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Development of computerized adaptive testing (CAT) for the EORTC QLQ-C30 physical functioning dimension

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Abstract

Purpose

Computerized adaptive test (CAT) methods, based on item response theory (IRT), enable a patient-reported outcome instrument to be adapted to the individual patient while maintaining direct comparability of scores. The EORTC Quality of Life Group is developing a CAT version of the widely used EORTC QLQ-C30. We present the development and psychometric validation of the item pool for the first of the scales, physical functioning (PF).

Methods

Initial developments (including literature search and patient and expert evaluations) resulted in 56 candidate items. Responses to these items were collected from 1,176 patients with cancer from Denmark, France, Germany, Italy, Taiwan, and the United Kingdom. The items were evaluated with regard to psychometric properties.

Results

Evaluations showed that 31 of the items could be included in a unidimensional IRT model with acceptable fit and good content coverage, although the pool may lack items at the upper extreme (good PF). There were several findings of significant differential item functioning (DIF). However, the DIF findings appeared to have little impact on the PF estimation.

Conclusions

We have established an item pool for CAT measurement of PF and believe that this CAT instrument will clearly improve the EORTC measurement of PF.

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Acknowledgments

The study was funded by grants from the EORTC Quality of Life Group. National Taiwan University, grant National Science Council, Taiwan, No. 95-2314-B-002-266-MY2, 97-2314-B-002-020-MY3.

Author information

Authors and Affiliations

  1. The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Bispebjerg bakke 23, 2400, Copenhagen NV, Denmark

    Morten Aa. Petersen & Mogens Groenvold

  2. Institute of Public Health, University of Copenhagen, Copenhagen, Denmark

    Mogens Groenvold

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

    Neil K. Aaronson

  4. Graduate Institute of Preventive Medicine and Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan

    Wei-Chu Chie

  5. Medical Oncology Department, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy, France

    Thierry Conroy

  6. Psychoncology Unit, Sant’Andrea Hospital, 2nd Faculty of Medicine, Sapienza University of Rome, Rome, Italy

    Anna Costantini

  7. Department of Public Health, University of Aberdeen, Aberdeen, UK

    Peter Fayers

  8. Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway

    Peter Fayers

  9. Department of Neuroscience, Norwegian University of Science and Technology and St. Olav University Hospital, Trondheim, Norway

    Jorunn Helbostad

  10. Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Innsbruck, Austria

    Bernhard Holzner

  11. Palliative Medicine Unit, University Hospital of Trondheim, Trondheim, Norway

    Stein Kaasa

  12. Department Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany

    Susanne Singer

  13. Cancer Research UK Centre, University of Leeds, Leeds, UK

    Galina Velikova

  14. Lynda Jackson Macmillan Centre, Mount Vernon Cancer Centre, Northwood, Middx, UK

    Teresa Young

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  1. Morten Aa. Petersen
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  2. Mogens Groenvold
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  7. Peter Fayers
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  8. Jorunn Helbostad
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  9. Bernhard Holzner
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  10. Stein Kaasa
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  11. Susanne Singer
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  12. Galina Velikova
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  13. Teresa Young
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Corresponding author

Correspondence to Morten Aa. Petersen.

Additional information

This study is conducted on behalf of the EORTC Quality of Life Group.

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Petersen, M.A., Groenvold, M., Aaronson, N.K. et al. Development of computerized adaptive testing (CAT) for the EORTC QLQ-C30 physical functioning dimension. Qual Life Res 20, 479–490 (2011). https://doi.org/10.1007/s11136-010-9770-x

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