Oerlemans Simone, Lodder Paul, van der Baan Frederieke, Giesinger Johannes M, Ezendam Nicole P M
Department of Research and development, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands; Department of Methodology and Statistics, Tilburg University, Tilburg, The Netherlands.
J Clin Epidemiol. 2025 May 29;184:111853. doi: 10.1016/j.jclinepi.2025.111853.
Across patient-reported outcome measures (PROMs), the European Organization of Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) is one of the most widely used among patients with cancer. Patients may also complete other PROMs such as forms of the Patient-Reported Outcomes Measurement Information System (PROMIS). The objective of this study was to develop crosswalks between the EORTC QLQ-C30 physical, role, social and emotional functioning, fatigue and global health status/quality of life (QoL) scales and their corresponding PROMIS scales.
In a single group-design, using the Netherlands Patient-Reported Outcomes Following Initial Treatment and Long-term Evaluation of Survivorship (PROFILES) registry, patients of various cancers were invited to complete the EORTC QLQ-C30 and PROMIS forms from September to December 2022. Data were randomly divided into a calibration and validation set. Crosswalks were developed using equipercentile equating and their predictive performance was assessed in terms of standardized mean absolute errors (SMAEs) and intraclass correlations (ICCs).
The total sample consisted of 1972 cancer patients (mean age 61 years; 55% female). We developed 15 crosswalks. Their SMAE was generally satisfactory (below 0.50) and comparable in the calibration and validation datasets. The highest precision was found for the physical functioning and fatigue crosswalks, followed by role functioning, emotional functioning and depression. The lowest precision was found for the EORTC QLQ-C30 to PROMIS general health, general QoL, and anxiety scores. Almost all ICC were above 0.70, except for EORTC QLQ-C30 to PROMIS anxiety/depression and PROMIS to EORTC social functioning.
We developed valid crosswalks for multiple scales of the EORTC QLQ-C30 and PROMIS. The established concordance tables can be used to convert scores in both directions and are valid for group level analyses. The crosswalks from EORTC emotional functioning toward PROMIS anxiety and depression demonstrate suboptimal performance and should therefore be used carefully.
在患者报告结局指标（PROMs）中，欧洲癌症研究与治疗组织生活质量问卷核心30项（EORTC QLQ-C30）是癌症患者中使用最广泛的指标之一。患者也可能会完成其他PROMs，如患者报告结局测量信息系统（PROMIS）的各种形式。本研究的目的是建立EORTC QLQ-C30的身体、角色、社会和情感功能、疲劳以及总体健康状况/生活质量（QoL）量表与其相应PROMIS量表之间的转换关系。
采用单组设计，利用荷兰初始治疗后患者报告结局及幸存者长期评估（PROFILES）登记库，邀请各类癌症患者在2022年9月至12月期间完成EORTC QLQ-C30和PROMIS表格。数据被随机分为校准集和验证集。使用等百分位等值法建立转换关系，并根据标准化平均绝对误差（SMAEs）和组内相关系数（ICCs）评估其预测性能。
总样本包括1972名癌症患者（平均年龄61岁；55%为女性）。我们建立了15种转换关系。它们的SMAE总体上令人满意（低于0.50），在校准集和验证数据集中相当。身体功能和疲劳转换关系的精度最高，其次是角色功能、情感功能和抑郁。EORTC QLQ-C30到PROMIS总体健康、总体QoL和焦虑评分的精度最低。几乎所有的ICC都高于0.70，EORTC QLQ-C30到PROMIS焦虑/抑郁以及PROMIS到EORTC社会功能的ICC除外。
我们为EORTC QLQ-C30和PROMIS的多个量表建立了有效的转换关系。已建立的一致性表格可用于双向转换分数，并且对组水平分析有效。从EORTC情感功能到PROMIS焦虑和抑郁的转换关系表现欠佳，因此应谨慎使用。
