The EORTC CAT Core-The computer adaptive version of the EORTC QLQ-C30 questionnaire
Morten Aa Petersen, Neil K Aaronson, Juan I Arraras, Wei-Chu Chie, Thierry Conroy, Anna Costantini, Linda Dirven, Peter Fayers, Eva-Maria Gamper, Johannes M Giesinger, Esther J J Habets, Eva Hammerlid, Jorunn Helbostad, Marianne J Hjermstad, Bernhard Holzner, Colin Johnson, Georg Kemmler, Madeleine T King, Stein Kaasa, Jon H Loge, Jaap C Reijneveld, Susanne Singer, Martin J B Taphoorn, Lise H Thamsborg, Krzysztof A Tomaszewski, Galina Velikova, Irma M Verdonck-de Leeuw, Teresa Young, Mogens Groenvold, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group, Morten Aa Petersen, Neil K Aaronson, Juan I Arraras, Wei-Chu Chie, Thierry Conroy, Anna Costantini, Linda Dirven, Peter Fayers, Eva-Maria Gamper, Johannes M Giesinger, Esther J J Habets, Eva Hammerlid, Jorunn Helbostad, Marianne J Hjermstad, Bernhard Holzner, Colin Johnson, Georg Kemmler, Madeleine T King, Stein Kaasa, Jon H Loge, Jaap C Reijneveld, Susanne Singer, Martin J B Taphoorn, Lise H Thamsborg, Krzysztof A Tomaszewski, Galina Velikova, Irma M Verdonck-de Leeuw, Teresa Young, Mogens Groenvold, European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group
Abstract
Background: To optimise measurement precision, relevance to patients and flexibility, patient-reported outcome measures (PROMs) should ideally be adapted to the individual patient/study while retaining direct comparability of scores across patients/studies. This is achievable using item banks and computerised adaptive tests (CATs). The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) is one of the most widely used PROMs in cancer research and clinical practice. Here we provide an overview of the research program to develop CAT versions of the QLQ-C30's 14 functional and symptom domains.
Methods: The EORTC Quality of Life Group's strategy for developing CAT item banks consists of: literature search to identify potential candidate items; formulation of new items compatible with the QLQ-C30 item style; expert evaluations and patient interviews; field-testing and psychometric analyses, including factor analysis, item response theory calibration and simulation of measurement properties. In addition, software for setting up, running and scoring CAT has been developed.
Results: Across eight rounds of data collections, 9782 patients were recruited from 12 countries for the field-testing. The four phases of development resulted in a total of 260 unique items across the 14 domains. Each item bank consists of 7-34 items. Psychometric evaluations indicated higher measurement precision and increased statistical power of the CAT measures compared to the QLQ-C30 scales. Using CAT, sample size requirements may be reduced by approximately 20-35% on average without loss of power.
Conclusions: The EORTC CAT Core represents a more precise, powerful and flexible measurement system than the QLQ-C30. It is currently being validated in a large independent, international sample of cancer patients.
Keywords: Computerized adaptive test; EORTC QLQ-C30; Health related quality of life; Item banking; Item development; Item response theory; Patient-reported outcome.
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Source: PubMed