Development Of The Quality Of Life Instrument For Cancer Patients-esophageal Cancer (QLICP-ES) And Comparisions With Chinese Version Of QLQ-OES48

Objective To Develop and validate the Quality of Life Instrument for Cancer patients-esophageal cancer (QLICP-ES) and the Chinese version of EORTC QLQ-OES48, and to compare both of them.Methods Based on the modular approach (a general modules plus specific modules) and Chinese culture, and also the programmed decision procedure including nominal group and focus group discussion, in-depth interview, pilot tests, pre-tests and the statistical procedures for item selection, a specific QOL instrument for patients with esophageal cancer QLICP-ES has been developed. A Chinese version of the EORTC QLQ-OES48 was developed by strict translation procedures of EORTC translation guidelines, including forward translation, backward translation, culture adaptation, and pilot-testing. Two instruments (QLQ-OES48, QLICP-ES) were used to a sample of 130 patients with esophageal cancer at the time of their admission to the hospital so that the psychometric properties (validity, reliability and responsiveness) can be evaluated. A sub-sample of patients (n=91) was sampled and assessed a second time 1-2 days after hospitalization so that the test-retest reliability could be calculated. A sub-sample of patients (n=117) was sampled and measured a third time at discharge to evaluate the responsiveness. Two instruments were compared with respect to contents and psychometrics. The statistic tools used in this study include statistic description,regression t-test,exploratory factor analysis and Generalizability Theory(GT).Results1. The QLICP-ES was developed including 41 items of the general module QLICP-GM and 19 items of esophageal cancer specific module. And the Chinese version of EORTC QLQ-OES48 was also developed.2. Results on psychometrics of QLICP-ES showed test-retest-reliability of the scale is 0.988, Cronbach's Alpha is 0.91. Correlation and factor analysis showed good Construct Validity. After treatments, the score changes of all facets of the specific module (expect early stage symptom) showed statistical significance compared to that of the pre-treatments.3. The Chinese version of EORTC QLQ-OES48 was also evaluated and compared with QLICP-ES. Both instruments reflected the contents of the quality of life with good reliability,validity and responsiveness. The Chinese version of QLQ-OES48 showed better responsiveness than that of the QLICP-ES, while QLICP-ES showed better half-spilt and internal consistency coefficients than that of the QLQ-OES48. Overall, the two instruments are not interchangeable for they reflect different domains.Conclusion QLICP-ES is of good validity, reliability and responsiveness, and can be used to measure QOL for Chinese patients with esophageal cancer. Although psychometrics of the Chinese version of QLQ-OES48 and QLICP-ES are similar, they are not interchangeable.