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Quality of Life Research

, Volume 22, Issue 8, pp 1927–1941 | Cite as

Performance of the EORTC questionnaire for the assessment of quality of life in head and neck cancer patients EORTC QLQ-H&N35: a methodological review

  • Susanne Singer
  • Juan Ignacio Arraras
  • Wei-Chu Chie
  • Sheila E. Fisher
  • Razvan Galalae
  • Eva Hammerlid
  • Ourania Nicolatou-Galitis
  • Claudia Schmalz
  • Irma Verdonck-de Leeuw
  • Eva Gamper
  • Judith Keszte
  • Dirk Hofmeister
Article

Abstract

Purpose

The EORTC QLQ-H&N35 (H&N35) is widely used to measure quality of life in head and neck cancer patients. The aims of this study were to obtain insight into a) the languages in which the H&N35 has been used and the psychometric properties in those languages, b) the study designs, and c) its acceptance by patients and investigators.

Methods

A systematic literature review was performed searching for all original papers that had used at least one item of the H&N35. Identified papers were read and the information about methodological issues abstracted statistically analysed.

Results

A total of 136 papers were identified. The H&N35 was administered in 19 different languages in 27 countries. The study design was cross-sectional in the majority of studies (53 %), prospective cohort studies (31 %), phase-II-trials (7 %), phase-III-trials (6 %) and case–control studies (1 %). The scales with the highest percentages of missing values were Sexuality (11.5 %) and Speech (7 %). The median Cronbach’s alpha of the multi-item scales ranged from 0.61 (Senses) to 0.93 (Sexuality). Construct validity was rarely investigated. On average, 12 scales (range 0-18) of the instrument were used by the investigators. The scale most often used was swallowing (in 85 % of studies) and least often used was Weight Gain (39 %).

Conclusion

The H&N35 is widely used throughout the world, mainly in observational studies, and has demonstrated robust psychometric features in different languages. However, some methodological problems reported imply that the instrument can be improved in some areas.

Keywords

Head and neck cancer EORTC QLQ-H&N35 Validation studies Psychometrics Reliability 

Supplementary material

11136_2012_325_MOESM1_ESM.doc (673 kb)
Supplementary material 1 (DOC 867 kb)

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Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Susanne Singer
    • 1
    • 10
  • Juan Ignacio Arraras
    • 2
  • Wei-Chu Chie
    • 3
  • Sheila E. Fisher
    • 4
  • Razvan Galalae
    • 5
  • Eva Hammerlid
    • 6
  • Ourania Nicolatou-Galitis
    • 7
  • Claudia Schmalz
    • 5
  • Irma Verdonck-de Leeuw
    • 8
  • Eva Gamper
    • 9
  • Judith Keszte
    • 10
  • Dirk Hofmeister
    • 10
  1. 1.Institute of Medical Biostatistics, Epidemiology, and InformaticsUniversity of MainzMainzGermany
  2. 2.Department of OncologyHospital de NavarraPamplonaSpain
  3. 3.Institute of Epidemiology and Preventive Medicine, College of Public HealthNational Taiwan UniversityTaipeiTaiwan
  4. 4.Psychosocial Oncology and Clinical Practice Research Group, Leeds Institute of Molecular MedicineUniversity of LeedsLeedsUK
  5. 5.Department of Radiation TherapyUniversity Hospital Schleswig–HolsteinCampus KielGermany
  6. 6.Department of Otolaryngology and Head and Neck Surgery, Sahlgrenska University HospitalGøteborg UniversityGøteborgSweden
  7. 7.Clinic of Hospital Dentistry, School of DentistryUniversity of AthensAthensGreece
  8. 8.Otolaryngology/Head & Neck SurgeryVU University Medical CenterAmsterdamThe Netherlands
  9. 9.Department of Psychiatry and PsychotherapyInnsbruck Medical UniversityInnsbruckAustria
  10. 10.Department of Medical Psychology and Medical SociologyUniversity of LeipzigLeipzigGermany

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