Performance of the EORTC questionnaire for the assessment of quality of life in head and neck cancer patients EORTC QLQ-H&N35: a methodological review

• Published in: Quality of life research Vol. 22; no. 8; pp. 1927 - 1941
• Main Authors: Singer, Susanne, Arraras, Juan Ignacio, Chie, Wei-Chu, Fisher, Sheila E., Galalae, Razvan, Hammerlid, Eva, Nicolatou-Galitis, Ourania, Schmalz, Claudia, Verdonck-de Leeuw, Irma, Gamper, Eva, Keszte, Judith, Hofmeister, Dirk
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer 01.10.2013; Springer Netherlands; Springer Nature B.V
• Subjects: Archives; Cancer and Oncology; Cancer och onkologi; Cancer therapies; Carcinoma; Cohort analysis; Cronbach's alpha; Dentistry; EORTC QLQ-H&N35; Epidemiology; Head; Head & neck cancer; Head and neck cancer; Head and neck neoplasms; Head and Neck Neoplasms - psychology; Health care; Health Status Indicators; Hospitals; Humans; Language; Medicine; Medicine & Public Health; Neck; Observational studies; Oncology; Otolaryngology; Patients; Preventive medicine; Psychometrics; Psychometrics - instrumentation; Public Health; Quality of Life; Quality of Life Research; Quantitative psychology; Questionnaires; Radiotherapy; Reliability; Reproducibility of Results; Research Design; Sensitivity and Specificity; Sexual Behavior; Sociology; Surveys and Questionnaires - standards; Swallowing; Systematic review; Validation studies; Head and neck cancer; Psychometrics; Reliability; EORTC QLQ-H&N35; Validation studies
• ISSN: 0962-9343; 1573-2649; 1573-2649
• DOI: 10.1007/s11136-012-0325-1

Purpose The EORTC QLQ-H&N35 (H&N35) is widely used to measure quality of life in head and neck cancer patients. The aims of this study were to obtain insight into a) the languages in which the H&N35 has been used and the psychometric properties in those languages, b) the study designs, and c) its acceptance by patients and investigators. Methods A systematic literature review was performed searching for all original papers that had used at least one item of the H&N35. Identified papers were read and the information about methodological issues abstracted statistically analysed. Results A total of 136 papers were identified. The H&H35 was administered in 19 different languages in 27 countries. The study design was cross-sectional in the majority of studies (53 %), prospective cohort studies (31 %), phase-II-trials (7 %), phase-III-trials (6 %) and case–control studies (1 %). The scales with the highest percentages of missing values were Sexuality (11.5 %) and Speech (7 %). The median Cronbach’s alpha of the multiitem scales ranged from 0.61 (Senses) to 0.93 (Sexuality). Construct validity was rarely investigated. On average, 12 scales (range 0-18) of the instrument were used by the investigators. The scale most often used was swallowing (in 85 % of studies) and least often used was Weight Gain (39 %). Conclusion The H&N35 is widely used throughout the world, mainly in observational studies, and has demonstrated robust psychometric features in different languages. However, some methodological problems reported imply that the instrument can be improved in some areas.