Assessment of the measurement properties of quality of life questionnaires in Brazilian women with breast cancer

Abstract

BACKGROUND: There are several questionnaires available to assess quality of life in breast cancer, however the choice of the best questionnaire often does not take into account the adequacy of these questionnaires' measurement properties. OBJECTIVE: To test the measurement properties of two generic quality of life questionnaires and one quality of life questionnaire specific for women with breast cancer. METHOD: We assessed 106 women after surgery for breast cancer. The assessment included application of the SF-36, WHOQOL-bref, and FACT-B+4 questionnaires as well as the Global Perceived Effect and Pain Numerical Rating scales. The participants were interviewed on three occasions to investigate internal consistency, floor and ceiling effects, construct validity, reproducibility, and responsiveness. RESULTS: Most of the instruments' domains showed adequate internal consistency (Cronbach's alpha varying from 0.66 to 0.91). Reliability varied from poor to substantial (ICC2,1 between 0.39 and 0.87) and agreement varied from negative to very good. The SF-36 presented doubtful agreement and showed floor and ceiling effects in three domains. The domains of the generic questionnaires presented moderate to good correlation with the FACT-B+4 (Pearson varying from 0.31 to 0.69). The internal responsiveness varied from small to large (ES varying from -0.26 to 0.98) and external responsiveness was found in only some of the instruments' domains. CONCLUSIONS: Most of the measurement properties tested for the WHOQOL-bref and FACT-B+4 were adequate as was their ability to assess quality of life in women with breast cancer. The SF-36 showed inadequacy in agreement and floor and ceiling effects and should not be used in women with breast cancer.

Standard error of measurement and smallest detectable change of the Sarcopenia Quality of Life (SarQoL) questionnaire: An analysis of subjects from 9 validation studies

“…Hart found a SEM of 4 points for the Physical Component Summary (PCS-range: 0-100 points) and the Mental Component Summary (MCS-range: 0-100 points) of the SF-36 in a population of 68 subjects with a variety of orthopedic impairments [25] and Palmer calculated a SEM of 3.09 points for the PCS and 5.57 points for the MCS in a population of 233 subjects with joint hypermobility [26]. Other studies looked at the SEM for the 8 domains of the SF-36 (all range between 0-100 points), and found SEMs between 8.82 and 34.52 points in 106 women undergoing surgery for breast cancer [27], between 13.2 and 44.7 points in 92 subjects with neck pain [28], between 6.82 and 11.22 points for 628 subjects undergoing foot or ankle surgery [29], and between 11 and 32 points for 515 subjects undergoing orthopedic surgery [30]. While these have been calculated in populations that differ from ours, they show a trend for higher standard errors of measurement compared to the SarQoL questionnaire.…”

Impact of breast cancer and quality of life of women survivors

“…Quality of Life: a translated and validated Portuguese version of the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) (13) , consisting of 27 items that evaluate physical well-being (seven items, score 0-28), social/family well-being (seven items, score 0-28), emotional well-being (six items; score 0-24), functional well-being (seven items, score 0-28) and additional concerns (10 items, 0-40 score). The scores of each domain are summed up, and the maximum total is 108 points.…”

Nordic walking for women with breast cancer: A systematic review

“…In the first place, small effect sizes were reported for a number of variables such as lymphedema, cardiovascular capacity, disability and quality of life. In the second place, the improvements observed in the participants’ quality of life (Oliveira, Costa, Manzoni, & Cabral, ), pain (Harrington, Gilchrist, & Sander, ) and shoulder function (Smoot et al, ) could not be considered as minimal detectable changes. These facts offer a better understanding of the impact that performing NW has on women with BC.…”

“…In the first place, small effect sizes were reported for a number of variables such as lymphedema, cardiovascular capacity, disability and quality of life. In the second place, the improvements observed in the participants' quality of life (Oliveira, Costa, Manzoni, & Cabral, 2014), pain (Harrington, Gilchrist, & Sander, 2014) and…”