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Investigating the response scale of the EORTC QLQ-C30 in German cancer patients and a population survey

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  • Michael Koller
  • Karolina Müller
  • Sandra Nolte
  • Heike Schmidt
  • Christina Harvey
  • Ulrike Mölle
  • Andreas Boehm
  • Daniel Engeler
  • Jürg Metzger
  • Monika Sztankay
  • Bernhard Holzner
  • Mogens Groenvold
  • Dagmara Kuliś
  • Andrew Bottomley
  • EORTC Quality of Life Group
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BACKGROUND: The European Organization for research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) scales are scored on a 4-point response scale, ranging from not at all to very much. Previous studies have shown that the German translation of the response option quite a bit as mäßig violates interval scale assumptions, and that ziemlich is a more appropriate translation. The present studies investigated differences between the two questionnaire versions.

METHODS: The first study employed a balanced cross-over design and included 450 patients with different types of cancer from three German-speaking countries. The second study was a representative survey in Germany including 2033 respondents. The main analyses included compared the ziemlich and mäßig version of the questionnaire using analyses of covariance adjusted for sex, age, and health burden.

RESULTS: In accordance with our hypothesis, the adjusted summary score was lower in the mäßig than in the ziemlich version; Study 1: - 4.5 (95% CI - 7.8 to - 1.3), p = 0.006, Study 2: - 3.1 (95% CI - 4.6 to - 1.5), p < 0.001. In both studies, this effect was pronounced in respondents with a higher health burden; Study 1: - 6.8 (95% CI - 12.2 to - 1.4), p = 0.013; Study 2: - 4.5 (95% CI - 7.3 to - 1.7), p = 0.002.

CONCLUSIONS: We found subtle but consistent differences between the two questionnaire versions. We recommend to use the optimized response option for the EORTC QLQ-C30 as well as for all other German modules.

TRIAL REGISTRATION: The study was retrospectively registered on the German Registry for Clinical Studies (reference number DRKS00012759, 04th August 2017, https://www.drks.de/DRKS00012759 ).

Original languageEnglish
Article number235
JournalHealth and Quality of Life Outcomes
Volume19
Issue number1
Pages (from-to)235
Number of pages14
ISSN1477-7525
DOIs
Publication statusPublished - 9 Oct 2021

Bibliographical note

© 2021. The Author(s).

    Research areas

  • Germany, Humans, Neoplasms, Quality of Life, Surveys and Questionnaires

ID: 69264936