Comparing translations of the EORTC QLQ-C30 using differential item functioning analyses

Neil William Scott, Peter Fayers, A. Bottomley, N. K. Aaronson, A. De Graeff, M. Groenvold, M. Koller, M. A. Petersen, M. A. G. Sprangers, Quality Life Cross Cultural Meta A, EORTC

Research output: Contribution to journalArticle

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Abstract

The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is one of the most widely used quality of life instruments for cancer patients. The aim of this study was to assess whether there were linguistic differences in the way an international sample answered the EORTC QLQ-C30 questionnaire. Thirteen translations of the EORTC QLQ-C30, representing 22 countries, were investigated using a database of 27,891 respondents, incorporating 103 separate studies. Differential item functioning (DIF) analyses were conducted using logistic regression to identify items which, after controlling for subscale, were answered differently by language of administration. Both uniform and non-uniform DIF were assessed. Although most languages showed similar results to English, at least one instance of statistically significant DIF was identified for each translation, and a few of these differences were large. In some cases, the patterns were supported by the results of qualitative interviews with bilingual people. Although, overall, there appeared to be good linguistic equivalence for most of the EORTC QLQ-C30 items, several scales showed strongly discrepant results for some translations. Some of these effects are large enough to impact on the results of clinical trials. Based on our experience in this study, we suggest that validation of translations of health-related quality of life instruments should include exploration of DIF.

Original languageEnglish
Pages (from-to)1103-1115
Number of pages13
JournalQuality of Life Research
Volume15
Issue number6
DOIs
Publication statusPublished - Aug 2006

Keywords

  • cancer
  • cross-cultural research
  • differential item functioning
  • EORTC QLQ-C30
  • translations
  • QUALITY-OF-LIFE
  • MANTEL-HAENSZEL PROCEDURES
  • LOGISTIC-REGRESSION
  • SPANISH TRANSLATION
  • RESPONSE THEORY
  • EFFECT SIZE
  • CANCER
  • BIAS
  • DIF
  • IMPACT

Cite this

Scott, N. W., Fayers, P., Bottomley, A., Aaronson, N. K., De Graeff, A., Groenvold, M., ... Quality Life Cross Cultural Meta A, EORTC (2006). Comparing translations of the EORTC QLQ-C30 using differential item functioning analyses. Quality of Life Research, 15(6), 1103-1115. https://doi.org/10.1007/s11136-006-0040-x

Comparing translations of the EORTC QLQ-C30 using differential item functioning analyses. / Scott, Neil William; Fayers, Peter; Bottomley, A.; Aaronson, N. K.; De Graeff, A.; Groenvold, M.; Koller, M.; Petersen, M. A.; Sprangers, M. A. G.; Quality Life Cross Cultural Meta A, EORTC.

In: Quality of Life Research, Vol. 15, No. 6, 08.2006, p. 1103-1115.

