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Consistency matters: measurement invariance of the EORTC QLQ-C30 questionnaire in patients with hematologic malignancies

Quality of Life Research volume 29, pages 815–823 (2020)Cite this article

Abstract

Purpose

To ensure that observed differences in the scores of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) reflect actual differences in health-related quality of life (HRQoL) rather than measurement bias, measurement invariance needs to be established. We investigated the assumption of measurement invariance of the EORTC QLQ-C30 in patients with hematological malignancies across age, sex, comorbidity, disease type, and time.

Methods

We used a large database of patients with hematological malignancies, which included HRQoL data collected with the EORTC QLQ-C30. We used the structural equation modeling approach to test for measurement (metric and scalar) invariance across groups (age, sex, comorbidity, disease) and time (baseline, 1 month and 2 month follow-up). Longitudinal invariance was examined in a subgroup of patients diagnosed with myelodysplastic syndromes.

Results

Confirmatory factor analyses demonstrated full measurement invariance for age and comorbidity and over time, while support for partial scalar invariance was obtained for sex and disease. Violations of invariance for sex were observed for items of the physical functioning scale and the emotional functioning scale, while for disease type, violations of invariance were observed for items of the physical functioning scale, emotional functioning scale, and the cognitive functioning scale.

Conclusions

Our findings support measurement invariance of the EORTC QLQ-C30 in a large sample of patients with hematological malignancies. The results showed that the number of non-invariant items was negligible, suggesting that this questionnaire is a valid and robust measurement tool in patients with hematological malignancies, also for comparisons across groups and time.

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Author information

Affiliations

  1. Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA), Rome, Italy

    Kathrin Sommer, Francesco Cottone, Paola Fazi, Marco Vignetti & Fabio Efficace

  2. Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Neil K. Aaronson

  3. Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK

    Peter Fayers

  4. European Palliative Care Research Centre (PRC), Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Peter Fayers

  5. Institute of Hematology “L. and A. Seràgnoli”, Department of Experimental, Diagnostic and Specialty Medicine, “S. Orsola-Malpighi” University Hospital, University of Bologna, Bologna, Italy

    Gianantonio Rosti & Michele Baccarani

  6. Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

    Emanuele Angelucci

  7. Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy

    Gianluca Gaidano

  8. Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy

    Adriano Venditti & Maria Teresa Voso

Authors
  1. Kathrin Sommer
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  2. Francesco Cottone
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Correspondence to Kathrin Sommer.

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Appendix

Appendix

See Table  5.

Table 5 Clinical characteristics of patient populations included in the multi-group CFA
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Sommer, K., Cottone, F., Aaronson, N.K. et al. Consistency matters: measurement invariance of the EORTC QLQ-C30 questionnaire in patients with hematologic malignancies. Qual Life Res 29, 815–823 (2020). https://doi.org/10.1007/s11136-019-02369-5

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Keywords

  • Health-related quality of life
  • EORTC QLQ-C30
  • Measurement invariance
  • Hematological malignancies
  • Structural equation modeling
  • Confirmatory factor analysis