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The English and Chinese versions of the five-level EuroQoL Group's five-dimension questionnaire (EQ-5D) were valid and reliable and provided comparable scores in Asian breast cancer patients

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Abstract

Objective

To examine the measurement properties of and comparability between the English and Chinese versions of the five-level EuroQoL Group’s five-dimension questionnaire (EQ-5D) in breast cancer patients in Singapore.

Methods

This is an observational study of 269 patients. Known-group validity and responsiveness of the EQ-5D utility index and visual analog scale (VAS) were assessed in relation to various clinical characteristics and longitudinal change in performance status, respectively. Convergent and divergent validity was examined by correlation coefficients between the EQ-5D and a breast cancer-specific instrument. Test–retest reliability was evaluated. The two language versions were compared by multiple regression analyses.

Results

For both English and Chinese versions, the EQ-5D utility index and VAS demonstrated known-group validity and convergent and divergent validity, and presented sufficient test–retest reliability (intraclass correlation = 0.72 to 0.83). The English version was responsive to changes in performance status. The Chinese version was responsive to decline in performance status, but there was no conclusive evidence about its responsiveness to improvement in performance status. In the comparison analyses of the utility index and VAS between the two language versions, borderline results were obtained, and equivalence cannot be definitely confirmed.

Conclusion

The five-level EQ-5D is valid, responsive, and reliable in assessing health outcome of breast cancer patients. The English and Chinese versions provide comparable measurement results.

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References

  1. Axelsson B, Sjoden PO (1999) Assessment of quality of life in palliative care: psychometric properties of a short questionnaire. Acta Oncol 38:229–237

    Article  PubMed  CAS  Google Scholar 

  2. Ballatori E (2001) Unsolved problems in evaluating the quality of life of cancer patients. Ann Oncol 12(Suppl 3):S11–S13

    Article  PubMed  Google Scholar 

  3. Kopec JA, Willison KD (2003) A comparative review of four preference-weighted measures of health-related quality of life. J Clin Epidemiol 56:317–325

    Article  PubMed  Google Scholar 

  4. Barton GR, Sach TH, Jenkinson C et al (2008) Do estimates of cost-utility based on the EQ-5D differ from those based on the mapping of utility scores? Health Qual Life Outcomes 6:51

    Article  PubMed  Google Scholar 

  5. Janssen MF, Birnie E, Haagsma JA, Bonsel GJ (2008) Comparing the standard EQ-5D three-level system with a five-level version. Value Health 11:275–284

    Article  PubMed  Google Scholar 

  6. Janssen MF, Birnie E, Bonsel GJ (2008) Quantification of the level descriptors for the standard EQ-5D three-level system and a five-level version according to two methods. Qual Life Res 17:463–473

    Article  PubMed  CAS  Google Scholar 

  7. Herdman M, Gudex C, Lloyd A, et al. (2011) Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 20:1727–1736

    Article  PubMed  CAS  Google Scholar 

  8. Sullivan PW, Ghushchyan V (2006) Preference-based EQ-5D index scores for chronic conditions in the United States. Med Decis Making 26:410–420

    Article  PubMed  Google Scholar 

  9. Gao F, Ng GY, Cheung YB et al (2009) The Singaporean English and Chinese versions of the EQ-5D achieved measurement equivalence in cancer patients. J Clin Epidemiol 62:206–213

    Article  PubMed  Google Scholar 

  10. Graddol D (2004) The future of language. Science 303:1329–1331

    Article  PubMed  CAS  Google Scholar 

  11. Brady M, Cella D, Mo F et al (1997) Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. J Clinic Oncol 15:974–986

    CAS  Google Scholar 

  12. Wan C, Zhang D, Yang Z et al (2007) Validation of the simplified Chinese version of the FACT-B for measuring quality of life for patients with breast cancer. Breast Cancer Res Treat 106:413–418

    Article  PubMed  Google Scholar 

  13. Oken MM, Creech RH, Tormey DC et al (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655

    Article  PubMed  CAS  Google Scholar 

  14. Cheung YB, Goh C, Thumboo J et al (2005) Variability and sample size requirements of quality-of-life measures: a randomized study of three major questionnaires. JCO 23:4936–4944

    Article  Google Scholar 

  15. Blagden SP, Charman SC, Sharples LD et al (2003) Performance status score: do patients and their oncologists agree? Br J Cancer 89:1022–1027

    Article  PubMed  CAS  Google Scholar 

  16. Pickard AS, Kohlmann T, Janssen MF et al (2007) Evaluating equivalency between response systems application of the Rasch model to a 3-level and 5-level EQ-5D. Med Care 45:812–819

    Article  PubMed  Google Scholar 

  17. Luo N, Li MH, Liu GG, Lloyd A, de Charro F, Herdman M (2012) Developing the Chinese version of the new 5-level EQ-5D descriptive system: the response scaling approach. Qual Life Res. doi:10.1007/s11136-012-0200-0

