Testing the measurement invariance of the EORTC QLQ-C30 across primary cancer sites using multi-group confirmatory factor analysis

D. S.J. Costa* (Corresponding Author), N. K. Aaronson, P. M. Fayers, J. F. Pallant, G. Velikova, M. T. King

*Corresponding author for this work

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose: The EORTC Quality of Life Questionnaire is a widely used cancer-specific quality of life instrument comprising a core set of 30 items (QLQ-C30) supplemented by cancer site-specific modules. The purpose of this paper was to examine the extent to which the conventional multi-item domain structure of the QLQ-C30 holds across patients with seven different primary cancer sites. Methods: Multi-group confirmatory factor analysis was used to test whether a measurement model of the QLQ-C30 was invariant across cancer sites. Configural (same patterns of factor loadings), metric (equivalence of factor loadings) and scalar (equivalence of thresholds) invariance amongst the cancer site groups were assessed (N = 1,906) by comparing the fit of a model with these parameters freely estimated to a model where estimates were constrained to be equal for the corresponding items in each group. Results: All groups exhibited good model fit except for the prostate group, which was excluded. Only 1 of 576 parameters was found to differ between primary sites: specifically, the first threshold of Item 1 in the breast cancer group exhibited non-invariance. In a post hoc analysis, several instances of non-invariance by treatment status (baseline, on-treatment, off-treatment) were observed. Conclusions: Given only one instance of non-invariance between cancer sites, there is a reason to be confident in the validity of conclusions drawn when comparing QLQ-C30 domain scores between different sites and when interpreting the scores of heterogeneous samples, although future research should assess the potential impact of confounding variables such as treatment and gender.

Original languageEnglish
Pages (from-to)125-133
Number of pages9
JournalQuality of Life Research
Volume24
Issue number1
Early online date6 Sep 2014
DOIs
Publication statusPublished - Jan 2015

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Statistical Factor Analysis
Neoplasms
Quality of Life
Confounding Factors (Epidemiology)
Therapeutics
Prostate
Breast Neoplasms

Keywords

  • EORTC QLQ-C30
  • Measurement invariance
  • Multi-group confirmatory factor analysis
  • Quality of life

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Testing the measurement invariance of the EORTC QLQ-C30 across primary cancer sites using multi-group confirmatory factor analysis. / Costa, D. S.J. (Corresponding Author); Aaronson, N. K.; Fayers, P. M.; Pallant, J. F.; Velikova, G.; King, M. T.

In: Quality of Life Research, Vol. 24, No. 1, 01.2015, p. 125-133.

Research output: Contribution to journalArticle

Costa, D. S.J. ; Aaronson, N. K. ; Fayers, P. M. ; Pallant, J. F. ; Velikova, G. ; King, M. T. / Testing the measurement invariance of the EORTC QLQ-C30 across primary cancer sites using multi-group confirmatory factor analysis. In: Quality of Life Research. 2015 ; Vol. 24, No. 1. pp. 125-133.
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title = "Testing the measurement invariance of the EORTC QLQ-C30 across primary cancer sites using multi-group confirmatory factor analysis",
abstract = "Purpose: The EORTC Quality of Life Questionnaire is a widely used cancer-specific quality of life instrument comprising a core set of 30 items (QLQ-C30) supplemented by cancer site-specific modules. The purpose of this paper was to examine the extent to which the conventional multi-item domain structure of the QLQ-C30 holds across patients with seven different primary cancer sites. Methods: Multi-group confirmatory factor analysis was used to test whether a measurement model of the QLQ-C30 was invariant across cancer sites. Configural (same patterns of factor loadings), metric (equivalence of factor loadings) and scalar (equivalence of thresholds) invariance amongst the cancer site groups were assessed (N = 1,906) by comparing the fit of a model with these parameters freely estimated to a model where estimates were constrained to be equal for the corresponding items in each group. Results: All groups exhibited good model fit except for the prostate group, which was excluded. Only 1 of 576 parameters was found to differ between primary sites: specifically, the first threshold of Item 1 in the breast cancer group exhibited non-invariance. In a post hoc analysis, several instances of non-invariance by treatment status (baseline, on-treatment, off-treatment) were observed. Conclusions: Given only one instance of non-invariance between cancer sites, there is a reason to be confident in the validity of conclusions drawn when comparing QLQ-C30 domain scores between different sites and when interpreting the scores of heterogeneous samples, although future research should assess the potential impact of confounding variables such as treatment and gender.",
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note = "Acknowledgments The following individuals contributed to data for this analysis: U. Abacioglu, J. Arraras, E. Brenne, W.-C. Chie, S. Kaasa, P. Klepsted, S. Peacock, R. Schwarz, G. Velikova and the Australian Gastro-Intestinal Trials Group. This research was supported by a National Health and Medical Research Council (Australia) Project Grant.",
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AU - Velikova, G.

AU - King, M. T.

N1 - Acknowledgments The following individuals contributed to data for this analysis: U. Abacioglu, J. Arraras, E. Brenne, W.-C. Chie, S. Kaasa, P. Klepsted, S. Peacock, R. Schwarz, G. Velikova and the Australian Gastro-Intestinal Trials Group. This research was supported by a National Health and Medical Research Council (Australia) Project Grant.

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N2 - Purpose: The EORTC Quality of Life Questionnaire is a widely used cancer-specific quality of life instrument comprising a core set of 30 items (QLQ-C30) supplemented by cancer site-specific modules. The purpose of this paper was to examine the extent to which the conventional multi-item domain structure of the QLQ-C30 holds across patients with seven different primary cancer sites. Methods: Multi-group confirmatory factor analysis was used to test whether a measurement model of the QLQ-C30 was invariant across cancer sites. Configural (same patterns of factor loadings), metric (equivalence of factor loadings) and scalar (equivalence of thresholds) invariance amongst the cancer site groups were assessed (N = 1,906) by comparing the fit of a model with these parameters freely estimated to a model where estimates were constrained to be equal for the corresponding items in each group. Results: All groups exhibited good model fit except for the prostate group, which was excluded. Only 1 of 576 parameters was found to differ between primary sites: specifically, the first threshold of Item 1 in the breast cancer group exhibited non-invariance. In a post hoc analysis, several instances of non-invariance by treatment status (baseline, on-treatment, off-treatment) were observed. Conclusions: Given only one instance of non-invariance between cancer sites, there is a reason to be confident in the validity of conclusions drawn when comparing QLQ-C30 domain scores between different sites and when interpreting the scores of heterogeneous samples, although future research should assess the potential impact of confounding variables such as treatment and gender.

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