Rapid communication: CME articleDevelopment and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer☆
Section snippets
Instrument development
Content from the original University of California-Los Angeles Prostate Cancer Index (UCLA-PCI)5 was expanded with guidance from a development cohort of localized prostate cancer patients and an expert panel comprised of urologic oncologists, radiation oncologists (including brachytherapy expertise), survey researchers, and prostate cancer nurses. Patient experts were unselected volunteers from our multidisciplinary urologic oncology clinics who had undergone the range of therapies represented
Results
Relevant EPIC validation cohort characteristics appear in Table I. Unique features of this cohort include equal representation of subjects between brachytherapy, external beam radiation, and radical prostatectomy, as well as representation of patients who received hormonal therapy. These characteristics were sought to ensure adequate representation of side effects from each therapy. To determine valid EPIC item groupings for HRQOL domain scores, survey item responses were evaluated by factor
Comment
Existing HRQOL instruments that have been validated for use in prostate cancer studies are limited in evaluating contemporary prostate cancer therapies.5, 6, 7, 10, 11, 12, 13, 14, 15 These limitations include lack of irritative and obstructive urinary symptom assessment (complementing concurrent incontinence assessment), lack of multi-item scales for measuring function-related bother, and lack of validated, multi-item summary scores to specifically measure hormonal therapy effects and their
Acknowledgements
This article benefited from the guidance of an expert panel comprised of radiation oncologists (P. William McLaughlin, M.D. and John Fiveash, M.D., in addition to coauthor H.M.S.); prostate cancer nurses (Peg Esper, M.S.N., Phil Rupp, M.S.N., and Chris Brown, R.N.); urologists (James E. Montie, M.D., in addition to coauthors J.T.W. and M.G.S.); and a medical oncologist (Ken Pienta, M.D.) for recommendations regarding items to improve instrument content. We thank Michael Miklosovic, M.S. for
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Supported by National Institutes of Health grants 5P30CA46598 and 1P50CA69568 (National Cancer Institute Prostate Cancer Specialized Projects of Oncology Research Excellence [SPORE]), American Cancer Society Clinical Career Development Award 96-77 (M.G.S.), Robert Wood Johnson Scholars Program (J.T.W.), and American Foundation for Urological Diseases Fellowship Award (J.T.W.).