  18. Rabin R, Oemar M, Oppe M, et al. (2011) EQ-5D-5L user guide: basic information on how to use the EQ-5D-5L instrument. EuroQoL Group. Available at http://www.euroqol.org/fileadmin/user_upload/Documenten/PDF/Folders_Flyers/UserGuide_EQ-5D-5L.pdf; assessed 2 Jul 2011

  19. Tsuchiya A, Ikeda S, Ikegami N et al (2002) Estimating an EQ-5D population value set: the case of Japan. Health Econ 11:341–353

    Article  PubMed  Google Scholar 

  20. Ng R, Lee CF, Wong NS, et al. (2012) Measurement properties of the English and Chinese versions of the Functional Assessment of Cancer Therapy-Breast (FACT-B) in Asian breast cancer patients. Breast Cancer Res Treat 131:619–625

    Article  PubMed  Google Scholar 

  21. Cella D (1997) FACIT Manual: manual of the functional assessment of chronic illness therapy (FACIT) measurement system. Evanston, IL, CORE

  22. Cuzick JA (1985) Wilcoxon-type test for trend. Stat Med 4:87–90

    Article  PubMed  CAS  Google Scholar 

  23. Senn S (1997) Statistical issues in drug development. Chichester, UK: Wiley; 320

  24. Cheung YB, Thumboo J, Goh C et al (2004) The equivalence and difference between the English and Chinese versions of two major cancer-specific health-related quality of life questionnaires. Cancer 101:2874–2880

    Article  PubMed  Google Scholar 

  25. Cheung YB (2007) A modified least-squares regression approach to the estimation of risk difference. Am J Epidemiol 166:1337–1344

    Article  PubMed  Google Scholar 

  26. Luo N, Chew LH, Fong KY et al (2003) Do English and Chinese EQ-5D versions demonstrate measurement equivalence? Health Qual Life Outcomes 1:7

    Article  PubMed  Google Scholar 

  27. McNamee R (2005) Regression modelling and other methods to control confounding. Occup Environ Med 62:500–506

    Article  PubMed  CAS  Google Scholar 

  28. Pickard AS, De Leon MC, Kohlmann T et al (2007) Psychometric comparison of the standard EQ-5D to a 5 level version in cancer patients. Med Care 45:259–263

    Article  PubMed  Google Scholar 

  29. Mehta CR, Patel NR (1983) A network algorithm for performing Fisher's exact test in r × c contingency tables. JASA 78:427–434

    Google Scholar 

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Acknowledgment

The study was funded by National Medical Research Council, Singapore (NMRC/EDG/0063/2009).

Conflict of interest

We declare that we have no potential conflict of interest, and this manuscript has not been published and is not under consideration for publication elsewhere. We have full control of all primary data, and we agree to allow the Journal of Supportive Care in Cancer to review the data if requested.

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Authors and Affiliations

  1. Center for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore, Singapore

    Chun Fan Lee, Celest Wong & Yin Bun Cheung

  2. Department of Biostatistics, Singapore Clinical Research Institute, Singapore, Singapore

    Chun Fan Lee & Yin Bun Cheung

  3. Department of Medical Oncology, National Cancer Center, Singapore, Singapore

    Raymond Ng, Nan Soon Wong, Yoon Sim Yap, Soo Kien Lo & Whay Kuang Chia

  4. Department of Epidemiology and Public Health & Centre for Health Services Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Nan Luo

  5. Department of Palliative Medicine, National Cancer Center, Singapore, Singapore

    Alethea Yee, Lalit Krishna & Cynthia Goh

  6. Department of International Health, University of Tampere, Tampere, Finland

    Yin Bun Cheung

  7. Singapore Clinical Research Institute, 31 Biopolis Way Nanos #02-01, Singapore, 138669, Singapore

    Chun Fan Lee

Authors
  1. Chun Fan Lee
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  2. Raymond Ng
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  3. Nan Luo
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  4. Nan Soon Wong
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  5. Yoon Sim Yap
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  6. Soo Kien Lo
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  7. Whay Kuang Chia
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  8. Alethea Yee
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  9. Lalit Krishna
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  10. Celest Wong
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  11. Cynthia Goh
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  12. Yin Bun Cheung
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Corresponding author

Correspondence to Chun Fan Lee.

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Lee, C.F., Ng, R., Luo, N. et al. The English and Chinese versions of the five-level EuroQoL Group's five-dimension questionnaire (EQ-5D) were valid and reliable and provided comparable scores in Asian breast cancer patients. Support Care Cancer 21, 201–209 (2013). https://doi.org/10.1007/s00520-012-1512-x

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  • DOI: https://doi.org/10.1007/s00520-012-1512-x

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