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Cheng Z, Johar A, Nilsson M, Schandl A, Lagergren P. Cancer-related fatigue trajectories up to 5 years after curative treatment for oesophageal cancer. Br J Cancer 2024; 130:628-637. [PMID: 38135716 PMCID: PMC10876982 DOI: 10.1038/s41416-023-02551-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Whether cancer-related fatigue develops differently after curative-intended oesophageal cancer treatment and the related modifiable factors are unclear. METHODS This population-based and longitudinal cohort included 409 oesophageal cancer patients who underwent curative oesophagectomy in 2013-2020 in Sweden. The main outcome was cancer-related fatigue trajectories with measurements at 1, 1.5, 2, 2.5, 3, 4 and 5 years postoperatively by validated EORTC QLQ-FA12 questionnaire, and analysed using growth mixture models. Weighted logistic regressions provided odds ratios (OR) with 95% confidence intervals (95% CI) for underlying sociodemographic, clinical, and patient-reported outcome factors in relation to the identified trajectories. RESULTS Two distinct overall cancer-related fatigue trajectories were identified: low level of persistent fatigue and high level of increasing fatigue, with 64% and 36% of patients, respectively. The odds of having high level of fatigue trajectory were increased by Charlson comorbidity index (≥ 2 versus 0: OR = 2.52, 95% CI 1.07-5.94), pathological tumour Stage (III-IV versus 0-I: OR = 2.52, 95% CI 1.33-4.77), anxiety (OR = 7.58, 95% CI 2.20-26.17), depression (OR = 15.90, 95% CI 4.44-56.93) and pain (continuous score: OR = 1.02, 95% CI 1.01-1.04). CONCLUSIONS Long-term trajectories with high level of increasing cancer-related fatigue and the associated modifiable factors were identified after oesophageal cancer treatment. The results may facilitate early identification and targeted intervention for such high-risk patients.
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Affiliation(s)
- Zhao Cheng
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Asif Johar
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Nilsson
- Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden
- Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Schandl
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Pernilla Lagergren
- Surgical Care Science, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
- Department of Surgery and Cancer, Imperial College London, London, UK.
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Hinz A, Schulte T, Mehnert-Theuerkauf A, Richter D, Sender A, Brock H, Friedrich M, Briest S. Fear of Cancer Progression: A Comparison between the Fear of Progression Questionnaire (FoP-Q-12) and the Concerns about Recurrence Questionnaire (CARQ-4). Healthcare (Basel) 2024; 12:435. [PMID: 38391810 PMCID: PMC10888487 DOI: 10.3390/healthcare12040435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/04/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024] Open
Abstract
As cancer patients often suffer from fear of cancer progression (FoP), valid screening for FoP is of high relevance. The aims of this study were to test psychometric properties of two FoP questionnaires, to determine their relationship to other anxiety-related constructs, and to analyze the impact of sociodemographic and clinical factors on the FoP. Our sample consisted of n = 1733 patients with mixed cancer diagnoses. For measuring FoP, the Fear of Progression questionnaire (FoP-Q-12) and the Concerns About Cancer Recurrence Questionnaire (CARQ-4) were used. The mean scores of the FoP-Q-12 and the CARQ-4 were 30.0 ± 10.4 and 16.1 ± 10.8, respectively, indicating relatively high levels of FoP. Both questionnaires showed excellent internal consistency coefficients, α = 0.895 and α = 0.915, respectively. The correlation between the two FoP questionnaires was r = 0.72. Female patients reported more FoP than male patients (d = 0.84 and d = 0.54, respectively). There was a nonlinear age dependency of FoP, with an increase found in the age range from 18 to 50 years and a decrease in the older age range. Radiation, chemotherapy, and antibody therapy, but not surgery, lead to an increase in FoP. Both questionnaires show good psychometric properties and can be recommended for use in an oncological routine. Female patients and patients in the middle-age range deserve special attention from healthcare providers.
