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Use of item response theory to develop a shortened version of the EORTC QLQ-C30 emotional functioning scale

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Abstract

Background: As part of a larger study whose objective is to develop an abbreviated version of the EORTC QLQ-C30 suitable for research in palliative care, analyses were conducted to determine the feasibility of generating a shorter version of the 4-item emotional functioning (EF) scale that could be scored in the original metric. Methods: We used data from 24 European cancer studies conducted in 10 different languages (n=8242). Item selection was based on analyses by item response theory (IRT). Based on the IRT results, a simple scoring algorithm was developed to predict the original 4-item EF sum scale score from a reduced number of items. Results: Both a 3-item and a 2-item version (item 21 ‘Did you feel tense?’ and item 24 ‘Did you feel depressed?’) predicted the total score with excellent agreement and very little bias. In group comparisons, the 2-item scale led to the same conclusions as those based on the original 4-item scale with little or no loss of measurement efficiency. Conclusion: Although these results are promising, confirmatory studies are needed based on independent samples. If such additional studies yield comparable results, incorporation of the 2-item EF scale in an abbreviated version of the QLQ-C30 for use in palliative care research settings would be justified. The analyses reported here demonstrate the usefulness of the IRT-based methodology for shortening questionnaire scales.

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Abbreviations

DIF:

differential item functioning

EAP :

expected a posteriori

EF:

emotional function

EORTC :

European Organisation for Research and Treatment of Cancer

IIF:

item information function

IRT :

item response theory

References

  • G Johnston C Abraham (1995) ArticleTitleThe WHO objectives for palliative care: To what extent are we achieving them? Palliat Med 9 123–137

    Google Scholar 

  • ML Vachon L Kristjanson I Higginson (1995) ArticleTitlePsychosocial issues in palliative care: The patient, the family, and the process and outcome of care. J Pain Symptom Manage 10 142–150 Occurrence Handle10.1016/0885-3924(94)00076-W

    Article  Google Scholar 

  • I Higginson (1993) Clinical Audit in Palliative Care. Radcliffe Medical Press Oxford

    Google Scholar 

  • J Corner (1996) ArticleTitleIs there a research paradigm for palliative care? Palliat Med 10 201–208

    Google Scholar 

  • Bruera E. Patient assessment in palliative cancer care. Cancer Treatment Rev 1996; 3–12.

  • J Hearn IJ Higginson (1997) ArticleTitleOutcome measures in palliative care for advanced cancer patients: A review. J Public Health Med 19 193–199

    Google Scholar 

  • Alexander DA. Psychosocial research in palliative care. In: Oxford Textbook of Palliative Medicine, Oxford: Oxford Medical Publ, 1998: 187–192.

  • DF Cella DS Tulsky G Gray et al. (1993) ArticleTitleThe Functional Assessment of Cancer Therapy scale: Development and validation of the general measure. J Clin Oncol 11 570–579 Occurrence Handle1:STN:280:ByyC1cjmvFc%3D Occurrence Handle8445433

    CAS  PubMed  Google Scholar 

  • NK Aaronson S Ahmedzai B Bergman et al. (1993) ArticleTitleThe European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85 IssueID5 365–376 Occurrence Handle10.1093/jnci/85.5.365 Occurrence Handle1:STN:280:ByyC28vivVc%3D Occurrence Handle8433390

    Article  CAS  PubMed  Google Scholar 

  • Clinch JJ, Dudgeon D, Schipper H. Quality of life assessment in palliative care. In: Oxford Textbook of Palliative Medicine, Oxford: Oxford Medical Publ, 1998: 83–94.

  • PM Fayers NK Aaronson K Bjordal M Groenvold D Curran A Bottomley (2001) The EORTC QLQ-C30 Scoring Manual. European Organization for Research and Treatment of Cancer Brussels

    Google Scholar 

  • A.S. Stromgren M. Groenvold L. Pedersen A.K. Olsen P. Sjogren (2002) ArticleTitleSymptomatology of cancer patients in palliative care: Content validation of self-assessment questionnaires against medical records Eur J Cancer 38 788–794

    Google Scholar 

  • RJ Mislevy (1992) Linking Educational Assessments: Concepts, Issues, Methods, and Prospects. Educational Testing Service, Policy Information Center Princeton, NJ

    Google Scholar 

  • R.K. Hambleton (1989) Principles and Selected Applications of Item Response Theory R.L. Linn (Eds) Educational Measurement Macmillan New York 143–200

    Google Scholar 

  • WJ van der Linden RK Hambleton (1997) Handbook of Modern Item Response Theory. Springer Berlin

    Google Scholar 

  • M.A. Petersen M. Groenvold J.B. Bjorner (2003) ArticleTitleUse of differential item functioning analysis to assess the equivalence of translations of a questionnaire. Qual Life Res 12 373–385 Occurrence Handle10.1023/A:1023488915557

    Article  Google Scholar 

  • N.K. Aaronson A. Cull S. Kaasa M.A.G. Sprangers (1996) The european organization for research and treatment of cancer (EORTC) modular approach to quality of life assessment in oncology An Update B. Spilker (Eds) Quality of Life and Pharmacoeconomics in Clinical Trials Lippincott-Raven Publishers Philadelphia 179–188

    Google Scholar 

  • M. Groenvold JB Bjorner MC Klee S Kreiner (1995) ArticleTitleTest for item-bias in a quality of life measure. J Clin Epidemiol 48 805–816 Occurrence Handle10.1016/0895-4356(94)00195-V

