Giesinger Johannes M, Kieffer Jacobien M, Fayers Peter M, Groenvold Mogens, Petersen Morten Aa, Scott Neil W, Sprangers Mirjam A G, Velikova Galina, Aaronson Neil K
Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
Institute of Applied Health Sciences, University of Aberdeen, Foresterhill Road, AB25 2ZD Aberdeen, UK; Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Postboke 8905, N-7491 Trondheim, Norway.
J Clin Epidemiol. 2016 Jan;69:79-88. doi: 10.1016/j.jclinepi.2015.08.007. Epub 2015 Sep 28.
To further evaluate the higher order measurement structure of the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30), with the aim of generating a summary score.
Using pretreatment QLQ-C30 data (N = 3,282), we conducted confirmatory factor analyses to test seven previously evaluated higher order models. We compared the summary score(s) derived from the best performing higher order model with the original QLQ-C30 scale scores, using tumor stage, performance status, and change over time (N = 244) as grouping variables.
Although all models showed acceptable fit, we continued in the interest of parsimony with known-groups validity and responsiveness analyses using a summary score derived from the single higher order factor model. The validity and responsiveness of this QLQ-C30 summary score was equal to, and in many cases superior to the original, underlying QLQ-C30 scale scores.
Our results provide empirical support for a measurement model for the QLQ-C30 yielding a single summary score. The availability of this summary score can avoid problems with potential type I errors that arise because of multiple testing when making comparisons based on the 15 outcomes generated by this questionnaire and may reduce sample size requirements for health-related quality of life studies using the QLQ-C30 questionnaire when an overall summary score is a relevant primary outcome.
进一步评估欧洲癌症研究与治疗组织（EORTC）生活质量问卷核心30项（QLQ-C30）的高阶测量结构，旨在生成一个汇总分数。
利用治疗前的QLQ-C30数据（N = 3282），我们进行了验证性因子分析，以检验七个先前评估的高阶模型。我们将表现最佳的高阶模型得出的汇总分数与原始QLQ-C30量表分数进行比较，使用肿瘤分期、体能状态和随时间的变化（N = 244）作为分组变量。
尽管所有模型均显示出可接受的拟合度，但为了简洁起见，我们继续使用从单一高阶因子模型得出的汇总分数进行已知组效度和反应性分析。该QLQ-C30汇总分数的效度和反应性与原始的基础QLQ-C30量表分数相当，且在许多情况下优于后者。
我们的结果为QLQ-C30产生单一汇总分数的测量模型提供了实证支持。该汇总分数的可用性可以避免在基于该问卷产生的15个结果进行比较时因多重检验而出现的潜在I型错误问题，并且在总体汇总分数是相关主要结果时，可能会减少使用QLQ-C30问卷进行健康相关生活质量研究的样本量要求。