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Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Thomas Schulte
- Rehabilitation Clinic Bad Oexen, 32549 Bad Oeynhausen, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Diana Richter
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Annekathrin Sender
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Hannah Brock
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
| | - Susanne Briest
- Department of Gynecology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, 04103 Leipzig, Germany
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3
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Tang X, Chapman RS, Peipert JD, Cella D. Establishing a common metric for physical function: Linking SARC-F and PROMIS® physical function. J Geriatr Oncol 2023; 14:101622. [PMID: 37678050 DOI: 10.1016/j.jgo.2023.101622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/26/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023]
Abstract
INTRODUCTION Aligned with the increasing need for standardized assessment of physical function in older individuals with cancer and other conditions, several patient-reported outcome measures (PROMs) have been developed and published. The aim of this study is to link the Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls questionnaire (SARC-F), and the Patient-Reported Outcomes Measurement Information System® (PROMIS®) Physical Function Short Form 8c (PROMIS PF 8c), and make their scores convertible, in order to expand the use of both instruments in research and inform clinicians and researchers about the interchangeability of critical cut-off scores. MATERIALS AND METHODS The sample included 300 participants recruited from an online panel. Participants were included if they had received a cancer diagnosis from a clinician and reported receiving anti-cancer treatment. We conducted five linking procedures and selected an optimal one to generate the crosswalk table between the two measures. RESULTS The linked T scores of all five methods showed acceptably small mean differences from the observed T scores, and the standard deviation (SD), and root-mean-squared deviation (RMSD) of the differences were generally similar across all methods. After comparing across all statistics, the Stocking-Lord approach was considered as the optimal approach to compute the crosswalk table for converting SARC-F raw scores to PROMIS PF 8c scores. The crosswalk table shows that the SARC-F cut-off value of 4 between healthy versus symptomatic with a corresponding score of 37 fell in the range of moderate physical function limitation from 30 to 39 on the PROMI PF 8c T score metric. DISCUSSION The linkage in this study has potential for improving clinical and research activities for people with cancer and perhaps others with a similar range of physical function. It facilitates the interpretability in scores of both measures on a common metric anchored on general population for further group-level analysis. Researchers can use this crosswalk to harmonize data collected from either instrument without requiring all cohorts to administer the same instrument for a prospective data collection or retrospective data analysis purpose or for a cross-study effectiveness study.
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Affiliation(s)
- Xiaodan Tang
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Chicago, IL, USA.
| | - Robert S Chapman
- Department of Psychology, University of Minnesota, 75 East River Parkway, Minneapolis, MN 55455, USA.
| | - John Devin Peipert
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Chicago, IL, USA.
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Chicago, IL, USA.
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de Beurs E, Oudejans S, Terluin B. A Common Measurement Scale for Self-Report Instruments in Mental Health Care. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2022. [DOI: 10.1027/1015-5759/a000740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract. The diversity of measures in clinical psychology hampers a straightforward interpretation of test results, complicates communication with the patient, and constitutes a challenge to the implementation of measurement-based care. In educational research and assessment, it is common practice to convert test scores to a common metric, such as T scores. We recommend applying this also in clinical psychology and propose and test a procedure to arrive at T scores approximating a normal distribution that can be applied to individual test scores. We established formulas to estimate normalized T scores from raw scale scores by regressing IRT-based θ scores on raw scores. With data from a large population and clinical samples, we established crosswalk formulas. Their validity was investigated by comparing calculated T scores with IRT-based T scores. IRT and formulas yielded very similar T scores, supporting the validity of the latter approach. Theoretical and practical advantages and disadvantages of both approaches to convert scores to common metrics and alternative approaches are discussed. Provided that scale characteristics allow for their computation, T scores will help to better understand measurement results, which makes it easier for patients and practitioners to use test results in joint decision-making about the course of treatment.
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Affiliation(s)
- Edwin de Beurs
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University, The Netherlands
- Arkin Mental Health Institute, Amsterdam, The Netherlands
| | | | - Berend Terluin
- EMGO Institute, VU Medical Center, Amsterdam, The Netherlands
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Hofmeister D, Schulte T, Mehnert-Theuerkauf A, Geue K, Zenger M, Esser P, Götze H, Hinz A. The association between sleep problems and general quality of life in cancer patients and in the general population. Front Psychol 2022; 13:960029. [PMID: 36591026 PMCID: PMC9800265 DOI: 10.3389/fpsyg.2022.960029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
Objective It is well-known that patients with cancer frequently experience sleep problems, and that sleep quality is associated with general quality of life (QoL). The aims of this study were to analyze the relationship between sleep problems and other components of QoL in more detail and to investigate sex and age differences in sleep quality in cancer patients in comparison with the general population. Method This study comprised one general population sample (n = 4,476) and eight samples with cancer patients (n between 323 and 4,020). Sleep Quality was measured using the QoL questionnaire EORTC QLQ-C30. Results All of the cancer patient groups reported more sleep problems than the general population. Sleep problems were associated with all facets of QoL both in cancer patients and in the general population. The highest associations were found in cancer patients for fatigue (r = 0.52) and emotional functioning (r = -0.47). The association between sleep quality and general QoL was lower in the cancer samples (r = -0.37) than in the general population (r = -0.46). Female cancer patients reported markedly more sleep problems than male patients did (d = 0.45), while this sex difference was lower in the general population (d = 0.15). In contrast to the general population, younger cancer patients had greater trouble sleeping than older patients did (d = -0.17). Conclusion The results underline the significance of the role mental factors play in sleep problems. Health care providers should pay special attention to female patients and younger patients concerning this issue.
