Advertisement

Quality of Life Research

, Volume 8, Issue 1–2, pp 25–43 | Cite as

Assessing the consistency of psychometric properties of the HRQoL scales within the EORTC QLQ-C30 across populations by means of the Mokken Scaling Model

  • K. Ringdal
  • G. I. Ringdal
  • S. Kaasa
  • K. Bjordal
  • F. Wisløff
  • S. Sundstrøm
  • M. J. Hjermstad
Article

Abstract

This paper demonstrates how the Mokken Scaling Model and other statistical tools may be useful in assessing the consistency of psychometric properties of health-related quality of life (HRQoL) scales across various populations. The main focus is the psychometric performance of the scales proposed for the EORTC QLQ-C30 in seven patient groups totalling more than 2,000 cancer patients. All scales performed satisfactorily in the total sample with the exception of the role functioning and cognitive functioning scales, which failed in terms of reliability and item discriminant validity. The descriptive statistics for the scales show that several of them, particularly those that build upon only two items, have discrimination problems at the extremes, visible in the high percentages at the maximum or the minimum observed values. The scalability analysis in the subsamples showed that the essential assumption in the Mokken Scaling Model of equal item step order does not hold for the cognitive functioning, emotional functioning and physical functioning scales. We conclude that the Mokken Scaling Model is well suited to the purpose of examining the generalizability of HRQoL scales across subpopulations although a global statistical test of the fit of the measurement model is not available.

