University Surgical Unit, University of Southampton School of Medicine, Tremona Road, Southampton, UK.
Eur J Cancer. 2010 Aug;46(12):2242-52. doi: 10.1016/j.ejca.2010.04.014. Epub 2010 May 23.
There is a lack of instruments that focus on the specific health-related quality of life (HRQOL) issues that affect older people with cancer. The aim of this study was to develop a HRQOL questionnaire module to supplement the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire, the EORTC QLQ-C30 for older (>70years) patients with cancer.
Phases 1-3 were conducted in seven countries following modified EORTC Quality of Life Group guidelines for module development. Phase 1: potentially relevant issues were identified by a systematic literature review, a questionnaire survey of 17 multi-disciplinary health professionals and two rounds of qualitative interviews. The first round included 9 patients aged >70. The second round was a comparative series of interviews with 49 patients >70years with a range of cancer diagnoses and 40 patients aged 50-69years matched for gender and disease site. In Phase 2 the issues were formulated into a long provisional item list. This was administered in Phase 3 together with the QLQ-C30 to two further groups of cancer patients aged >70 (n=97) or 50-69years (n=85) to determine the importance, relevance and acceptability of each item. Redundant and duplicate items were removed; issues specific to the older group were selected for the final questionnaire.
In Phase 1, 75 issues were identified. These were reduced in Phase 2 to create a 45 item provisional list. Phase 3 testing of the provisional list led to the selection of 15 items with good range of response, high scores of importance and relevance in the older patients. This resulted in the EORTC QLQ-ELD15, containing five conceptually coherent scales (functional independence, relationships with family and friends, worries about the future, autonomy and burden of illness).
The EORTC QLQ-ELD15 in combination with the EORTC QLQ-C30 is ready for large-scale validation studies, and will assess HRQOL issues of most relevance and concern for older people with cancer across a wide range of cancer sites and treatment stages.
目前缺乏专门针对影响老年癌症患者的特定健康相关生活质量（HRQOL）问题的工具。本研究旨在开发一个 HRQOL 问卷模块，以补充欧洲癌症研究与治疗组织（EORTC）核心问卷 EORTC QLQ-C30，用于评估年龄>70 岁的癌症患者。
按照 EORTC 生活质量小组模块开发指南，在七个国家进行了 3 个阶段的研究。第 1 阶段：通过系统文献回顾、对 17 名多学科卫生专业人员的问卷调查和两轮定性访谈，确定潜在相关问题。第一轮纳入 9 名年龄>70 岁的患者。第二轮是对 49 名年龄>70 岁、患有多种癌症且诊断不同的患者和 40 名年龄 50-69 岁、性别和疾病部位匹配的患者进行的比较系列访谈。在第 2 阶段，将这些问题纳入一个长的暂定项目清单。在第 3 阶段，将这个暂定项目清单与 EORTC QLQ-C30 一起，分别对年龄>70 岁（n=97）或 50-69 岁（n=85）的两组癌症患者进行评估，以确定每个项目的重要性、相关性和可接受性。删除冗余和重复的项目；选择与老年组相关的问题作为最终问卷。
第 1 阶段共确定了 75 个问题，第 2 阶段减少至 45 个暂定项目清单。第 3 阶段对暂定清单的测试导致选择了 15 个项目，这些项目在老年患者中有较好的反应范围、高重要性和相关性得分。这就产生了 EORTC QLQ-ELD15，包含五个概念上一致的量表（功能独立性、与家人和朋友的关系、对未来的担忧、自主性和疾病负担）。
EORTC QLQ-ELD15 与 EORTC QLQ-C30 结合使用，已准备好进行大规模验证研究，将评估广泛癌症部位和治疗阶段的老年癌症患者最相关和最关注的 HRQOL 问题。
