making the eortc qlq-c30 interactive: development and...
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Making the EORTC QLQ-C30
interactive:
development and validation of CAT
for EORTC QLQ-C30 dimensions
- project updates
Morten Aa. Petersen & Mogens Groenvold
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Dim Lit. search,
devel. items
Expert
interviews
Patient
interviews
Data
collection
IRT
analyses
No.
items
Publica-
tions
PF √ Completed Completed Completed Completed Completed 31 2
FA √ Completed Completed Completed Completed Completed 34 2
PA √ Completed Completed Completed Completed Completed 16 1
AP √ Completed Completed Completed Completed Completed 7 1
SL √ Completed Completed Completed Completed Completed 8
DY √ Completed Completed Completed Completed Completed 32 1
EF √ Completed Completed Completed Completed Completed 24 1+1
RF √ Completed Completed Completed Completed Completed 10 1
SF √ Completed Completed Completed Completed Completed 13 1?
CO √ Completed Completed Completed Completed Completed 10
CF Completed Completed Ongoing
FI Completed Completed Ongoing
NV,DI Completed Ongoing
Status of the CAT-project Sep ‘13
1
General paper: 1 (MAPI)
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Publications, published
1. Petersen et al. (2010). Development of CAT for the EORTC QLQ-C30 dimensions - General approach and initial results for PF. EJC 46, 1352-1358
2. Petersen et al. (2010). Development of CAT for the EORTC QLQ-C30 PF dimension. QLR 20(4), 479-490
3. Giesinger et al. (2011). Cross-cultural development of an item list for CAT of fatigue in oncological patients. HQLO 9(19)
4. Petersen et al (2012). The EORTC computer-adaptive tests (CATs) measuring physical functioning and fatigue exhibited high levels of measurement precision and efficiency. JCE 66(3), 330-339
5. Petersen et al. (2013). Psychometric evaluation of the EORTC CAT fatigue item pool. QLR, Epub ahead of print
6. Petersen & Groenvold (2013). Development of CAT for the EORTC QLQ-C30. MAPI PRO Newsletter
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Publications, being drafted
7. Gamper et al. The EORTC Emotional Functioning computer adaptive test (CAT): phase I-III of a cross-cultural item bank development – reviewed, revised, and resubmitted
8. Petersen et al. Development of an item bank for computerized adaptive test (CAT) measurement of pain – reviewed, being revised
9. Petersen et al. Psychometric evaluation of the EORTC CAT emotional functioning item pool – 1st version drafted, co-author commenting
10. Holst et al. Development of a lack of appetite item bank for computer-adaptive testing (CAT) – being drafted
11. Gamper et al. The EORTC Role functioning computer adaptive test (CAT) – being drafted
12. Petersen et al. Development of an item bank for computerized adaptive test (CAT) measurement of dyspnoea – being drafted
13. Young et al. Development of an item bank for computerized adaptive test (CAT) measurement of social functioning – being drafted
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CAT- validation
project
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Aim of the validation project
• To implement, test, and validate the EORTC
CAT instrument using web-based administration
• Consists of two parts:
- A feasibility study to investigate the acceptability,
optimal design and logistics of CAT administration
- A field study (main study) to test the validity of the
EORTC CAT, particularly the measurement
precision of the CAT compared to the QLQ-C30
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Feasibility study
• Test the administration of the EORTC CAT in 7-10
centres each with min. 10 cancer patients, and a total
N=100
Currrently there
are centres
involved in the
project from:
Australia
Austria
Denmark
Germany
Italy
the Netherlands
Poland
Taiwan
Turkey
UK
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Feasibility study
• Test the administration of the EORTC CAT in 7-10
centres each with min. 10 cancer patients, and a total
N=100
• Obtain local approvals, test, adjust, and correct
software and field study design
• Patients are tested as planned for the field study:
#items in C30 scale + 4 (5-9 items per dim) using
CAT + QLQ-C30 items not used in CAT
• Afterwards patients are interviewed regarding the
experience, should anything be changed?
• Time-frame: appr. 1 year, starting now! Currently
translating items and protocol for ethical approval
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Field study • Evaluate the measurement precision by
investigating:
- sensitivity using known groups comparisons
- Responsiveness, i.e. ability to detect expected changes over time
• Same centres as in feasibility study
• At least 100 cancer patients from each centre and total N=1,000
• Mixed sample: Both genders, different age groups, cancer sites, cancer stages etc.
• Time-frame: appr. 2 years, starting when feasibility study is completed
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Field study design • Two CAT-measurements, before (baseline)
and after chemotherapy
Chemotherapy circle 2nd assessment
Days
2 6 14
Baseline
14 1 22
Any previous treatment
• Some centres will have two baseline
assessments to evaluate test-retest reliability
Chemotherapy circle 2nd assessment
Days
2 6 14
Baseline 1
14 1 3
Baseline 2, 2-7 days after
baseline 1
12 24
Any previous treatment
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Field study analyses • Evaluate CAT performance:
- Time used, item usage, precision of different length CAT,…
• Sensitivity analyses:
- Relative validity (RV) of CAT compared to QLQ-C30 scales when comparing groups expected to differ (e.g. stage III+IV vs. I+II)
• Responsiveness:
- RV based on scores before and after treatment
• Test-retest reliability:
- Comparing the two baseline assessments. Mean differences, ICC, correlation etc.
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Software, the “CAT-engine” • The CAT-engine is the program handling all
computation within the CAT:
- Item selection - what item should be asked next?
- Stopping criteria - When should a CAT session stop?
- All estimations - IRT (scale) scores, information,…
- Ensures all imposed requirements/restrictions for a CAT are
fulfilled
• CAT-engine does not have a graphical interface to
present items etc. Another program should handle this
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Software, structure
Program for
presenting and
collecting
questionnaire data
(e.g. CHES running
on own server)
CAT setting (once).
Request for next
item
CAT-engine
running on own
server
Info on item to
ask next or stop
Present item e.g.
on web-page
Response to item
Patient with
internet access
using any
device
Logs in
pro-cat.dk/CatValTest/
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Thank you!
Any comments/questions to the
projects please contact us: