Instrumental activities of daily living in neuro-oncology: International validation of the EORTC IADL-BN32 questionnaire

• Published in: European journal of cancer (1990) Vol. 212; p. 114335
• Main Authors: Oort, Q., Reijneveld, J.C., Sikkes, S.A.M., Koekkoek, J.A.F., Boele, F., Young, T., Brannan, C., Chalk, T., Talacchi, A., Mazzotta, A., Narita, Y., Sato, H., Miyakita, Y., Shamieh, O., Alrjoob, W., Pace, A., Petranovic, D., Ploh, M., Capela, A., Silva, J., Hjermstad, M.J., Purkart, T. Urbanic, Seidel, C., Talhi, N., Pichler, J., Höllmüller, I., Brown, L., Hand, M., Klein, M., Aaronson, N.K., Uitdehaag, B.M.J., Taphoorn, M.J.B., Dirven, L.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2024
• Subjects: Brain metastasis; Brain tumour; Daily functioning; Glioma; IADL; Instrumental activities of daily living; IADL; Daily functioning; Brain tumour; Glioma; Instrumental activities of daily living; Brain metastasis
• ISSN: 0959-8049; 1879-0852; 1879-0852
• DOI: 10.1016/j.ejca.2024.114335

Neurocognitive impairments are common in patients with a brain tumour, and may negatively impact on functioning in daily life, particularly on instrumental activities of daily living (IADL). The EORTC IADL-BN32 questionnaire was developed to measure IADL in this patient population. In this international validation study, we evaluated the EORTC IADL-BN32 questionnaire on several psychometric properties in a large sample of patients with a primary or metastatic brain tumour. We administered the 32-item questionnaire three times: at ‘baseline’, after 2 weeks and after 3 months. Procedures were in accordance with EORTC Quality of Life Group module development guidelines. In total, 326 patients participated in the study. A bifactor scale structure showed satisfactory model fit measures, with five multi-item scales and two single items, and an IADL sum score. The internal consistency of the multi-item scales ranged from good to excellent (range Cronbach’s α: 0.86–0.97). We found significant differences in scale scores between patients with and without neurocognitive impairments or complaints, supporting the construct validity. Initial cross-cultural validity analyses showed indications of item response biases for certain items. Analyses indicated moderate to good test-retest agreement (intraclass correlation coefficient > 0.70) between baseline and the 2-week follow-up assessment for all but one scale. Deterioration of EORTC IADL-BN32 scale scores were consistent with clinically relevant deterioration on other functional measures with small to large effect sizes, however, subgroup sample sizes were small. Overall, the EORTC IADL-BN32 questionnaire exhibited adequate to excellent psychometric properties. Cross-cultural validity and responsiveness should be further explored. •A brain tumour can negatively impact patients’ ability to function in daily life.•Instrumental activities of daily living (IADL) relates to autonomous functioning.•No valid and reliable instrument exists to assess IADL in brain tumour patients.•This validation study of the EORTC IADL-BN32 shows adequate validity and reliability.•The results justify using the EORTC IADL-BN32 in clinical trials and -practice.