    Article  Google Scholar 

  • E. Muraki (1997) A generalized partial credit model WJ van der Linden RK Hambleton (Eds) Handbook of Modern Item Response Theory Springer Berlin 153–164

    Google Scholar 

  • F. Samejima (1997) Graded response model WJ van der Linden RK Hambleton (Eds) Handbook of Modern Item Response Theory Springer Berlin 85–100

    Google Scholar 

  • A Maydeu-Olivares F Drasgow AD. Mead (1994) ArticleTitleDistinguishing among parametric item response models for polychotomous ordered data Appl Psychol Meas 18 245–256

    Google Scholar 

  • S van Buuren M Hopman-Rock (2001) ArticleTitleRevision of the ICIDH Severity of Disabilities Scale by data linking and item response theory. Stat Med 20 1061–1076 Occurrence Handle10.1002/sim.723

    Article  Google Scholar 

  • GN Masters BD. Wright (1997) The Partial Credit Model WJ van der Linden RK Hambleton (Eds) Handbook of Modern Item Response Theory Springer Berlin 101–122

    Google Scholar 

  • GH Fischer IW Molenaar (1995) Rasch Models – Foundations, Recent Developments, and Applications. Springer-Verlag Berlin

    Google Scholar 

  • D Andrich (1978) ArticleTitleA rating formulation for ordered response categories. Psychometrika 43 561–573

    Google Scholar 

  • E Muraki RD Bock (1996) Parscale – IRT based Test Scoring and Item Analysis for Graded Open-ended Exercises and Performance Tasks. Scientific Software Inc. Chicago

    Google Scholar 

  • RD Bock M Aitkin (1981) ArticleTitleMarginal maximum likelihood estimation of item parameters: Application of an EM algorithm. Psychometrika 46 443–459

    Google Scholar 

  • RD Bock RJ Mislevy (1982) ArticleTitleAdaptive EAP estimation of ability in a microcomputer environment. Appl Psychol Meas 6 431–444

    Google Scholar 

  • E Muraki (1993) ArticleTitleInformation functions of the generalized partial credit model. Appl Psychol Meas 17 351–363

    Google Scholar 

  • J Cohen (1968) ArticleTitleWeighted kappa: Nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull 70 213–220

    Google Scholar 

  • PW Holland H Wainer (1993) Differential Item Functioning. Lawrence Erlbaum Associates, Inc. Hillsdale, NJ

    Google Scholar 

  • DA Karnofsky WH Abelmann LF Craver (1948) ArticleTitleThe use of nitrogen mustards in the palliative treatment of carcinoma Cancer I 634–656

    Google Scholar 

  • CG Zubrod M Schneiderman E Frei (1960) ArticleTitleAppraisal of methods for the study of chemotherapy of cancer in man: Comparative therapeutic trial of nitrogen mustard and triethylene thiophosphoramide. J Chronic Dis 11 7–33 Occurrence Handle10.1016/0021-9681(60)90137-5

    Article  Google Scholar 

  • WP Fisher SuffixJr. RL Eubanks RL Marier (1997) ArticleTitleEquating the MOS SF36 and the LSU HSI Physical Functioning Scales. J Outcome Meas 1 329–362

    Google Scholar 

  • WD Spector JA Fleishman (1998) ArticleTitleCombining activities of daily living with instrumental activities of daily living to measure functional disability. J Gerontol B Psychol Sci Soc Sci 53 S46–S57

    Google Scholar 

  • X Badia L Prieto M Roset A Diez-Perez M Herdman (2002) ArticleTitleDevelopment of a short osteoporosis quality of life questionnaire by equating items from two existing instruments. J Clin Epidemiol 55 32–40 Occurrence Handle10.1016/S0895-4356(01)00432-2 Occurrence Handle1:STN:280:DC%2BD38%2FlsFyntg%3D%3D Occurrence Handle11781120

    Article  CAS  PubMed  Google Scholar 

  • CA McHorney (2002) ArticleTitleUse of item response theory to link 3 modules of functional status items from the Asset and Health Dynamics Among the Oldest Old study. Arch Phys Med Rehabil 83 383–394 Occurrence Handle10.1053/apmr.2002.29610

    Article  Google Scholar 

  • M Orlando CD Sherbourne D Thissen (2000) ArticleTitleSummed-score linking using item response theory: Application to depression measurement. Psychol Assess 12 354–359 Occurrence Handle10.1037//1040-3590.12.3.354

    Article  Google Scholar 

  • C-H Chang D Cella (1997) ArticleTitleEquating health-related quality of life instruments in applied oncology settings. Phys Med Rehabil State Art Rev 11 397–406

    Google Scholar 

  • AC Leon PM Marzuk L Portera (1995) ArticleTitleMore reliable outcome measures can reduce sample size requirements. Arch Gen Psychiatry 52 867–871

    Google Scholar 

  • JC Nunnally IH Bernstein (1994) Psychometric Theory. McGraw-Hill, Inc. New York

    Google Scholar 

  • EW Steyerberg FE Harrell SuffixJr. GJ Borsboom MJ Eijkemans Y Vergouwe JD Habbema (2001) ArticleTitleInternal validation of predictive models: Efficiency of some procedures for logistic regression analysis. J Clin Epidemiol 54 774–781 Occurrence Handle10.1016/S0895-4356(01)00341-9

    Article  Google Scholar 

Download references

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Bjorner, J., Petersen, M., Groenvold, M. et al. Use of item response theory to develop a shortened version of the EORTC QLQ-C30 emotional functioning scale. Qual Life Res 13, 1683–1697 (2004). https://doi.org/10.1007/s11136-004-7866-x

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