The European Organization for Research and Treatment of Cancer QLQ-C30: A Quality-of-Life Instrument for Use in International Clinical Trials in Oncology

Background: In 1986, the European Organization for Research and Treatment of Cancer (EORTC) initiated a research program to develop an integrated, modular approach for evaluating the quality of life of patients participating in international clinical trials. Purpose: We report here the results of an...

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Published in:JNCI : Journal of the National Cancer Institute 1993-03, Vol.85 (5), p.365-376
Main Authors: Aaronson, Neil K., Ahmedzai, Sam, Bergman, Bengt, Bullinger, Monika, Cull, Ann, Duez, Nicole J., Filiberti, Antonio, Flechtner, Henning, Fleishman, Stewart B., Haes, Johanna C. J. M. de, Kaasa, Stein, Klee, Marianne, Osoba, David, Razavi, Darius, Rofe, Peter B., Schraub, Simon, Sneeuw, Kommer, Sullivan, Marianne, Takeda, Fumikazu
Format: Article
Language:English
Subjects:
Activities of Daily Living
Adult
Aged
Aged, 80 and over
Antineoplastic agents
Biological and medical sciences
Cancer
Clinical Trials as Topic
Female
General aspects
Health Status
Humans
Lung Neoplasms - therapy
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Quality of Life
Questionnaires
Reproducibility of Results
Surveys and Questionnaires
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Summary:Background: In 1986, the European Organization for Research and Treatment of Cancer (EORTC) initiated a research program to develop an integrated, modular approach for evaluating the quality of life of patients participating in international clinical trials. Purpose: We report here the results of an international field study of the practicality, reliability, and validity of the EORTC QLQ-C30, the current core questionnaire. The QLQ-C30 incorporates nine multi-item scales: five functional scales (physical, role, cognitive, emotional, and social); three symptom scales (fatigue, pain, and nausea and vomiting); and a global health and quality-of-life scale. Several single-item symptom measures are also included. Methods: The questionnaire was administered before treatment and once during treatment to 305 patients with nonresectable lung cancer from centers in 13 countries. Clinical variables assessed included disease stage, weight loss, performance status, and treatment toxicity. Results: The average time required to complete the questionnaire was approximately 11 minutes, and most patients required no assistance. The data supported the hypothesized scale structure of the questionnaire with the exception of role functioning (work and household activities), which was also the only multi-item scale that failed to meet the minimal standards for reliability (Cronbach's alpha coefficient >.70) either before or during treatment. Validity was shown by three findings. First, while all interscale correlations were statistically significant, the correlation was moderate, indicating that the scales were assessing distinct components of the quality-of-life construct. Second, most of the functional and symptom measures discriminated clearly between patients differing in clinical status as defined by the Eastern Cooperative Oncology Group performance status scale, weight loss, and treatment toxicity. Third, there were statistically significant changes, in the expected direction, in physical and role functioning, global quality of life, fatigue, and nausea and vomiting, for patients whose performance status had improved or worsened during treatment. The reliability and validity of the questionnaire were highly consistent across the three language-cultural groups studied: patients from English-speaking countries, Northern Europe, and Southern Europe. Conclusions: These results support the EORTC QLQ-C30 as a reliable and valid measure of the quality of life of cancer patients
ISSN:0027-8874
1460-2105
DOI:10.1093/jnci/85.5.365