Validation of the functional assessment of cancer therapy-gastric module for the Chinese population

Health and Quality of Life Outcomes

Khay Guan Yeoh⁴  Shu Chuen Li²  Nasheen Naidoo¹  Feng Zhu⁴  Nan Luo¹  Wei Peng Yong⁵  Jimmy BY So³  Hui Jun Zhou¹ 

[1] Saw Swee Hock School of Public Health, National University of Singapore, 16 Medical Drive, Block MD3, Singapore 117597, Singapore;Discipline of Pharmacy & Experimental Pharmacology, School of Biomedical Sciences & Pharmacy, Room 607c, Medical Sciences Building, University of Newcastle, Callaghan, N.S.W, 2308, Australia;Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 8, 1E Kent Ridge Road, Singapore 119228, Singapore;Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E, Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228, Singapore;Department of Haematology-Oncology, National University Cancer Institute, Singapore 14 Medical Drive, #12-01, Singapore 117599, Singapore

关键词: Chinese;    Validity;    Reliability;    Quality of life;    Functional assessment of cancer therapy- gastric;    Gastric cancer;   

Others  :  824824
DOI  :  10.1186/1477-7525-10-145

 received in 2012-07-03, accepted in 2012-11-23,  发布年份 2012

【 摘 要 】

Background

Quality of life (QoL) assessment has become an important aspect of the clinical management of gastric cancer (GC), which poses a greater health threat in Chinese populations around the world. Functional Assessment of Cancer Therapy-Gastric Module (FACT-Ga), a questionnaire developed specifically to measure QoL of patients with GC, has never been validated in Chinese subjects. The current study was designed to examine the psychometric properties of FACT-Ga as a GC specific QoL instrument for its future use in Chinese populations.

Methods

A sample of 67 Chinese patients with GC in the National University Hospital, Singapore was investigated cross-sectionally. The participants independently completed either English or Chinese versions of the FACT-Ga and the European Quality of Life-5 Dimensions (EQ-5D). Reliability was measured as the Cronbach’s α for EQ-5D, and five subscale scores and two total scores of FACT-Ga. The sensitivity to patients’ clinical status was evaluated by comparing EQ-5D and FACT-Ga scores between clinical subgroups classified by Clinical Stage and Treatment Intent. The construct validity of FACT-Ga was assessed internally by examining the item-to-scale correlations and externally by contrasting the FACT-Ga subscales with the EQ-5D domains.

Results

For both FACT-Ga and EQ-5D, patients treated with curative intent rated their QoL higher than those treated for palliation, and early stage patients scored higher than those in the late stage. The sensitivity to clinical status of FACT-Ga scores were differential as four of seven FACT-Ga scores were significant for Treatment Intent while only one subscale score was significant for Clinical Stage. Six FACT-Ga scores had Cronbach’s α of 0.8 or above indicating excellent reliability. For construct validity, 45 of 46 items converged about their respective subscales. The monotrait-multimethod correlations between QoL constructs of FACT-Ga and EQ-5D were stronger than the multitrait-multimethod correlations as theoretically hypothesized, suggesting good convergent and discriminant validities.

Conclusions

Given the excellent reliability and good construct validity, FACT-Ga scores are able to distinguish patient groups with different clinical characteristics in the expected direction. Therefore FACT-Ga can be used as a discriminative instrument for measuring QoL of Chinese patients with GC.

