The EORTC QLQ-C15-PAL questionnaire: validation study for Spanish bone metastases patients
Quality of life (QL) is a key outcome for advanced disease cancer patients. The European Organization for Research and Treatment of Cancer (EORTC) has developed the QLQ-C15-PAL questionnaire, a short version of the QLQ-C30 for palliative care. The aim of the present study is to validate the QLQ-C15-PAL for use with Spanish patients with bone metastasis.
For this study, we used a consecutive sample of stage IV cancer patients with bone metastases who started radiotherapy with palliative intention. Two assessments were proposed for each patient: one on the first day of treatment and one a month after the end of the radiotherapy sessions. Psychometric evaluation of the structure, reliability, and validity was undertaken.
One hundred and sixteen patients completed the first questionnaire and seventy five completed the second. Multitrait scaling analysis showed that all items met the standards for convergent validity, and all except the fatigue scale met the standards for divergent validity. Cronbach’s coefficient met the 0.7 alpha criterion on all scales except pain (second assessment). Most QLQ-C15-PAL areas had low-to-moderate correlations with the other areas. Significant differences appeared in the comparisons between groups with regard to: patients who died before the second assessment (six areas); patients receiving chemotherapy before starting radiotherapy in the two assessments (three and four areas, respectively); the performance status in the two assessments (nine and eight areas); and the number of RT sessions received (four). Quality of life was better in the second assessment in nine areas.
The QLQ-C15-PAL is a reliable and valid instrument when applied to a sample of Spanish patients. These results are in line with those of other validation studies.
KeywordsEORTC Quality of life Cancer Advanced disease Questionnaire Validation
This study was supported by the Departamento de Salud del Gobierno de Navarra, Spain. We would like to thank Morten Petersen for his advice in the analyses.
- 1.Caissie, A., Zeng, L., Nguyen, J., Zhang, L., Jon, F., Dennis, K., et al. (2012). Assessment of health-related quality of life with the European Organization for Research and Treatment of Cancer QLQ-C15-PAL after palliative radiotherapy of bone metastases. Clinical Oncology (Royal College of Radiologists), 24(2), 125–133.CrossRefGoogle Scholar
- 5.Lien, K., Zeng, L., Nguyen, J., Cramarossa, G., Culleton, S., Caissie, A., et al. (2011). Comparison of the EORTC QLQ-C15-PAL and the FACIT-Pal for assessment of quality of life in patients with advanced cancer. Expert Review of Pharmacoeconomics and Outcomes Research, 11(5), 541–547.PubMedCrossRefGoogle Scholar
- 6.Miyazaki, K., Suzukamo, Y., Shimozuma, K., & Nakayama, T. (2012). Verification of the psychometric properties of the Japanese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 palliative (EORTC QLQ-C15-PAL). Quality of Life Research, 21(2), 335–340.PubMedCrossRefGoogle Scholar
- 8.Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., 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. Journal of National Cancer Institute, 85(5), 365–376.CrossRefGoogle Scholar
- 12.Taphoorn, M. J., Claassens, L., Aaronson, N. K., Coens, C., Mauer, M., Osoba, D., et al. (2010). An international validation study of the EORTC brain cancer module (EORTC QLQ-BN20) for assessing health-related quality of life and symptoms in brain cancer patients. European Journal of Cancer, 46(6), 1033–1040.PubMedCrossRefGoogle Scholar
- 13.Vivat, B., Young, T., Efficace, F., Sigurdadóttir, V., Arraras, J. I., Asgeirsdóttir, G. H., et al. (2013). Cross-cultural development of the EORTC QLQ-SWB36: A stand-alone measure of spiritual wellbeing for palliative care patients with cancer. Palliative Medicine, 27(5), 457–469.PubMedCrossRefGoogle Scholar
- 14.Cull, A., Sprangers, M., Bjordal, K., Aaronson, N. K., & West, K. (2002). EORTC quality of life group translation procedure (2nd ed.). Brussels: EORTC.Google Scholar
- 15.Karnofsky, D. A., & Burchenal, J. H. (1948). The clinical evaluation of chemotherapeutic agents in cancer. In C. M. McLeod (Ed.), Evaluation of chemotherapeutic agents (pp. 199–205). New York: Colombia University.Google Scholar
- 16.Tabachnik, B. J., & Fidell, L. S. (1993). Using multivariate statistics. London: Harper & Row.Google Scholar
- 17.Ware, J. E., Harris, W. J., Gandek, B., Rogers, B. W., & Reese, P. R. (1997). MAP-R for windows: Multitrait multi-item analysis program—revised user’s guide. Boston: Health Assessment Lab.Google Scholar
- 23.Middel, B., & Van Sonderen, E. (2002). Statistical significant change versus relevant or important change in (quasi) experimental design: some conceptual and methodological problems in estimating magnitude of intervention-related change in health services research. International Journal of Integrated Care, 2(17), 1–18.Google Scholar
- 27.Suárez-del-Real, Y., Allende-Pérez, S., Alférez-Mancera, A., Rodríguez, R. B., Jiménez-Toxtle, S., Mohar, A., et al. (2001). Validation of the Mexican-Spanish version of the EORTC QLQ-C15-PAL questionnaire for the evaluation of health-related quality of life in patients on palliative care. Psychooncology, 20(8), 889–896.CrossRefGoogle Scholar
- 30.Steinmann, D., Paelecke-Habermann, Y., Geinitz, H., Aschoff, R., Bayerl, A., Bölling, T., et al. (2012). Prospective evaluation of quality of life effects in patients undergoing palliative radiotherapy for brain metastases. BioMed Central Cancer, 10(12), 283.Google Scholar