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Affiliation(s)
- Dirk Hofmeister
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Thomas Schulte
- Rehabilitation Clinic Bad Oexen, Bad Oeynhausen, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Kristina Geue
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Markus Zenger
- Department of Applied Human Studies, University of Applied Sciences Magdeburg-Stendal, Stendal, Germany,Integrated Research and Treatment Center Adiposity Diseases, Leipzig University, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Heide Götze
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany,*Correspondence: Andreas Hinz,
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6
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de Beurs E, Boehnke JR, Fried EI. Common measures or common metrics? A plea to harmonize measurement results. Clin Psychol Psychother 2022; 29:1755-1767. [PMID: 35421265 PMCID: PMC9796399 DOI: 10.1002/cpp.2742] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/26/2022] [Accepted: 04/11/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE There is a great variety of measurement instruments to assess similar constructs in clinical research and practice. This complicates the interpretation of test results and hampers the implementation of measurement-based care. METHOD For reporting and discussing test results with patients, we suggest converting test results into universally applicable common metrics. Two well-established metrics are reviewed: T scores and percentile ranks. Their calculation is explained, their merits and drawbacks are discussed, and recommendations for the most convenient reference group are provided. RESULTS We propose to express test results as T scores with the general population as reference group. To elucidate test results to patients, T scores may be supplemented with percentile ranks, based on data from a clinical sample. The practical benefits are demonstrated using the published data of four frequently used instruments for measuring depression: the CES-D, PHQ-9, BDI-II and the PROMIS depression measure. DISCUSSION Recent initiatives have proposed to mandate a limited set of outcome measures to harmonize clinical measurement. However, the selected instruments are not without flaws and, potentially, this directive may hamper future instrument development. We recommend using common metrics as an alternative approach to harmonize test results in clinical practice, as this will facilitate the integration of measures in day-to-day practice.
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Affiliation(s)
- Edwin de Beurs
- Department of Clinical PsychologyLeiden University & Arkin GGZAmsterdamThe Netherlands
| | | | - Eiko I. Fried
- Department of Clinical PsychologyLeiden UniversityLeidenZuid‐HollandThe Netherlands
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7
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Westenberger A, Nöhre M, Brähler E, Morfeld M, de Zwaan M. Psychometric properties, factor structure, and German population norms of the multidimensional fatigue inventory (MFI-20). Front Psychiatry 2022; 13:1062426. [PMID: 36606126 PMCID: PMC9807811 DOI: 10.3389/fpsyt.2022.1062426] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The Multidimensional Fatigue Inventory (MFI-20) is commonly used, but its factor structure remains unclear. The MFI-20 consists of five subscales (general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue). This study investigates the psychometric properties, including the factor structure, of a general German population sample and tests group hypotheses on gender and age. Another objective is to provide normative data by gender and age groups. METHODS Using data from a representative German sample (n=2,509), reliability and convergent validity measures, group hypothesis testing, and confirmatory/exploratory factor analyses were conducted. RESULTS The MFI-20 demonstrated satisfactory internal consistency and showed adequate convergent validity with the SF-36. All subscales of the MFI-20 were significantly correlated (0.71-0.85). Physical fatigue exhibited the highest (0.42) and mental fatigue had the lowest (0.19) correlation with age. Fatigue scores were significantly higher for women and significantly increased with age. A five-factor structure showed poor model fit; using an exploratory factor analysis, a two-factor structure emerged (a general factor and a mental/motivational factor). CONCLUSION The MFI-20 is a reliable and valid instrument for measuring fatigue in the general population, but the five-factor structure is not supported. The subscale general fatigue or the MFI-20 total score might measure fatigue sufficiently. The provided norms can be used for further research and individual assessment.