Mokken Scaling Model psychometric properties in subpopulations HRQoL quality of life EORTC QLQ-C30. 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Sijtsma K, Debets P, Molenaar IW. Mokken scale analysis for polychotomous items: theory, a computer program and an empirical application. Quality and Quantity 1990; 24:173–188.Google Scholar
  2. 2.
    Aaronson NK, Ahmedzai S, Bullinger M et al. The EORTC core quality-of-life questionnaire: interim results of an international field study. In: Osoba D, ed. Effects of Cancer on Quality of Life. London: CRC Press, 1991: 185–204.Google Scholar
  3. 3.
    Aaronson NK, Bullinger M, Ahmedzai S. A modular approach to quality of life assessment in cancer clinical trials. Rec Res Cancer Res 1988; 3: 231–249.Google Scholar
  4. 4.
    Aaronson NK, Ahmedzai S, Bergman B et al. 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 1993; 85: 365–376.Google Scholar
  5. 5.
    Osoba D, Aaronson N, Zee B, Sprangers M, te Velde A. Modification of the EORTC QLQ-C30 (version 2.0) based on content validity and reliability testing in large samples of patients with cancer. Qual Life Res 1997; 6: 103–108.Google Scholar
  6. 6.
    Bjordal K, Tollesson E, Ahlner-Elmqvist M et al. Development of a European Organization for Research and Treatment of Cancer (EORTC) Questionnaire Module to be used in Quality of Life assessments in head and neck cancer patients. Acta Oncol 1994; 33(8):879–885. K.Ringdal et al. 42 Quality of Life Research.Vol 8.1999 Google Scholar
  7. 7.
    Sigurdardóttir V, Bolund C, Brandberg Y, Sullivan M. The impact of generalized malignant melanoma on quality of life evaluated by the EORTC questionnaire technique. Qual Life Res 1993; 2: 193–203.Google Scholar
  8. 8.
    Sprangers MAG, Cull A, Bjordal K, Groenvold M, Aaronson NK. The European Organization for Research and Treatment of Cancer approach to quality of life assessment: guidelines for developing questionnaire modules. Qual Life Res 1993; 2: 287–295.Google Scholar
  9. 9.
    Spranger M, Groenvold M, Arrattas J et al. The international construction and testing of the EORTC breastcancer specific questionnaire module. Qual Life Res 1995; 4: 487–488.Google Scholar
  10. 10.
    Blazeby JM, Winstone K, Williams MH et al. Development of an oesophageal cancer specific module for use with the EORTC quality of life questionnaire (EORTC QLQ-C30). Qual Life Res 1995; 4: 399–400.Google Scholar
  11. 11.
    Biermann W, Schulze H, Kuchler Th. Quality of life in urological cancer: data to develop EORTC-specific tumor modules. Qual Life Res 1995;4: 399.Google Scholar
  12. 12.
    Osoba D, Zee B, Pater J, Warr D, Kaizer L, Latrelle J. Psychometric properties and responsiveness of the EORTC Quality of Life Questionnaire (QLQ-C30) in patients with breast, ovarian and lung cancer. Qual Life Res 1994; 3: 353–364.Google Scholar
  13. 13.
    Bjordal K, Kaasa S. Psychometric validation of the EORTC core quality of life questionnaire, 30-item version and a diagnosis-specific module for head and neck cancer patients. Acta Oncol 1992; 31:311–321.Google Scholar
  14. 14.
    Kaasa S, Bjordal K, Aaronson N et al. The EORTC Core Quality of Life Questionnaire (QLQ-C30): validity and reliability when analysed with patients with palliative radiotherapy. Eur J Cancer 1995; 31A: 2260–2263.Google Scholar
  15. 15.
    Wisløff F, Eika S, Hippe E et al. Measurement of healthrelated quality of life in multiple myeloma. Br J Haematol 1996; 92: 604–613.Google Scholar
  16. 16.
    Hjermstad MJ, Fossa SD, Bjordal K, Kaasa Stein. Test/Retest study of the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire. J Clin Oncol1995; 13: 1249–1254.Google Scholar
  17. 17.
    Ringdal GI, Ringdal K. Testing the EORTC quality of life questionnaire on cancer patients with heterogeneous diagnoses. Qual Life Res 1993; 2: 129–140.Google Scholar
  18. 18.
    Niezgoda HE, Pater JL. A validation study of the domains of the core EORTC quality of life questionnaire. Qual Life Res 1993; 2 (5): 319–25.Google Scholar
  19. 19.
    Fayers P, Aaronson N, Bjordal K, Sullivan M. EORTC QLQ-C30 Scoring Manual. Brusssels: EORTC Study Group on Quality of Life, 1995.Google Scholar
  20. 20.
    Ringdal GI, Ringdal K, Kvinnsland S, Götestam KG. Quality of life of cancer patients with different prognoses. Qual Life Res 1994; 3: 143–154.Google Scholar
  21. 21.
    Hambleton RK, Swaminathan H, Rogers HJ, MMSS.Fundamentals of Item Response Theory. London: Sage, 1991.Google Scholar
  22. 22.
    Molenaar IW, Debets P, Sijtsma K, Hemker BT. MSP User's Manual.A Program for Mokken Scale Analysis for Polychotomous Items.Version 3.0. Groningen, The Netherlands: iec ProGAMMA, 1994.Google Scholar
  23. 23.
    Nunnally JC. Psychometric Theory, 2nd edn. New York: McGraw-Hill, 1978.Google Scholar
  24. 24.
    Bollen KA. Structural Equations with Latent Variables. New York: Wiley, 1989.Google Scholar
  25. 25.
    Norusis MJ. SPSS for Windows.Advanced Statistics.Release 6.0. Chicago: SPSS Inc., 1993.Google Scholar
  26. 26.
    Hays RD, Hayashi T, Carson S, Ware J. User's Guide for Multitrait Analysis Program (MAP).A Rand Note. RAND, 1988.Google Scholar
  27. 27.
    Bjordal K, Kaasa S, Mastekaasa A. Quality of Life in patients treated for head and neck cancer: a follow-up study 7 to 11 years after radiotherapy. Int.J.Radiation Oncology Biol Phys 1994; 28(4):847–856.Google Scholar
  28. 28.
    Bjordal K, Freng A, Thorvik J, Kaasa S. Patient selfreported and clinician-rated quality of life in head and neck cancer patients: a cross-sectional study. Oral Oncol, Eur J of Cancer 1995 31B(4):235–241.Google Scholar
  29. 29.
    Jöreskog KG, Sörbom D. LISREL 8 User's Reference Guide. Chicago, Ill.: Scientific Software, 1993.Google Scholar

Copyright information

© Chapman and Hall 1999

Authors and Affiliations

  • K. Ringdal
    • 1
  • G. I. Ringdal
    • 2
  • S. Kaasa
    • 3
  • K. Bjordal
    • 4
  • F. Wisløff
    • 1
  • S. Sundstrøm
    • 4
  • M. J. Hjermstad
    • 5
    • 6
  1. 1.Departments of Sociology and Political ScienceNorwegian University of Science and TechnologyDragvollNorway
  2. 2.Department of PsychologyNorwegian University of Science and TechnologyDragvollNorway
  3. 3.Palliative Medicine Unit and Unit for Epidemiology and Clinical Research, Faculty of MedicineNorwegian University of Science and Technology, Trondheim University HospitalTrondheimNorway
  4. 4.Department of Medical Oncology and RadiotherapyNorwegian Radium HospitalOsloNorway
  5. 5.Department of HematologyUllevål HospitalOsloNorway
  6. 6.Norwegian Radium Hospital and Norwegian Cancer SocietyOsloNorway

Personalised recommendations