Introduction
What is new?
Key findings- •
The EORTC QLQ-CR38 had the greatest number of positive ratings and the most positive ratings on measurement property according to quality assessment criteria.
- •
The EORTC QLQ-CR38 was recommended to measure health-related quality of life (HRQOL) in patients with CRC, regardless of disease stage and location of primary tumor site.
What this adds to what was known?- •
There is a shortage of a perfect methodological quality for measurement property of HRQOL instrument used in CRC patients, despite the large amount of instruments available.
What is the implication and what should change now?- •
There is a need for an improvement in the reporting quality of measurement properties in newly developed or translated instruments. Efforts on the universal consensus on whether the measurement properties met the acceptable quality criteria, especially construct validity and responsiveness, should be commenced.
Colorectal cancer (CRC) is one of the major cancer deaths worldwide [1], being the third leading cause of cancer death in the United States [2], [3]. Previous studies suggested that there is a growing trend of CRC incidence rates in some economically developing countries, which involves a rapid transition in dietary style and exercise patterns [2], [3]. Emerging medical treatment of CRC has contributed to the extension on prolonged survivals. In addition to disease survivals, health-related quality of life (HRQOL) is becoming a standard outcome measurement of the impact of illness and treatment for CRC in clinical care and research. Among cancer survivors living with disease, certain aspects of HRQOL (ie, physical, psychological, social and so forth) were challenged by the impairment in the ability to perform daily activities and the presentation of symptoms arising from disease and treatment [4]. The appropriate usage and adoption of instruments to evaluate HRQOL were considered important for the better assessment of rehabilitation needs and treatment benefits from the standpoint of patients, clinicians, and health policy makers [5].
Classical literature of HRQOL has classified instruments [6], [7] into two major types: generic and condition-specific (or disease-specific) instruments. Generic instruments are designed for assessing HRQOL in a wide range of clinical settings and used in various areas of health conditions in a population. They allowed for cross-cultural and international comparisons of HRQOL from one population to another. Condition-specific instruments measure more aspects unique to the HRQOL in patients with specific condition and have generally been reported to be more responsive than generic instruments [8]. Measurement properties are important to support the evidence-based selection of the best instrument for a particular purpose or population, and quality assurance criteria [9] have been recommended by Scientific Advisory Committee of the Medical Outcomes Trust [10]. Comprehensive quality assessment of measurement properties for available HRQOL instruments is presented based on a wide range of cancer populations [11], [12], [13], but there is little evidence concerning HRQOL instruments in CRC [14]. In spite of multiple instruments had developed for the measurement of HRQOL in patients with CRC, clinicians and researchers urged for the most recommended and appropriate HRQOL instruments under a comprehensive process of psychometric quality assessment. A recent literature review [15] across a wide range of HRQOL instruments administered in CRC patients, sourcing from Ovid searching engine and several key journals, recommended SF-12 for generic measure, EQ-5D for preference-based measure, and European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire (QLQ-C30) and Functional Assessment of Cancer Therapy-Colorectal (FACT-C) for condition-specific measures. The aforementioned review was, however, limited by the inclusion of studies with English-speaking populations only. Articles concerning the target population of other language speakers were still relevant. Yet, no systematic review synthesized evidence on the critical appraisal of the measurement properties of generic and condition-specific HRQOL instruments that have been validated for use in patients with CRC. The aim of this article was to conduct a systematic literature review on the measurement properties of standardized HRQOL instruments for CRC, providing recommendations on the HRQOL instrument through collective evidence from previous studies.