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Affiliation(s)
- Adrian Westenberger
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Elmar Brähler
- Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.,Department of Psychosomatic Medicine, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Matthias Morfeld
- Department of Applied Human Sciences, Magdeburg-Stendal University of Applied Sciences, Stendal, Sachsen-Anhalt, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
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8
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Clarijs ME, Thurell J, Kühn F, Uyl-de Groot CA, Hedayati E, Karsten MM, Jager A, Koppert LB. Measuring Quality of Life Using Patient-Reported Outcomes in Real-World Metastatic Breast Cancer Patients: The Need for a Standardized Approach. Cancers (Basel) 2021; 13:cancers13102308. [PMID: 34065805 PMCID: PMC8151772 DOI: 10.3390/cancers13102308] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/20/2021] [Accepted: 05/10/2021] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Metastatic breast cancer (MBC) remains incurable despite treatment improvements. The health-related quality of life is a multidimensional entity which covers physical, psychological and social dimensions. It is an important outcome particularly in patients with metastatic disease, as the primary goal of therapy is no longer curation, but to provide the best possible quality of life weighted against treatment risks and adverse symptoms. Patient-reported outcomes reflecting the quality of life are usually measured with validated questionnaires to evaluate treatment strategies based on symptom burden and to improve care delivery. This review shares insights into the role of patient-reported outcome measurements in MBC patients and describes the heterogeneity of current questionnaires. We conclude that an up-to-date and standardized outcome set is needed, containing relevant domains referring to individual needs to improve the quality of life assessment among MBC patients. This is a prerequisite to learn about how they could impact the clinical care pathway. Abstract Metastatic breast cancer (MBC) patients are almost always treated to minimize the symptom burden, and to prolong life without a curative intent. Although the prognosis of MBC patients has improved in recent years, the median survival after diagnosis is still only 3 years. Therefore, the health-related quality of life (HRQoL) should play a leading role in making treatment decisions. Heterogeneity in questionnaires used to evaluate the HRQoL in MBC patients complicates the interpretability and comparability of patient-reported outcomes (PROs) globally. In this review, we aimed to provide an overview of PRO instruments used in real-world MBC patients and to discuss important issues in measuring HRQoL. Routinely collecting symptom information using PROs could enhance treatment evaluation and shared decision-making. Standardizing these measures might help to improve the implementation of PROs, and facilitates collecting and sharing data to establish valid comparisons in research. This is a prerequisite to learn about how they could impact the clinical care pathway. In addition, the prognostic value of intensified PRO collection throughout therapy on survival and disease progression is promising. Future perspectives in the field of PROs and MBC are described.
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Affiliation(s)
- Marloes E. Clarijs
- Academic Breast Cancer Center, Department of Surgical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands;
| | - Jacob Thurell
- Department of Oncology-Pathology, Karolinska Institute and Karolinska University Hospital, 171 76 Stockholm, Sweden; (J.T.); (E.H.)
| | - Friedrich Kühn
- Department of Gynecology with Breast Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (F.K.); (M.M.K.)
| | - Carin A. Uyl-de Groot
- Department of Health Technology Assessment, Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 3062 PA Rotterdam, The Netherlands;
| | - Elham Hedayati
- Department of Oncology-Pathology, Karolinska Institute and Karolinska University Hospital, 171 76 Stockholm, Sweden; (J.T.); (E.H.)
| | - Maria M. Karsten
- Department of Gynecology with Breast Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (F.K.); (M.M.K.)
| | - Agnes Jager
- Academic Breast Cancer Center, Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands;
| | - Linetta B. Koppert
- Academic Breast Cancer Center, Department of Surgical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands;
- Correspondence: ; Tel.: +31-107-041-161
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Hinz A, Schulte T, Finck C, Gómez Y, Brähler E, Zenger M, Körner A, Tibubos AN. Psychometric evaluations of the Life Orientation Test-Revised (LOT-R), based on nine samples. Psychol Health 2021; 37:767-779. [PMID: 33754894 DOI: 10.1080/08870446.2021.1892111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The aim of this study was to examine psychometric properties of the Life Orientation Test-Revised (LOT-R). DESIGN AND MAIN OUTCOME MEASURES The LOT-R was administered in five clinical samples, three samples of the adult general population, and one sample of adolescents. Seven of the studies were performed in Germany and two in Colombia. All of the sample sizes were above 300. RESULTS Cronbach's alpha coefficients were between .57 and .75 for the eight adult samples, the correlations between the scales optimism and pessimism ranged from -.05 to -.37, and the coefficients of temporal stability (test-retest correlations) of the scales ranged from .43 to .69. There were no systematic age and gender effects observed in the nine studies. While the one-factor model of confirmatory factor analyses showed clearly insufficient fit indices among all of the samples, the two-factor model fit was markedly better. CONCLUSIONS The LOT-R proved to be a suitable instrument for measuring dispositional optimism in patients and in the general population, though the sum score should be viewed with caution. Studies comparing the LOT-R mean scores of different samples need not take age and gender distributions into account.
