Tumor Biology Centre, University Clinic Centre, Freiburg, Germany.
Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.
J Natl Cancer Inst. 2017 May 1;109(5). doi: 10.1093/jnci/djw273.
The European Organisation for Research and Treatment of Cancer (EORTC) Group has developed a new multidimensional instrument measuring cancer-related fatigue to be used in conjunction with the quality of life core questionnaire (EORTC QLQ-C30). The module EORTC QLQ-FA13 assesses physical, cognitive, and emotional aspects of cancer-related fatigue.
The methodology follows the EORTC guidelines for phase IV validation of modules. This paper focuses on the results of the psychometric validation of the factorial structure of the module. For validation and cross-validation confirmatory factor analysis (maximum likelihood estimation), intraclass correlation and Cronbach alpha for internal consistency were employed. The study involved an international multicenter collaboration of 11 European and non-European countries.
A total of 946 patients with various tumor diagnoses were enrolled. Based on the confirmatory factor analysis, we could approve the three-dimensional structure of the module. Removing one item and reassigning the factorial mapping of another item resulted in the EORTC QLQ-FA12. For the revised scale, we found evidence supporting good local (indicator reliability ≥ 0.60, factor reliability ≥ 0.82) and global model fit (GFI t1|t2 = 0.965/0.957, CFI t1|t2 = 0.976/0.972, RMSEA t1|t2 = 0.060/0.069) for both measurement points. For each scale, test-retest reliability proved to be very good (intraclass correlation: R t1-t2 = 0.905-0.921) and internal consistency proved to be good to high (Cronbach alpha = .79-.90).
Based on the former phase III module, the multidimensional structure was revised as a phase IV module (EORTC FA12) with an improved scale structure. For a comprehensive validation of the EORTC FA12, further aspects of convergent and divergent validity as well as sensitivity to change should be determined.
欧洲癌症研究与治疗组织（EORTC）小组开发了一种新的多维工具，用于测量癌症相关疲劳，与生活质量核心问卷（EORTC QLQ-C30）一起使用。模块 EORTC QLQ-FA13 评估与癌症相关的疲劳的身体、认知和情绪方面。
该方法遵循 EORTC 模块第四阶段验证指南。本文重点介绍该模块的因子结构的心理测量验证结果。验证和交叉验证采用确认性因子分析（最大似然估计）、内部一致性的组内相关和 Cronbach alpha。该研究涉及来自 11 个欧洲和非欧洲国家的国际多中心合作。
共有 946 名患有各种肿瘤诊断的患者入组。基于验证性因子分析，我们可以批准该模块的三维结构。删除一个项目并重新分配另一个项目的因子映射导致 EORTC QLQ-FA12。对于修订后的量表，我们发现支持良好的局部（指标可靠性≥0.60，因子可靠性≥0.82）和全球模型拟合（GFI t1|t2 = 0.965/0.957，CFI t1|t2 = 0.976/0.972，RMSEA t1|t2 = 0.060/0.069）的证据。对于每个量表，测试-重测可靠性非常好（组内相关：R t1-t2 = 0.905-0.921），内部一致性良好至较高（Cronbach alpha =.79-.90）。
基于前一阶段 III 模块，多维结构被修订为第四阶段模块（EORTC FA12），具有改进的量表结构。为了全面验证 EORTC FA12，还应确定收敛和发散有效性以及对变化的敏感性的进一步方面。
