Development and Validation of a Simplified Chinese Version of EORTC QLQ-CR38 to Measure the Quality of Life of Patients with Colorectal Cancer

Abstract

Objectives: This study aimed to develop and validate the simplified Chinese version of the EORTC Quality of Life Questionnaire for Colorectal Cancer, QLQ-CR38. Methods: It was developed by the strict translation procedure of EORTC translation guidelines, including translation, back translation, a pilot test and a cultural adaptation. Three instruments (QLQ-CR38, Quality of Life Instruments for Cancer Patients-Colorectal Cancer, and Functional Assessment of Cancer Therapy-Colorectal) were used on a sample of 110 patients with colorectal cancer at the time of their admission to the hospital and 1–2 days after hospitalization, and a subsample of patients was measured a third time at discharge. The psychometric properties were evaluated by correlational analysis, multi-trait scaling analysis, factor analysis, and t tests. Results: Multi-trait scaling analysis and correlation analysis among domains and items of the three instruments showed good construct validity and criterion-related validity. Cronbach’s α and the test-retest reliability coefficients were greater than 0.70 for all domains (except chemotherapy side effects, 0.44 and 0.60, respectively). All domains had statistically significant changes after treatment with the standardized response mean ranging from 0.44 to 2.47. Conclusions: The simplified Chinese version of QLQ-CR38 has good validity, reliability, and responsiveness and can be used to measure the quality of life of Chinese patients with colorectal cancer.

Validation of the Taiwan Chinese version of the EORTC QLQ-CR29 to assess quality of life in colorectal cancer patients

“…This is not the case of the EORTC colon and rectum-specific module. The QLQ-CR29 is the revised and shorter version of the QLQ-CR38 [ 21 ], with the Chinese version validated and reported in Hong Kong [ 22 ] and Mainland China [ 23 ]. The QLQ-CR38 questionnaire was limited in terms of missing data and lack of specificity, particularly with regard to emerging new technologies such as pre-operative chemo-radiotherapy, ultra-low anterior resection, and minimally invasive surgery [ 4 ].…”

Systematic review recommends the European Organization for Research and Treatment of Cancer colorectal cancer–specific module for measuring quality of life in colorectal cancer patients

“…Second, data on responsiveness were lacking. Of 22 studies that had investigated responsiveness, seven studies were rated as ''poor'' in methodological quality of responsiveness property [21,45,46,54,62,66,67] in part because of the controversy over whether the mean change exceeded the minimum clinically important difference or discriminated between groups defined by anchor using area under the curve. Besides, the methodological quality was rated as ''poor'' in the evaluation of properties of internal consistency, structural validity, and cross-cultural validity with a lack of details on the factor analysis or item response theory test used.…”

Psycho-oncology assessment in Chinese populations: a systematic review of quality of life and psychosocial measures

“…Consistent with recommendations, the majority described good test-retest reliability with intraclass correlation coefficients or Pearson's r ranging from 0.73 to 0.97 (Table 2). Seventeen studies validating quality of life measures reported suboptimal test-retest reliability on one or more subscales (ICC or Pearson's r range 0.19-0.69) (Chie et al 2003a,b;Chie et al 2004;Yeung et al 2006;Wan et al 2007aCheng et al 2009Cheng et al , 2011Ge et al 2011;Pien et al 2011;Kong et al 2012;…”

“…2003a,b; Chie et al 2004; Huang et al 2007a;Wan et al 2007a; Wan et al 2008b,d;Cheng et al 2011;). As well, in studies validating EORTC-QLQ colorectal, ovarian or prostate cancer-specific modules, chemotherapy side effects (range a 0.44-0.63) Chie et al 2010a;Kong et al 2012) and/or treatment-related symptom (range a 0.39-0.45) (Chie et al 2010a; Chie et al 2010c; Chang et al 2012) domains were identified as problematic in five studies. Regarding developed measures, eight studies validating the System of Quality of Life Instruments for Cancer Patients general and cancer-specific modules described low internal consistency for the social function domain (range a 0.53-0.68) (Meng et al 2008a; Wan et al 2008a, 2008c; Gu et al 2009; Wan et al 2009; Wan et al 2010; Xu et al 2012; Yang et al 2012a).…”