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Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Thomas Schulte
- Rehabilitation Clinic Bad Oexen, Bad Oeynhausen, Germany
| | - Carolyn Finck
- Department of Psychology, Universidad de los Andes, Bogotá, Colombia
| | - Yvonne Gómez
- Department of Psychology, Universidad de los Andes, Bogotá, Colombia
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.,Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Markus Zenger
- Department of Applied Human Studies, University of Applied Sciences Magdeburg-Stendal, Stendal, Germany.,Integrated Research and Treatment Center Adiposity Diseases, University of Leipzig, Leipzig, Germany
| | - Annett Körner
- Department of Educational and Counselling Psychology, McGill University, Montréal, Canada
| | - Ana-Nanette Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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10
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Hinz A, Schulte T, Rassler J, Zenger M, Geue K. Temporal stability of quality of life assessments in cancer patients. Sci Rep 2021; 11:5191. [PMID: 33664409 PMCID: PMC7933346 DOI: 10.1038/s41598-021-84681-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/18/2021] [Indexed: 01/23/2023] Open
Abstract
Quality of life (QoL) is an important outcome criterion in cancer research and practice. Multiple studies have been performed to test the short-term temporal stability (1 day–2 weeks) of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire EORTC QLQ-C30, but its stability over longer periods of time is largely unknown. The EORTC QLQ-C30 was administered at two time points between 3 and 12 months apart in six samples of cancer patients with varying characteristics (N between 298 and 923). Averaged across the six samples, the coefficients of temporal stability (intra-class correlation coefficients ICC) were between 0.31 and 0.59 for the single scales. The 2-item global health/QoL scale showed a mean coefficient of 0.44. When the stability coefficients were calculated separately for males and females and for younger vs. older patients, no systematic gender or age differences were found in the temporal stability of the QoL scales, though the stability was slightly higher in males (vs. females) and in older subgroups (vs. younger subgroups). It is nearly impossible to predict the course a cancer patients’ QoL will take over a several month period. Repeated measurements are necessary to track QoL developments.
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Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany.
| | - Thomas Schulte
- Rehabilitation Clinic Bad Oexen, Bad Oeynhausen, Germany
| | - Jörg Rassler
- Department of Urology, St. Elisabeth Hospital, Leipzig, Germany
| | - Markus Zenger
- Faculty of Applied Human Studies, University of Applied Sciences Magdeburg and Stendal, Magdeburg, Germany.,Integrated Research and Treatment Center Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Kristina Geue
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
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11
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Schwall P, Meesters C, Hardt J. Estimating person parameters via item response model and simple sum score in small samples with few polytomous items: A simulation study. Stat Med 2019; 38:4040-4050. [PMID: 31236972 DOI: 10.1002/sim.8280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 04/23/2019] [Accepted: 05/18/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND The Item Response Theory (IRT) is becoming increasingly popular for item analysis. Theoretical considerations and simulation studies suggest that parameter estimates will become precise only by utilizing many items in large samples. METHOD A simulation study focusing on a single scale was performed on data with (a) n = 40, 60, 80, 120, 200, 300, 500, and 900 cases utilizing (b) 4, 8, 16, or 32 items. The items were (c) symmetrically distributed vs. skew (skewness 0, 1, and 2). Item loadings were (d) homogeneous vs. heterogeneous. Item loadings were (e) low vs. high. Half of the items had (f) a correlated error or not. The number of answering categories (g) was four vs. five. A total of 10% of each item had missing values. The ability-estimates from the IRT model and the simple sum score served as criteria for evaluating the results. RESULTS The ability-estimate from the IRT model outperformed the sum score when there were many items, skewed distributed items, and the item loadings were heterogeneous and high. The sum score outperformed the ability-estimate when there were few items, nonskewed items, and homogeneous and low item loadings. However, convergence rates were partly low in small samples. Correlated errors affected, both negatively, the ability-estimate and the sum score. CONCLUSION With skew item distributions and heterogeneous item loadings, utilizing an IRT model is recommended. However, with few items, many cases are required, conversely, with few cases many items. With few items and few cases, the sum score performs better.
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Affiliation(s)
- Philipp Schwall
- Medical Psychology and Medical Sociology, Clinic for Psychosomatic Medicine and Psychotherapy, University of Mainz, Mainz, Germany
| | - Christian Meesters
- Zentrum für Datenverarbeitung (ZDV), High Performance Computing Group, Mainz, Germany
| | - Jochen Hardt
- Medical Psychology and Medical Sociology, Clinic for Psychosomatic Medicine and Psychotherapy, University of Mainz, Mainz, Germany
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