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Head-to-head comparisons of quality of life instruments for young adult survivors of childhood cancer

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Abstract

Purpose

Few studies examine the relevance of health-related quality of life (HRQOL) instruments for young adult survivors of childhood cancer (YASCC). This study compared the psychometric properties of two survivor-specific instruments, the Quality of Life–Cancer Survivor (QOL-CS) and Quality of Life in Adult Cancer Survivor (QLACS).

Methods

Data from 151 YASCC who enrolled in cancer/tumor registries of two medical centers were used. We examined construct validity by conducting confirmatory factor analysis using indices of chi-square statistic, comparative fit index, and root mean square error of approximation. We examined convergent/discriminant validity by comparing Pearson’s correlation coefficients of homogeneous (e.g., physical functioning and pain) of both instruments versus heterogeneous domains (e.g., physical and psychological functioning). We assessed known-groups validity by examining the extent to which HRQOL differed by late effects and comorbid conditions and calculated relative validity (RV) defined as contrasting F-statistics of individual domains to the domain with the lowest F-statistic. Superior known-groups validity is observed if a domain of one instrument demonstrates a higher RV than other domains of the instruments.

Results

YASCC data cannot replicate the constructs both instruments intend to measure, suggesting poor construct validity. Correlations of between-homogeneous and between-heterogeneous domains of both instruments were not discernible, suggesting poor convergent/discriminant validity. Both instruments were equally able to differentiate HRQOL between YASCC with and without late effects and comorbid conditions, suggesting similar known-groups validity.

Conclusions

Neither instrument is superior. Item response theory is suggested to select high-quality items from different instruments to improve HRQOL measure for YASCC.

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Acknowledgments

This work was supported in part by the University of Florida and Moffitt Cancer Centers Collaborative Initiative (IH, GQ, KE, DM, ES, and PS) and the National Institute of Health K23 HD057146 (IH).

Conflict of interests

Principal author and all co-authors declare that they have no conflict of interests.

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Authors and Affiliations

  1. Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, USA

    I-Chan Huang & Elizabeth A. Shenkman

  2. Institute for Child Health Policy, College of Medicine, University of Florida, Gainesville, FL, USA

    I-Chan Huang, Katie Z. Eddleton & Elizabeth A. Shenkman

  3. Department of Oncologic Sciences, College of Medicine, University of South Florida, Tampa, USA

    Gwendolyn P. Quinn

  4. Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA

    Gwendolyn P. Quinn

  5. Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Kevin Krull

  6. Jonathan Jaques Children’s Cancer Center, Miller Children’s Hospital, Long Beach, CA, 90806, USA

    Devin C. Murphy

  7. Department of Pediatrics, School of Medicine, University of Maryland, Baltimore, MD, USA

    Patricia D. Shearer

  8. Department of Health Outcomes and Policy, and Institute for Child Health Policy, College of Medicine, University of Florida, PO Box 100177, Gainesville, FL, 32610, USA

    I-Chan Huang

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  1. I-Chan Huang
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Correspondence to I-Chan Huang.

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Huang, IC., Quinn, G.P., Krull, K. et al. Head-to-head comparisons of quality of life instruments for young adult survivors of childhood cancer. Support Care Cancer 20, 2061–2071 (2012). https://doi.org/10.1007/s00520-011-1315-5

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  • DOI: https://doi.org/10.1007/s00520-011-1315-5

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