International validation of the revised European Organisation for Research and Treatment of Cancer Head and Neck Cancer Module, the EORTC QLQ‐HN43: Phase IV

Abstract

Background We validated the new European Organisation for Research and Treatment of Cancer Quality of Life Head and Neck Module (EORTC QLQ‐HN43). Methods We enrolled 812 patients with head and neck cancer from 18 countries. Group 1 completed the questionnaire before therapy, and 3 and 6 months later. In group 2 (survivors), we determined test–retest reliability using intraclass correlation coefficients (ICC). Internal consistency was assessed using Cronbach's Alpha, the scale structure with confirmatory factor analysis, and discriminant validity with known‐group comparisons. Results Cronbach's alpha was >0.70 in 10 of the 12 multi‐item scales. All standardized factor loadings exceeded 0.40. The ICC was >0.70 in all but two scales. Differences in scale scores between known‐groups were >10 points in 17 of the 19 scales. Sensitivity to change was found to be sufficient in 18 scales. Conclusions Evidence supports the reliability and validity of the EORTC QLQ‐HN43 as a measure of quality of life.

Health-related quality of life became worse in short-term during treatment in head and neck cancer patients: a prospective study

“…EORTC QLQ-H&N 35 [ 19 ] and EORTC QLQ-H&N 43 [ 8 ] questionnaires contain 35 questions with 18 scales and 43 questions with 19 scales, respectively. In both questionnaires, all questions are assessed on a 4-point Likert scale, where higher scores indicate a worse QoL.…”

“…The two questionnaires are specific for HNC patients and evaluate symptoms, sexuality and body image. However, despite presenting similar questions, the QLQ-H&N 43 contains additional questions, addressing skin, neurological and shoulder problems, while other questions were removed from the traditional version, such as nutritional supplements and use of a feeding tube [ 8 ]. The values obtained from scales were converted into scores from 0 to 100, according to the recommendations of EORTC [ 20 ].…”

“…So, our cut-off was considered ±10 points. Any scales with this delta ≥10 or ≤ − 10 points was considered as clinically relevant, similar to a previous study [ 8 ]. In our study, only the worsening between times was shown, i.e., the clinical negative significant changes, respecting the negative direction of the scales and items.…”

“…This clinical scenario is accentuated by the presence of symptoms like xerostomia, dysgeusia, oral mucositis, pain and dysphagia [ 6 , 7 ], probably as a treatment result. This set of changes negatively impacts health-related quality of life (HRQOL) of these patients [ 8 ].…”

Complex Mandibular Reconstruction for Head and Neck Squamous Cell Carcinoma—The Ongoing Challenge in Reconstruction and Rehabilitation

“…Compared to the previous version, the updated H&N43 includes additional questions that specifically address side effects of newer cancer treatment strategies. These include skin problems, shoulder problems or neurological side effects [54].…”