Establishing the European Norm for the health-related quality of life domains of the computer-adaptive test EORTC CAT Core

Abstract

The computer-adaptive test (CAT) of the European Organisation for Research and Treatment of Cancer (EORTC), the EORTC CAT Core, assesses the same 15 domains as the EORTC QLQ-C30 health-related quality of life questionnaire but with increased precision, efficiency, measurement range and flexibility. CAT parameters for estimating scores have been established based on clinical data from cancer patients. This study aimed at establishing the European Norm for each CAT domain based on general population data. Methods: We collected representative general population data across 11 European Union (EU) countries, Russia, Turkey, Canada and the United States (n ! 1000/country; stratified by sex and age). We selected item subsets from each CAT domain for data collection (totalling 86 items). Differential item functioning (DIF) analyses were conducted to investigate crosscultural measurement invariance. For each domain, means and standard deviations from the EU countries (weighted by country population, sex and age) were used to establish a Tmetric with a European general population mean Z 50 (standard deviation Z 10). Results: A total of 15,386 respondents completed the online survey (n Z 11,343 from EU countries). EORTC CAT Core norm scores for all 15 countries were calculated. DIF had negligible impact on scoring. Domain-specific T-scores differed significantly across countries with small to medium effect sizes. Conclusion: This study establishes the official European Norm for the EORTC CAT Core. The European CAT Norm can be used globally and allows for meaningful interpretation of scores. Furthermore, CAT scores can be compared with sex-and age-adjusted norm scores at a national level within each of the 15 countries.

The Relationship between Quality of Life, Bone Pain, Skin Pruritus and Depression among Patients with Secondary Hyperparathyroidism: A Cross-Sectional Study

“…The vast majority of SHPT patients have skin pruritus,bone pain,electrolyte disorder,coupled with longterm dialysis leading to the destruction of various systems of body,which complicates the screening,such as sleep disturbances,fatigue,loss of energy and poor appetite.However,no related surveys on QOL, bone pain, or skin pruritus in patients with SHPT have been reviewed at home or abroad. In this study, the average QOL score was 41.76±8.15, which was lower than the norm [23], and the average score for bone pain was 5.08±2.65, which was higher than the norm [24]. This was consistent with Galvez-Sanchez's [25] and Rehman's [26] ndings.…”

The Relationship between Quality of Life, Bone Pain, Skin Pruritus and Depression among Patients with Secondary Hyperparathyroidism undergoing Parathyroidectomy: A Cross-Sectional Study

“…The status of SHPT patients' QOL, bone pain, and skin pruritus The vast majority of patients with SHPT undergoing PTX have skin pruritus,bone pain,electrolyte disorder,coupled with long-term dialysis leading to the destruction of various systems of body,which complicates the screening,such as sleep disturbances,fatigue,loss of energy and poor appetite.However,no related surveys on QOL, bone pain, or skin pruritus in patients with SHPT have been reviewed at home or abroad. In this study, the average QOL score was 41.76±8.15, which was lower than the norm [23], and the average score for bone pain was 5.08±2.65, which was higher than the norm [24]. This was consistent with Galvez-Sanchez's [25] and Rehman's [26] ndings.…”

Thresholds for clinical importance were defined for the European Organisation for Research and Treatment of Cancer Computer Adaptive Testing Core—an adaptive measure of core quality of life domains in oncology clinical practice and research

“…This could indicate a response shift phenomenon [29], resulting in an underestimation of the true difference between cancer patients and the general population but may also reflect the high percentage of individuals suffering from (chronic) diseases in the general population. In the normative sample for the EORTC CAT Core [9], for example, 61.0% of the participants from the general population reported at least one health condition, with chronic pain (23%), arthritis (13%), and diabetes (10%) being most common. Development of thresholds for PRO measures has been recommended in the literature because the interpretation of scores on abstract metrics has been identified as one of the major barriers to the use of PRO measures in daily clinical practice [30].…”

“…The symptom domains cover fatigue (FA), pain (PA), nausea/vomiting (NV), appetite loss (AP), dyspnea (DY), sleep disturbances (SL), diarrhea (DI), constipation (CO), and financial impact of disease (FI). The EORTC CAT Core presents results as T-scores that are based on a representative general population sample of 11,343 individuals from 11 European countries [9]. Higher scores on the functioning scales indicate higher levels of functioning, whereas higher scores on the symptom scales represent more symptom burden.…”

“…Scores from the EORTC CAT Core are presented on a T-score metric, which is a standardized metric with a mean of 50 and a standard deviation (SD) of 10 points. Standardization is reached through the use of a reference population [9]. This scoring method is different from the scoring of the QLQ-C30, which presents scores on a 0e100 metric derived from summing responses to individual questions and the use of linear transformation [10].…”