Does it matter how we evaluate HRQOL? Longitudinal comparison of the EORTC QLQ-C30/QLQ - OG25 and FACT-E
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Does it matter how we evaluate HRQOL? Longitudinal comparison of the EORTC QLQ-C30/QLQ-OG25 and FACT-E Gail E. Darling 1
&
Joanne Sulman 1,2 & Osvaldo Espin-Garcia 3 & Julie G. Trudel 4 & Eshetu G. Atenafu 5 & Biniam Kidane 6
Received: 10 August 2020 / Accepted: 10 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To determine whether EORTC QLQ-C30/QLQ-OG25 and FACT-E compared longitudinally provide similar reflections of health-related quality of life (HRQOL). Methods Eighty-six esophageal cancer patients treated with curative intent, scheduled to complete both questionnaires at baseline and post-treatment time points until 36 months. A generalized estimating equation model utilizing a Gaussian family compared instruments longitudinally. The two-one-sided-test (TOST) method assessed equivalence between the instruments. Results Trajectories for social domain and overall quality of life differed significantly between instruments. Also, FACT-G’s functional well-being post-treatment returns to baseline 3–6 months earlier than the EORTC QLQ-C30’s role functioning subscale, suggesting measurement of different components. Trajectories for physical and esophageal symptom subscales are similar and are deemed equivalent. Emotional domains are comparable and bear little resemblance to the physical domain trajectories indicating reflection of emotional experience rather than a physical proxy. EORTC QLQ-C30 subscales have a trajectory similar to its physical functioning scale except for the emotional and esophageal symptoms scales. Overall HRQOL in both instruments showed a consistent return to baseline/pre-treatment levels by 6 months post-treatment. Conclusions Overall HRQOL recovers earlier after curative-intent treatment than previously reported despite persistence of physical symptoms, with a consistent return to pre-treatment levels by 6 months after treatment. This supports the concept that HRQOL is not primarily defined by physical function. Based on this longitudinal comparison, FACT-E provides a more multidimensional assessment of HRQOL. Implications for Cancer Survivors Curative intent treatment for esophageal cancer has adverse effects on HRQOL but despite intense treatment, overall HRQOL recovers within 6 months. Keywords Health-related quality of life instruments . Longitudinal study . Esophageal cancer . FACT-E . EORTC QLQ-C30 OG25 Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11764-020-00957-w) contains supplementary material, which is available to authorized users. * Gail E. Darling [email protected] 1
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Department of Surgery, Division of Thoracic Surgery, Toronto General Hospital, University Health Network and the University of Toronto, 200 Elizabeth Street, 9N-955, Toronto, Ontario M5G 2C4, Canada Factor-Inwentash Faculty of Social Work, University of Toronto, , 246 Bloor Street W., Toronto M5S 1V4, Canada Department of Biostatistics, Princess Margaret Cancer Center, University Health Network & Divisi
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