Skip to main content
Log in

Clinical and psychometric validation of the quality of life assessment system for advanced gastric cancer based on traditional Chinese medicine

  • Original Article
  • Published:
Chinese Journal of Integrative Medicine Aims and scope Submit manuscript



To establish questionnaire scaling and reliability and examine the clinical and psychometric validity of the quality of life assessment based on Traditional Chinese Medicine for advanced gastric cancer (QLASTCM-Ga).


The QLASTCM-Ga was developed based on programmed decision procedures with multiple nominal and focus group discussions, in-depth interview, pretesting and quantitative statistical procedures. The questionnaire was administered to 240 patients diagnosed with advanced gastric cancer before and after treatment. Structured group methods were employed to establish a general and a specifific module respectively. The psychometric properties of the scale were evaluated with respect to validity, reliability and responsiveness.


The three identified scales of the QLASTCM-Ga and the total score demonstrated good psychometric properties. Test-retest reliability of the total scale and all domains ranged from 0.90 to 0.94, and internal consistency ranged from 0.86 to 0.93. Correlation and factor analysis demonstrated good construct validity. Signifificant difference in the subscales and the total score were found among groups differing in traditional Chinese medicine syndrome, supporting the clinical sensitivity of the QLASTCM-Ga. Statistically signifificant changes were found for each scale and the total score. Responsiveness was also good.


The QLASTCM-Ga demonstrates good psychometric and clinical validity to assess quality of life in patients with advanced gastric cancer undergoing traditional Chinese medicine therapy. This study is an important fifirst step for future research in this area.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. WHO. Are the number of cancer cases increasing or decreasing in the world? 2008: WHO Online Q&A.

    Google Scholar 

  2. Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics. Cancer J Clin 2011;61:212–236.

    Article  Google Scholar 

  3. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893–2917.

    Article  CAS  PubMed  Google Scholar 

  4. Zhao L, Shen ZX, Luo HS, Yu JP. Clinical investigation on coexisting of duodenal ulcer and gastric cancer in China. Int J Clin Pract 2005;59:1153–1156.

    Article  CAS  PubMed  Google Scholar 

  5. Garland SN, Pelletier G, Lawe A, Biagioni BJ, Easaw J, Eliasziw M, et al. Prospective evaluation of the reliability, validity, and minimally important difference of the functional assessment of cancer therapy-gastric (FACT-Ga) qualityof-life instrument. Cancer 2011;117:1302–1312.

    Article  PubMed  Google Scholar 

  6. Huang CC, Lien HH, Sung YC, Liu HT, Chie WC. Quality of life of patients with gastric cancer in Taiwan: validation and clinical application of the Taiwan Chinese version of the EORTC QLQ-C30 and EORTC QLQ-STO22. Psycho-Oncol 2007;16:945–949.

    Article  Google Scholar 

  7. Kobayashi D, Kodera Y, Fujiwara M, Koike M, Nakayama G, Nakao A. Assessment of quality of life after gastrectomy using EORTC QLQ-C30 and STO22. World J Surgery 2011;35:357–364.

    Article  Google Scholar 

  8. Blazeby J, Conroy T, Bottomley A, Vickery C, Arraras J, Sezer O, et al. Clinical and psychometric validation of a questionnaire module, the EORTC QLQ-STO 22, to assess quality of life in patients with gastric cancer. Eur J Cancer 2004;40:2260–2268.

    Article  CAS  PubMed  Google Scholar 

  9. Xu W, Towers AD, Li P, Collet JP. Traditional Chinese medicine in cancer care: perspectives and experiences of patients and professionals in China. Eur J Cancer Care 2006;15:397–403.

    Article  CAS  Google Scholar 

  10. Kuyken W, Orley J, Power M, Herrman H, Schofield H, Murphy B. The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med 1995;41:1403–1409.

    Article  Google Scholar 

  11. Patwardhan B, Warude D, Pushpangadan P, Bhatt N. Ayurveda and traditional Chinese medicine: a comparative overview. Evid-based Complem Alternat Med 2005;2:465–474.

    Article  Google Scholar 

  12. Haynes SN, Richard DCS, Kubany ES. Content validity in psychological assessment: a functional approach to concepts and methods. Psychol Assess 1995;7:238–247.

    Article  Google Scholar 

  13. Ullman JB, Bentler PM, eds. Structural equation modeling. Handbook of psychology. John Wiley & Sons, Inc. 2003.

    Google Scholar 

  14. Henson RK. Understanding internal consistency reliability estimates: A conceptual primer on coefficient alpha. Measure Evaluat Counsel Devel 2001;34:177–189.

    Google Scholar 

  15. Bland JM, Altman DG. Statistics notes: Cronbach’s alpha. BMJ 1997;314:572.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Husted JA, Cook RJ, Farewell VT, Gladman DD. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol 2000;53:459–468.

    Article  CAS  PubMed  Google Scholar 

  17. Fayers PM, Aaronson NK, Bjordal K, Grønvold M, Curran D, Bottomley A. EORTC QLQ-C30 scoring manual. European Organization for Research and Treatment of Cancer Brussels. 2001.

    Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Chong-hua Wan  (万崇华).

Additional information

Supported by the National Basic Research Program of China (No. 2006CB504604), the Key Discipline and Science & Technology Innovation Fund of Guangdong Medical College (No. STIF201119), the Natural Science Foundation of Guangdong Province (No. S2012040006254), and the Research Fund of Guangdong Medical College, China (No. B2011028)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Quan, P., Zheng, Py., You, Sf. et al. Clinical and psychometric validation of the quality of life assessment system for advanced gastric cancer based on traditional Chinese medicine. Chin. J. Integr. Med. 22, 581–588 (2016).

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: