The use of differential item functioning analyses to identify cultural differences in responses to the EORTC QLQ-C30

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

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Introduction: The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is a widely used health-related quality of life instrument. The main aim of this study is to investigate whether there are international differences in response to the questionnaire that can be explained by cultural factors. Methods: Analyses involved a database of 106 separate studies including data from over 28,000 respondents. Differential item functioning (DIF) analyses using logistic regression were conducted for each item of the EORTC QLQ-C30 with respect to cultural/geographic group. Results were qualitatively compared with previously reported DIF analyses by translation to explore whether the source of the DIF was more likely to be linguistic or cultural in nature. Results: Although most response patterns were similar, there were a number of international differences in how the questionnaire was answered. The largest variations were found in the results for Eastern Europe and East Asia. Results for the UK, the US and Australia tended to be similar. Many of the European results followed patterns that were more clearly explained when grouped by translation than when grouped by geographical region. Discussion: Our results suggest that, in general, the EORTC QLQ-C30 is suitable for use in a wide variety of countries and settings. Some response variations that have the potential to affect the results of international studies were identified, but it was not always clear whether the source of the variation was primarily linguistic or cultural.

Original languageEnglish
Pages (from-to)115-129
Number of pages15
JournalQuality of Life Research
Volume16
Issue number1
DOIs
Publication statusPublished - Feb 2007

Keywords

  • cancer
  • cross-cultural research
  • differential item functioning
  • EORTC QLQ-C30
  • quality of life
  • comparing translations
  • Spanish translation
  • depressive symptoms
  • questionnaire
  • bias
  • race/ethnicity
  • equivalence
  • countries

Cite this

The use of differential item functioning analyses to identify cultural differences in responses to the EORTC QLQ-C30. / Scott, Neil William; Fayers, Peter; Aaronson, N. K.; Bottomley, A.; de Graeff, A.; Groenvold, M.; Koller, M.; Peterson, M. A.; Sprangers, M. A. G.; EORTC Quality Life Cross Cultural.

In: Quality of Life Research, Vol. 16, No. 1, 02.2007, p. 115-129.

Research output: Contribution to journalArticle

Scott, NW, Fayers, P, Aaronson, NK, Bottomley, A, de Graeff, A, Groenvold, M, Koller, M, Peterson, MA, Sprangers, MAG & EORTC Quality Life Cross Cultural 2007, 'The use of differential item functioning analyses to identify cultural differences in responses to the EORTC QLQ-C30', Quality of Life Research, vol. 16, no. 1, pp. 115-129. https://doi.org/10.1007/s11136-006-9120-1
Scott, Neil William ; Fayers, Peter ; Aaronson, N. K. ; Bottomley, A. ; de Graeff, A. ; Groenvold, M. ; Koller, M. ; Peterson, M. A. ; Sprangers, M. A. G. ; EORTC Quality Life Cross Cultural. / The use of differential item functioning analyses to identify cultural differences in responses to the EORTC QLQ-C30. In: Quality of Life Research. 2007 ; Vol. 16, No. 1. pp. 115-129.
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abstract = "Introduction: The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is a widely used health-related quality of life instrument. The main aim of this study is to investigate whether there are international differences in response to the questionnaire that can be explained by cultural factors. Methods: Analyses involved a database of 106 separate studies including data from over 28,000 respondents. Differential item functioning (DIF) analyses using logistic regression were conducted for each item of the EORTC QLQ-C30 with respect to cultural/geographic group. Results were qualitatively compared with previously reported DIF analyses by translation to explore whether the source of the DIF was more likely to be linguistic or cultural in nature. Results: Although most response patterns were similar, there were a number of international differences in how the questionnaire was answered. The largest variations were found in the results for Eastern Europe and East Asia. Results for the UK, the US and Australia tended to be similar. Many of the European results followed patterns that were more clearly explained when grouped by translation than when grouped by geographical region. Discussion: Our results suggest that, in general, the EORTC QLQ-C30 is suitable for use in a wide variety of countries and settings. Some response variations that have the potential to affect the results of international studies were identified, but it was not always clear whether the source of the variation was primarily linguistic or cultural.",
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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 - Aaronson, N. K.

AU - Bottomley, A.

AU - de Graeff, A.

AU - Groenvold, M.

AU - Koller, M.

AU - Peterson, M. A.

AU - Sprangers, M. A. G.

AU - EORTC Quality Life Cross Cultural

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.

PY - 2007/2

Y1 - 2007/2

N2 - Introduction: The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is a widely used health-related quality of life instrument. The main aim of this study is to investigate whether there are international differences in response to the questionnaire that can be explained by cultural factors. Methods: Analyses involved a database of 106 separate studies including data from over 28,000 respondents. Differential item functioning (DIF) analyses using logistic regression were conducted for each item of the EORTC QLQ-C30 with respect to cultural/geographic group. Results were qualitatively compared with previously reported DIF analyses by translation to explore whether the source of the DIF was more likely to be linguistic or cultural in nature. Results: Although most response patterns were similar, there were a number of international differences in how the questionnaire was answered. The largest variations were found in the results for Eastern Europe and East Asia. Results for the UK, the US and Australia tended to be similar. Many of the European results followed patterns that were more clearly explained when grouped by translation than when grouped by geographical region. Discussion: Our results suggest that, in general, the EORTC QLQ-C30 is suitable for use in a wide variety of countries and settings. Some response variations that have the potential to affect the results of international studies were identified, but it was not always clear whether the source of the variation was primarily linguistic or cultural.

AB - Introduction: The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is a widely used health-related quality of life instrument. The main aim of this study is to investigate whether there are international differences in response to the questionnaire that can be explained by cultural factors. Methods: Analyses involved a database of 106 separate studies including data from over 28,000 respondents. Differential item functioning (DIF) analyses using logistic regression were conducted for each item of the EORTC QLQ-C30 with respect to cultural/geographic group. Results were qualitatively compared with previously reported DIF analyses by translation to explore whether the source of the DIF was more likely to be linguistic or cultural in nature. Results: Although most response patterns were similar, there were a number of international differences in how the questionnaire was answered. The largest variations were found in the results for Eastern Europe and East Asia. Results for the UK, the US and Australia tended to be similar. Many of the European results followed patterns that were more clearly explained when grouped by translation than when grouped by geographical region. Discussion: Our results suggest that, in general, the EORTC QLQ-C30 is suitable for use in a wide variety of countries and settings. Some response variations that have the potential to affect the results of international studies were identified, but it was not always clear whether the source of the variation was primarily linguistic or cultural.

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KW - depressive symptoms

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