Borghede G, Karlsson J, Sullivan M
Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden.
J Urol. 1997 Oct;158(4):1477-85; discussion 1486. doi: 10.1016/s0022-5347(01)64247-2.
We evaluated a prostate cancer-specific module in an unselected patient population.
A population study design was used to confirm the psychometric properties and clinical relevance of a prostate cancer-specific module, supplementing the standardized EORTC QLQ-C30 in Sweden. The study sample comprised 1,138 patients (81% response rate) examined by a mailout/mailback procedure 1.5 to 3.5 years after diagnosis. The standardized multitrait analysis method estimated the internal consistency and convergent and discriminant validity of 3 multi-item scales on sexuality, urinary symptoms and bowel symptoms. Confirmation of prostate-specific scales by disease stage and treatment used principal components analysis. The clinical relevance was tested by correlation analysis including disease and treatment-related parameters.
Convergent and discriminant validity of all 3 prostate-specific scales was confirmed. The internal consistency was satisfactory for the sexuality and urinary scales (alpha 0.92 and 0.76, respectively), while the bowel scale failed to reach the alpha level of 0.70 required for group comparisons. The former scales showed invariance over all principal components analyses of subgroups (disease stage and treatment). The latter scale comprised differing numbers of items in the subgroup analyses, suggesting the use of single items at present. Descriptive data of the core and module questionnaires by disease and treatment-related parameters confirmed their interpretability and thus their clinical usefulness.
The presented self-report questionnaire technique has great potential to inform clinicians about the quality of life in patients suffering from prostate cancer.
我们在一个未经挑选的患者群体中评估了一个前列腺癌特异性模块。
采用群体研究设计来确认一个前列腺癌特异性模块的心理测量特性和临床相关性,该模块补充了瑞典标准化的欧洲癌症研究与治疗组织核心问卷(EORTC QLQ-C30)。研究样本包括1138名患者(应答率81%),在诊断后1.5至3.5年通过邮寄/回寄程序进行检查。标准化的多特质分析方法估计了关于性功能、泌尿系统症状和肠道症状的3个多项目量表的内部一致性、收敛效度和区分效度。通过疾病分期和治疗对前列腺特异性量表进行确认采用主成分分析。通过包括疾病和治疗相关参数的相关分析来检验临床相关性。
所有3个前列腺特异性量表的收敛效度和区分效度均得到确认。性功能和泌尿系统量表的内部一致性令人满意(α分别为0.92和0.76),而肠道量表未达到组间比较所需的α水平0.70。前两个量表在亚组(疾病分期和治疗)的所有主成分分析中表现出不变性。后一个量表在亚组分析中包含不同数量的项目,表明目前使用单个项目。按疾病和治疗相关参数对核心问卷和模块问卷的描述性数据证实了它们的可解释性,从而证实了它们的临床实用性。
所提出的自我报告问卷技术有很大潜力为临床医生提供有关前列腺癌患者生活质量的信息。