Evidence-based guidelines for interpreting change scores for the European Organisation for the Research and Treatment of Cancer quality of life questionnaire core 30 (EORTC QLQ-C30).

K Cocks (Corresponding Author), M. T. King, G. Velikova, G de Castro Jr, M. Martyn St. James, P. M. Fayers, J.M. Brown

Research output: Contribution to journalArticle

111 Citations (Scopus)

Abstract

Aim
To use published literature and experts’ opinion to investigate the clinical meaning and magnitude of changes in the Quality of Life (QOL) of groups of patients measured with the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30).

Methods
An innovative method combining systematic review of published studies, expert opinions and meta-analysis was used to estimate large, medium, and small mean changes over time for QLQ-C30 scores.

Results
Nine hundred and eleven papers were identified, leading to 118 relevant papers. One thousand two hundred and thirty two mean changes in QOL over time were combined in the meta-analysis, with timescales ranging from four days to five years. Guidelines were produced for trivial, small, and medium size classes, for each subscale and for improving and declining scores separately. Estimates for improvements were smaller than respective estimates for declines.

Conclusions
These guidelines can be used to aid sample size calculations and interpretation of mean changes over time from groups of patients. Observed mean changes in the QLQ-C30 scores are generally small in most clinical situations, possibly due to response shift. Careful consideration is needed when planning studies where QOL changes over time are of primary interest; the timing of follow up, sample attrition, direction of QOL changes, and subscales of primary interest are key considerations.
Original languageEnglish
Pages (from-to)1713-1721
Number of pages9
JournalEuropean Journal of Cancer
Volume48
Issue number11
Early online date12 Mar 2012
DOIs
Publication statusPublished - Jul 2012

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Quality of Life
Organizations
Guidelines
Research
Expert Testimony
Neoplasms
Meta-Analysis
Therapeutics
Sample Size
Surveys and Questionnaires

Keywords

  • EORTC QLQ-C30
  • Statistical data interpretation
  • Quality of Life
  • Longitudinal studies
  • Meaningful difference
  • Minimally important difference
  • Sample size

Cite this

Evidence-based guidelines for interpreting change scores for the European Organisation for the Research and Treatment of Cancer quality of life questionnaire core 30 (EORTC QLQ-C30). / Cocks, K (Corresponding Author); King, M. T.; Velikova, G.; de Castro Jr, G; Martyn St. James, M.; Fayers, P. M.; Brown, J.M.

In: European Journal of Cancer, Vol. 48, No. 11, 07.2012, p. 1713-1721.

Research output: Contribution to journalArticle

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title = "Evidence-based guidelines for interpreting change scores for the European Organisation for the Research and Treatment of Cancer quality of life questionnaire core 30 (EORTC QLQ-C30).",
abstract = "AimTo use published literature and experts’ opinion to investigate the clinical meaning and magnitude of changes in the Quality of Life (QOL) of groups of patients measured with the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30).MethodsAn innovative method combining systematic review of published studies, expert opinions and meta-analysis was used to estimate large, medium, and small mean changes over time for QLQ-C30 scores.ResultsNine hundred and eleven papers were identified, leading to 118 relevant papers. One thousand two hundred and thirty two mean changes in QOL over time were combined in the meta-analysis, with timescales ranging from four days to five years. Guidelines were produced for trivial, small, and medium size classes, for each subscale and for improving and declining scores separately. Estimates for improvements were smaller than respective estimates for declines.ConclusionsThese guidelines can be used to aid sample size calculations and interpretation of mean changes over time from groups of patients. Observed mean changes in the QLQ-C30 scores are generally small in most clinical situations, possibly due to response shift. Careful consideration is needed when planning studies where QOL changes over time are of primary interest; the timing of follow up, sample attrition, direction of QOL changes, and subscales of primary interest are key considerations.",
keywords = "EORTC QLQ-C30, Statistical data interpretation, Quality of Life, Longitudinal studies, Meaningful difference, Minimally important difference, Sample size",
author = "K Cocks and King, {M. T.} and G. Velikova and {de Castro Jr}, G and {Martyn St. James}, M. and Fayers, {P. M.} and J.M. Brown",
note = "Role of the funding source Cancer Research UK funded the study [Grant No. C7852/A5653] and a UICC ICRETT fellowship provided a travel and subsistence grant to K.C. at the start of the study. The funders had no role in the design and conduct of the study; the collection, management, analysis and interpretation of data; the writing of the manuscript; or the decision to submit the manuscript for publication. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.",
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AU - Velikova, G.

AU - de Castro Jr, G

AU - Martyn St. James, M.

AU - Fayers, P. M.

AU - Brown, J.M.

N1 - Role of the funding source Cancer Research UK funded the study [Grant No. C7852/A5653] and a UICC ICRETT fellowship provided a travel and subsistence grant to K.C. at the start of the study. The funders had no role in the design and conduct of the study; the collection, management, analysis and interpretation of data; the writing of the manuscript; or the decision to submit the manuscript for publication. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

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N2 - AimTo use published literature and experts’ opinion to investigate the clinical meaning and magnitude of changes in the Quality of Life (QOL) of groups of patients measured with the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30).MethodsAn innovative method combining systematic review of published studies, expert opinions and meta-analysis was used to estimate large, medium, and small mean changes over time for QLQ-C30 scores.ResultsNine hundred and eleven papers were identified, leading to 118 relevant papers. One thousand two hundred and thirty two mean changes in QOL over time were combined in the meta-analysis, with timescales ranging from four days to five years. Guidelines were produced for trivial, small, and medium size classes, for each subscale and for improving and declining scores separately. Estimates for improvements were smaller than respective estimates for declines.ConclusionsThese guidelines can be used to aid sample size calculations and interpretation of mean changes over time from groups of patients. Observed mean changes in the QLQ-C30 scores are generally small in most clinical situations, possibly due to response shift. Careful consideration is needed when planning studies where QOL changes over time are of primary interest; the timing of follow up, sample attrition, direction of QOL changes, and subscales of primary interest are key considerations.

AB - AimTo use published literature and experts’ opinion to investigate the clinical meaning and magnitude of changes in the Quality of Life (QOL) of groups of patients measured with the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30).MethodsAn innovative method combining systematic review of published studies, expert opinions and meta-analysis was used to estimate large, medium, and small mean changes over time for QLQ-C30 scores.ResultsNine hundred and eleven papers were identified, leading to 118 relevant papers. One thousand two hundred and thirty two mean changes in QOL over time were combined in the meta-analysis, with timescales ranging from four days to five years. Guidelines were produced for trivial, small, and medium size classes, for each subscale and for improving and declining scores separately. Estimates for improvements were smaller than respective estimates for declines.ConclusionsThese guidelines can be used to aid sample size calculations and interpretation of mean changes over time from groups of patients. Observed mean changes in the QLQ-C30 scores are generally small in most clinical situations, possibly due to response shift. Careful consideration is needed when planning studies where QOL changes over time are of primary interest; the timing of follow up, sample attrition, direction of QOL changes, and subscales of primary interest are key considerations.

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KW - Longitudinal studies

KW - Meaningful difference

KW - Minimally important difference

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