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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

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Abstract

Background

The aim of this study was to determine the smallest changes in health-related quality of life (HRQOL) scores in a subset of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire core 30 (EORTC QLQ-C30) scales, which could be considered as clinically meaningful in patients with non-small-cell lung cancer (NSCLC).

Methods

WHO performance status (PS) and weight change were used as clinical anchors to determine minimal important differences (MIDs) in HRQOL change scores (range, 0–100) in the EORTC QLQ-C30 scales. Selected distribution-based methods were used for comparison.

Findings

In a pooled dataset of 812 NSCLC patients undergoing treatment, the values determined to represent the MID depended on whether patients were improving or deteriorating. MID estimates for improvement (based on a one-category change in PS, 5 − <20% weight gain) were physical functioning (9, 5); role functioning (14, 7); social functioning (5, 7); global health status (9, 4); fatigue (14, 5); and pain (16, 2). The respective MID estimates for deterioration (based on PS, weight loss) were physical (4, 6); role (5, 5); social (7, 9); global health status (4, 4); fatigue (6, 11); and pain (3, 7).

Interpretation

Based on the selected QLQ-C30 scales, the MID may depend upon whether the patients’ PS is improving or worsening, but our results are not definitive. The MID estimates for the specified scales can help clinicians and researchers evaluate the significance of changes in HRQOL and assess the value of a health care intervention or compare treatments. The estimates also can be useful in determining sample sizes in the design of future clinical trials.

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Acknowledgements

This study was funded by an unrestricted academic grant from the Pfizer Foundation. We thank the EORTC clinical Lung Group and their clinical investigators and all the patients who participated in these trials.

Conflict of interest statement

The authors indicated no potential conflicts of interest.

Author information

Authors and Affiliations

  1. Quality of Life Department, EORTC, Brussels, Belgium

    John T. Maringwa, Chantal Quinten, Corneel Coens, Francesca Martinelli, Jurgen Vercauteren & Andrew Bottomley

  2. Psycho-oncology Co-operative Research Group, University of Sydney, Sydney, Australia

    Madeleine King

  3. The Princess Margaret Hospital, University of Toronto, Toronto, Canada

    Jolie Ringash

  4. Quality of Life Consulting, West Vancouver, Vancouver, Canada

    David Osoba

  5. Department of Symptom Research, University of Texas, Houston, TX, USA

    Charles S. Cleeland

  6. Child and Adolescent Psychiatry and Psychotherapy, University of Magdeburg, Magdeburg, Germany

    Henning Flechtner

  7. School of Population and Public Health, University of British Columbia, Vancouver, Canada

    Carolyn Gotay

  8. Obstetrics and Gynecology, Medical University Graz, Graz, Austria

    Eva Greimel

  9. VU Medical Center, Amsterdam, Netherlands

    Martin J. Taphoorn

  10. Division of Cancer Control and Population Science, National Cancer Institute, Bethesda, USA

    Bryce B. Reeve

  11. Medical Ethics, University of Regensburg, Regensburg, Germany

    Joseph Schmucker-Von Koch

  12. Tumor Biology Center, University Freiburg, Freiburg, Germany

    Joachim Weis

  13. Department of Pulmonary Diseases, Vrije Universiteit VUMC, Amsterdam, Netherlands

    Egbert F. Smit

  14. Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium

    Jan P. van Meerbeeck

  15. Medical Center Haaglanden, The Hague, Netherlands

    Martin J. Taphoorn

Authors
  1. John T. Maringwa
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  2. Chantal Quinten
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  3. Madeleine King
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  4. Jolie Ringash
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  7. Francesca Martinelli
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  8. Jurgen Vercauteren
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  9. Charles S. Cleeland
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  11. Carolyn Gotay
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  12. Eva Greimel
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  15. Joseph Schmucker-Von Koch
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  16. Joachim Weis
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  17. Egbert F. Smit
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  18. Jan P. van Meerbeeck
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  19. Andrew Bottomley
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on behalf of the EORTC PROBE project and the Lung Cancer Group

Corresponding author

Correspondence to John T. Maringwa.

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Maringwa, J.T., Quinten, C., King, M. et al. 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. Support Care Cancer 19, 1753–1760 (2011). https://doi.org/10.1007/s00520-010-1016-5

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  • DOI: https://doi.org/10.1007/s00520-010-1016-5

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