Research output: Contribution to journalArticle

Scott, NW, Fayers, P, Bottomley, A, Aaronson, NK, De Graeff, A, Groenvold, M, Koller, M, Petersen, MA, Sprangers, MAG & Quality Life Cross Cultural Meta A, EORTC 2006, 'Comparing translations of the EORTC QLQ-C30 using differential item functioning analyses', Quality of Life Research, vol. 15, no. 6, pp. 1103-1115. https://doi.org/10.1007/s11136-006-0040-x
Scott, Neil William ; Fayers, Peter ; Bottomley, A. ; Aaronson, N. K. ; De Graeff, A. ; Groenvold, M. ; Koller, M. ; Petersen, M. A. ; Sprangers, M. A. G. ; Quality Life Cross Cultural Meta A, EORTC. / Comparing translations of the EORTC QLQ-C30 using differential item functioning analyses. In: Quality of Life Research. 2006 ; Vol. 15, No. 6. pp. 1103-1115.
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title = "Comparing translations of the EORTC QLQ-C30 using differential item functioning analyses",
abstract = "The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is one of the most widely used quality of life instruments for cancer patients. The aim of this study was to assess whether there were linguistic differences in the way an international sample answered the EORTC QLQ-C30 questionnaire. Thirteen translations of the EORTC QLQ-C30, representing 22 countries, were investigated using a database of 27,891 respondents, incorporating 103 separate studies. Differential item functioning (DIF) analyses were conducted using logistic regression to identify items which, after controlling for subscale, were answered differently by language of administration. Both uniform and non-uniform DIF were assessed. Although most languages showed similar results to English, at least one instance of statistically significant DIF was identified for each translation, and a few of these differences were large. In some cases, the patterns were supported by the results of qualitative interviews with bilingual people. Although, overall, there appeared to be good linguistic equivalence for most of the EORTC QLQ-C30 items, several scales showed strongly discrepant results for some translations. Some of these effects are large enough to impact on the results of clinical trials. Based on our experience in this study, we suggest that validation of translations of health-related quality of life instruments should include exploration of DIF.",
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note = "Acknowledgements We gratefully acknowledge the assistance of the many individuals who helped supply datasets for this study. This work was funded by the EORTC Quality of Life Group and the University of Aberdeen and carried out under the auspices of the EORTC Quality of Life Group.",
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AU - Scott, Neil William

AU - Fayers, Peter

AU - Bottomley, A.

AU - Aaronson, N. K.

AU - De Graeff, A.

AU - Groenvold, M.

AU - Koller, M.

AU - Petersen, M. A.

AU - Sprangers, M. A. G.

AU - Quality Life Cross Cultural Meta A, EORTC

N1 - Acknowledgements We gratefully acknowledge the assistance of the many individuals who helped supply datasets for this study. This work was funded by the EORTC Quality of Life Group and the University of Aberdeen and carried out under the auspices of the EORTC Quality of Life Group.

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N2 - The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is one of the most widely used quality of life instruments for cancer patients. The aim of this study was to assess whether there were linguistic differences in the way an international sample answered the EORTC QLQ-C30 questionnaire. Thirteen translations of the EORTC QLQ-C30, representing 22 countries, were investigated using a database of 27,891 respondents, incorporating 103 separate studies. Differential item functioning (DIF) analyses were conducted using logistic regression to identify items which, after controlling for subscale, were answered differently by language of administration. Both uniform and non-uniform DIF were assessed. Although most languages showed similar results to English, at least one instance of statistically significant DIF was identified for each translation, and a few of these differences were large. In some cases, the patterns were supported by the results of qualitative interviews with bilingual people. Although, overall, there appeared to be good linguistic equivalence for most of the EORTC QLQ-C30 items, several scales showed strongly discrepant results for some translations. Some of these effects are large enough to impact on the results of clinical trials. Based on our experience in this study, we suggest that validation of translations of health-related quality of life instruments should include exploration of DIF.

AB - The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is one of the most widely used quality of life instruments for cancer patients. The aim of this study was to assess whether there were linguistic differences in the way an international sample answered the EORTC QLQ-C30 questionnaire. Thirteen translations of the EORTC QLQ-C30, representing 22 countries, were investigated using a database of 27,891 respondents, incorporating 103 separate studies. Differential item functioning (DIF) analyses were conducted using logistic regression to identify items which, after controlling for subscale, were answered differently by language of administration. Both uniform and non-uniform DIF were assessed. Although most languages showed similar results to English, at least one instance of statistically significant DIF was identified for each translation, and a few of these differences were large. In some cases, the patterns were supported by the results of qualitative interviews with bilingual people. Although, overall, there appeared to be good linguistic equivalence for most of the EORTC QLQ-C30 items, several scales showed strongly discrepant results for some translations. Some of these effects are large enough to impact on the results of clinical trials. Based on our experience in this study, we suggest that validation of translations of health-related quality of life instruments should include exploration of DIF.

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KW - LOGISTIC-REGRESSION

KW - SPANISH TRANSLATION

KW - RESPONSE THEORY

KW - EFFECT SIZE

KW - CANCER

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KW - DIF

KW - IMPACT

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JF - Quality of Life Research

SN - 0962-9343

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