Evaluating the Thresholds for Clinical Importance of the EORTC QLQ-C15-PAL in Patients Receiving Palliative Treatment

Abstract

Background: The EORTC QLQ-C15-PAL is a shortened version of the widely used EORTC QLQ-C30. This questionnaire was developed to measure the symptoms and functional health of patients receiving palliative care. Objective: To enhance clinical interpretability of the EORTC QLQ-C15-PAL, our aim was to evaluate the sensitivity and specificity of thresholds for clinical importance developed previously for the QLQ-C30 when applied to the QLQ-C15-PAL scales. Design: Cross-sectional observational study. Setting/Subjects: Patients with cancer receiving any type of palliative treatment. Measurement: Patients completed the EORTC QLQ-C15-PAL and anchor items on limitations, worries, and need for help for each of the health domains covered by the questionnaire. The anchor items were summarized in a binary criterion for clinical importance to calculate the sensitivity and specificity of the thresholds for clinical importance. Results: In total, 225 patients participated in the study (mean age 64.5 years). Patients were recruited from Austria, Italy, the Netherlands, Poland, Spain, and the United Kingdom. The thresholds for clinical importance for the QLQ-C15-PAL scales showed a median sensitivity of 0.88 (range: 0.82 for sleep disturbances to 1.00 for dyspnea) and a median specificity of 0.74 (range: 0.54 for dyspnea to 0.89 for constipation). Conclusion:The thresholds for clinical importance showed high sensitivity and mostly high specificity in identifying clinically important symptoms and functional health impairments as assessed by the QLQ-C15-PAL. These thresholds will facilitate interpretation of EORTC QLQ-C15-PAL scores in daily clinical practice and clinical research.

Impact of the COVID-19 pandemic on quality of life and emotional wellbeing in patients with bone metastases treated with radiotherapy: a prospective cohort study

“…The questionnaires consisted of: Brief Pain Inventory (BPI), European Organisation for Research and Treatment of Cancer quality of life questionnaires (EORTC-C15-PAL and EORTC-BM22) and the Euro-QoL five-dimensional instrument of health-related quality of life (EQ5D-3L). [11][12][13][14] The PRESENT-study was approved by the Medical Ethics Committee of the UMCU (NL49273.041.14, METC 13/261) and was registered on clinicaltrials.gov (NCT02356497). For the current study, an additional COVID-19 specific questionnaire was sent out to active PRESENT cohort patients who had given informed consent to receive quality of life questionnaires.…”

Twelve ESMO Congress 2022 breakthroughs: practicing oncologists’ perceptions and potential application on presented data

“… 26 The reported statistically significant difference of 7.7 points at 6 months can however not be regarded as clinically important based on previous validation research. 27 , 28 The percentage of patients with serious TRAEs was higher in the TIL study arm (100% versus 57.3%). It was not reported whether there had been toxic deaths in either study arm.…”

Associations between health-related quality of life and subsequent need for specialized palliative care and hospital utilization in patients with gastrointestinal cancer—a prospective single-center cohort study

“…Sensitivity analyses were performed for variables with statistically significant association to the outcomes by dichotomizing at two different cut-off points reflecting if the patient “experienced” the symptom/problem scores of ≥ 33 (a little) and experienced the symptom/problem “severely” with scores of ≥ 66 (quite a bit and very much) [ 32 ] . All adjusted analyses were adjusted for age, sex, cancer site, metastases, comorbidity, physical function, pain, and overall QoL.…”