analysed with patients treated with palliative radiotherapy. Eur J Cancer 31A:2260–2263

    Article  CAS  PubMed  Google Scholar 

  28. Karnofsky DA, Burchenal JH (1950) Present status of clinical cancer chemotherapy. Am J Med 8:767–788

    Article  CAS  PubMed  Google Scholar 

  29. Buccheri G, Ferrigno D, Tamburini M (1996) Karnofsky and ECOG performance status scoring in lung cancer: a prospective, longitudinal study of 536 patients from a single institution. Eur J Cancer 32A:1135–1141

    Article  CAS  PubMed  Google Scholar 

  30. Mor V, Laliberte L, Morris JN, Wiemann M (1984) The Karnofsky performance status scale. An examination of its reliability and validity in a research setting. Cancer 53:2002–2007

    Article  CAS  PubMed  Google Scholar 

  31. Juniper EF, Gordon HG, Roman J (1996) How to develop and validate a new health-related quality of life instrument. In: Spiker B (ed) Quality of life and pharmacoeconomics in clinical trials. Lippincott-Raven Publishers, Philadelphia, pp 49–56

    Google Scholar 

  32. Brazier J, Jones N, Kind P (1993) Testing the validity of the Euroqol and comparing it with the SF-36 health survey questionnaire. Qual Life Res 2:169–180

    Article  CAS  PubMed  Google Scholar 

  33. Nunnally JC, Bernstein IH (1994) Psychometric theory. McGraw-Hill, NY

    Google Scholar 

  34. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  CAS  PubMed  Google Scholar 

  35. Savoia E, Fantini MP, Pandolfi PP, Dallolio L, Collina N (2006) Assessing the construct validity of the Italian version of the EQ-5D: preliminary results from a cross-sectional study in North Italy. Health Qual Life Outcomes 4:47

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was funded by grant no. NHRI-EX90-9007PC from the Taiwan National Health Research Institute. We are grateful to Dr. Nan Luo in Singapore for his earlier discussion on data analysis. We are most grateful to Dr. Ming-Siah Yen, Dr. Siao-Fong Huang, and Dr. Wan-Yi Jian at Taipei, Taichung and Kaohsiung Veterans General Hospitals for helping design the questionnaire and for referring patients. We sincerely thank the interviewers who collected data in the three research hospitals.

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Authors and Affiliations

  1. Institute of Hospital and Health Care Administration, National Yang-Ming University, No. 155 Li-Nong Street, Section 2, Taipei, 112, Taiwan

    Hui-Chu Lang

  2. Centre for Health Economics, University of York, York, UK

    Linghsiang Chuang

  3. Department of Nursing, National Taiwan University, Taipei, Taiwan

    Shiow-Ching Shun

  4. School of Occupational Therapy, National Taiwan University, Taipei, Taiwan

    Ching-Lin Hsieh

  5. Institute of Health and Welfare Policy, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Chung-Fu Lan

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  1. Hui-Chu Lang
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Correspondence to Hui-Chu Lang.

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Lang, HC., Chuang, L., Shun, SC. et al. Validation of EQ-5D in patients with cervical cancer in Taiwan. Support Care Cancer 18, 1279–1286 (2010). https://doi.org/10.1007/s00520-009-0745-9

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  • DOI: https://doi.org/10.1007/s00520-009-0745-9

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