【 授权许可】

   
2012 Zhou et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Conroy T, Uwer L, Deblock M: Health-related quality-of-life assessment in gastrointestinal cancer: are results relevant for clinical practice? Curr Opin Oncol 2007, 19:401-406.
• [2]Holzner B, Kemmler G, Sperner-Unterweger B, Kopp M, Dunser M, Margreiter R, Marschitz I, Nachbaur D, Fleischhacker WW, Greil R: Quality of life measurement in oncology–a matter of the assessment instrument? Eur J Cancer 2001, 37:2349-2356.
• [3]Webster K, Cella D, Yost K: The functional assessment of chronic illness therapy (FACIT) measurement system: properties, applications, and interpretation. Health Qual Life Outcomes 2003, 1:79. BioMed Central Full Text
• [4]Cheung YB, Goh C, Thumboo J, Khoo KS, Wee J: Variability and sample size requirements of quality-of-life measures: a randomized study of three major questionnaires. J Clin Oncol 2005, 23:4936-4944.
• [5]Tong MC, Lo PS, Wong KH, Yeung RM, van Hasselt CA, Eremenco S, Cella D: Development and validation of the functional assessment of cancer therapy nasopharyngeal cancer subscale. Head Neck 2009, 31:738-747.
• [6]Uwer L, Rotonda C, Guillemin F, Miny J, Kaminsky MC, Mercier M, Tournier-Rangeard L, Leonard I, Montcuquet P, Rauch P, Conroy T: Responsiveness of EORTC QLQ-C30, QLQ-CR38 and FACT-C quality of life questionnaires in patients with colorectal cancer. Health Qual Life Outcomes 2011, 9:70. BioMed Central Full Text
• [7]Saitoh E, Yokomizo Y, Chang CH, Eremenco S, Kaneko H, Kobayashi K: Cross-cultural validation of the Japanese version of the lung cancer subscale on the functional assessment of cancer therapy-lung. J Nihon Med Sch 2007, 74:402-408.
• [8]Eremenco JC SL, Webster K, Ohashi Y, Locker GY, Pelletier G, Cella D: FACT-Gastric: a new international measure of QOL in gastric cancer. J Clin Oncol 2004, 22:755.
• [9]Garland SN, Pelletier G, Lawe A, Biagioni BJ, Easaw J, Eliasziw M, Cella D, Bathe OF: Prospective evaluation of the reliability, validity, and minimally important difference of the functional assessment of cancer therapy-gastric (FACT-Ga) quality-of-life instrument. Cancer 2011, 117:1302-1312.
• [10]Debb SM, Arnold B, Perez B, Cella D: Validation of the FACT-Gastric cancer quality of life questionnaire for use in Spanish-speaking countries. Psychooncology 2011, 20:19-27.
• [11]Ang TL, Fock KM, Dhamodaran S, Teo EK, Tan J: Racial differences in Helicobacter pylori, serum pepsinogen and gastric cancer incidence in an urban Asian population. J Gastroenterol Hepatol 2005, 20:1603-1609.
• [12]Bertuccio P, Chatenoud L, Levi F, Praud D, Ferlay J, Negri E, Malvezzi M, La Vecchia C: Recent patterns in gastric cancer: a global overview. Int J Cancer 2009, 125:666-673.
• [13]Zhang YQ, MacLennan R, Berry G: Mortality of Chinese in New South Wales, 1969–1978. Int J Epidemiol 1984, 13:188-192.
• [14]Anikeeva O, Bi P, Hiller JE, Ryan P, Roder D, Han GS: Trends in cancer mortality rates among migrants in Australia: 1981–2007. Cancer Epidemiol 2012, 36:e74-e82.
• [15]Yu CL, Fielding R, Chan CL, Tse VK, Choi PH, Lau WH, Choy DT, O SK, Lee AW, Sham JS: Measuring quality of life of Chinese cancer patients: a validation of the Chinese version of the functional assessment of cancer therapy-General (FACT-G) scale. Cancer 2000, 88:1715-1727.
• [16]Cheung YB, Thumboo J, Goh C, Khoo KS, Che W, Wee J: The equivalence and difference between the English and Chinese versions of two major, cancer-specific, health-related quality-of-life questionnaires. Cancer 2004, 101:2874-2880.
• [17]Cheung YB, Goh C, Wee J, Khoo KS, Thumboo J: Measurement properties of the Chinese language version of the functional assessment of cancer therapy-general in a Singaporean population. Ann Acad Med Singapore 2009, 38:225-229.
• [18]Fock KM, Ang TL: Epidemiology of Helicobacter pylori infection and gastric cancer in Asia. J Gastroenterol Hepatol 2010, 25:479-486.
• [19]Cheung YB, Wong LC, Tay MH, Toh CK, Koo WH, Epstein R, Goh C: Order effects in the assessment of quality of life in cancer patients. Qual Life Res 2004, 13:1217-1223.
• [20]Dolan P, Gudex C: Time preference, duration and health state valuations. Health Econ 1995, 4:289-299.
• [21]Gao F, Ng GY, Cheung YB, Thumboo J, Pang G, Koo WH, Sethi VK, Wee J, Goh C: The Singaporean English and Chinese versions of the EQ-5D achieved measurement equivalence in cancer patients. J Clin Epidemiol 2009, 62:206-213.
• [22]Cella D: FACIT Manual: Manual of the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System. CORE, Evanston; 1997.
• [23]Nunnally JC: Psychometric theory. New York: McGraw-Hill Inc.; 1978.
• [24]Peter M, Fayers DM: Quality of life: the assessment, analysis and interpretation of patient-reported outcomes. 2nd edition. John Wiley and Sons; 2007.
• [25]The Multitrait-Multimethod Matrix. http://www.socialresearchmethods.net/kb/mtmmmat.php webcite
• [26]McHorney CA, Tarlov AR: Individual-patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res 1995, 4:293-307.
• [27]Ellis PD: The Essential Guide to Effect Sizes: An Introduction to Statistical Power, Meta-Analysis and the Interpretation of Research Results. Cambridge: Cambridge University Press; 2010.
• [28]Ware JE Jr, Gandek B: Methods for testing data quality, scaling assumptions, and reliability: the IQOLA project approach. international quality of life assessment. J Clin Epidemiol 1998, 51:945-952.
• [29]Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC: Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007, 60:34-42.
• [30]Cheung YB, Daniel R, Ng GY: Response and non-response to a quality-of-life question on sexual life: a case study of the simple mean imputation method. Qual Life Res 2006, 15:1493-1501.
• [31]Fairclough DL, Cella DF: Functional assessment of cancer therapy (FACT-G): non-response to individual questions. Qual Life Res 1996, 5:321-329.
• [32]Fumimoto H, Kobayashi K, Chang CH, Eremenco S, Fujiki Y, Uemura S, Ohashi Y, Kudoh S: Cross-cultural validation of an international questionnaire, the general measure of the functional assessment of cancer therapy scale (FACT-G), for Japanese. Qual Life Res 2001, 10:701-709.
• [33]Victorson D, Barocas J, Song J, Cella D: Reliability across studies from the functional assessment of cancer therapy-general (FACT-G) and its subscales: a reliability generalization. Qual Life Res 2008, 17:1137-1146.