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Objective: The objective of this study was to adapt and validate the Vietnamese version of Active Aging Index (AAI). Method: We conducted an expert panel, focus groups, test-retest and examination of internal consistency, and construct and concurrent validity among 804 older Vietnamese adults. Results: Scale content validity index (CVI) was 0.98. Test-retest coefficients ranged from 0.70 to 1.00. The Cronbach's alphas of well-being, voluntary, affordability, and politics were 0.94, 0.70, 0.65, and 0.16, respectively. Voluntary and well-being had good construct validity. Regarding politics, only one of four items had good test-retest reliability (Kappa 0.84), while other three had low variance in both test-retest and field study. In exploratory factor analysis, items assessing affordability loaded on three components. AAI was positively associated with perceived health, life satisfaction, and quality of life; it was negatively associated with falls, loneliness, and frailty. Discussion: In adapting AAI, researchers should consider cultural sensitivity. Key modifications, findings, explanations, and suggestions are presented here.

Background: The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) assesses quality of life (QOL) in patients with lung cancer and was the first EORTC module developed for use in international clinical trials. Since its publication in 1994, major treatment advances with possible effects on QOL have occurred. These changes called for an update of the module and its international psychometric validation. We aimed to investigate the scale structure and psychometric properties of the updated lung cancer module, QLQ-LC29, in patients with lung cancer., Methods: This international, observational field study was done in 19 hospitals across 12 countries. Patients aged older than 18 years with a confirmed diagnosis of lung cancer and no other previous primary tumour, and who were mentally fit with sufficient language skills to understand and complete the questionnaire were included. Patients were asked during a hospital visit to fill in the paper versions of the core questionnaire EORTC QLQ-C30 plus QLQ-LC29, and investigators selected half of these patients to complete the questionnaire again 2-4 weeks later. Our primary aim was to assess the scale structure and psychometric properties of EORTC QLQ-LC29. We analysed scale structure using confirmatory factor analysis; reliability using Cronbach's α value (internal consistency) and intra-class coefficient (test-retest reliability); sensitivity using independent t tests stratified by Karnofsky performance status; and responsiveness to change over time by ANOVA. This study is registered with ClinicalTrials.gov, NCT02745691., Findings: Between April 12, 2016, and Sept 26, 2018, 523 patients with a confirmed diagnosis of either non-small-cell lung cancer (n=442) or small-cell lung cancer (n=81) were recruited. Confirmatory factor analysis provided a solution composed of five multi-item scales (coughing, shortness of breath, fear of progression, hair problems, and surgery-related symptoms) plus 15 single symptom or side-effect items: χ 2 =370·233, root mean square error of approximation=0·075, and comparative-fit index=0·901. Cronbach's α for internal consistencies of all multi-item scales were above the threshold of 0·70. Intra-class coefficients for test-retest reliabilities ranged between 0·82 and 0·97. Three (shortness of breath, fear of progression, and hair problems) of the five multi-item scales showed responsiveness to change over time (p values <0·05), as did nine of 15 single symptom items. Four (coughing, shortness of breath, fear of progression, and surgery-related symptoms) of the five multi-item scales and ten of the 15 single symptom items were sensitive to known group differences (ie, lower vs higher Karnofsky performance status)., Interpretation: Results determined the psychometric properties of the updated lung cancer module, which is ready for use in international clinical studies., Funding: EORTC Quality of Life Group., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective: The European Organisation for Research and Treatment of Cancer Quality of Life Group (EORTC QLG) has developed a multidimensional instrument measuring cancer-related fatigue, the EORTC QLQ-FA12. The analysis of sensitivity to change is an essential part of psychometric validation. With this study, we investigated the EORTC QLQ-FA12's sensitivity to change., Methods: The methodology follows the EORTC guidelines of EORTC QLG for phase IV validation of modules. We included cancer patients undergoing curative and palliative treatment at t1 and followed them up prospectively over the course of their treatment (t2) and 4 weeks after completion of treatment (t3). Data were collected prospectively at 17 sites in 11 countries. Sensitivity to change was investigated using analysis of variance., Results: A total sample of 533 patients was enrolled with various tumour types, different stages of cancer, and receiving either curative treatment (n=311) or palliative treatment (n=222). Over time all fatigue scores were significantly higher in the palliative treatment group compared with the curative group (p < .001). Physical fatigue increased with medium effect size over the course of treatment in the curative group (standardized response mean [SRM] (t1,t2) = 0.44]. After treatment physical [SRM (t2,t3) = 0.39], emotional [SRM (t2,t3)= 0.28] and cognitive fatigue (SRM [t2,t3] = 0.22) declined significantly in the curative group. In the palliative group, emotional (SRM [t2,t3] = 0.18) as well as cognitive [SRM [t2,t3] = 0.26) fatigue increases significantly., Conclusions: The EORTC-QLQ-FA12 proved to identify clinically significant changes in fatigue in the course of curative and palliative cancer treatment., (© 2019 John Wiley & Sons, Ltd.)

Purpose: Patient-reported outcomes should ideally be adapted to the individual patient while maintaining comparability of scores across patients. This is achievable using computerized adaptive testing (CAT). The aim here was to develop an item bank for CAT measurement of the pain domain as measured by the EORTC QLQ-C30 questionnaire., Methods: The development process consisted of four steps: (1) literature search, (2) formulation of new items and expert evaluations, (3) pretesting and (4) field-testing and psychometric analyses for the final selection of items., Results: In step 1, we identified 337 pain items from the literature. Twenty-nine new items fitting the QLQ-C30 item style were formulated in step 2 that were reduced to 26 items by expert evaluations. Based on interviews with 31 patients from Denmark, France and the UK, the list was further reduced to 21 items in step 3. In phase 4, responses were obtained from 1103 cancer patients from five countries. Psychometric evaluations showed that 16 items could be retained in a unidimensional item bank. Evaluations indicated that use of the CAT measure may reduce sample size requirements with 15-25% compared to using the QLQ-C30 pain scale., Conclusions: We have established an item bank of 16 items suitable for CAT measurement of pain. While being backward compatible with the QLQ-C30, the new item bank will significantly improve measurement precision of pain. We recommend initiating CAT measurement by screening for pain using the two original QLQ-C30 pain items. The EORTC pain CAT is currently available for "experimental" purposes.

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.

Objectives: To evaluate the reliability and construct validity of a Taiwan Chinese version of the 25-Item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ 25) in patients with visual impairment., Methods: The NEI-VFQ 25 was translated and adapted into the Taiwan Chinese version. In total, 222 patients responded to the questionnaire. To examine reliability, Cronbach's alpha for each subscale was used as an index of internal consistency. Test-retest reliability was evaluated with intraclass correlation coefficients. Regarding construct validity, both convergent and discriminant validities were calculated by means of multi-trait analysis. Clinical validity was examined by correlation of clinical measurements and subscale scores and known-groups comparison. Finally, correlation between different subscales was examined to evaluate hypothetical relationship between subscales., Results: Five patient groups were studied, each including participants with a single cause of visual impairment. Group 1 consisted of 53 cataract patients; group 2 included 51 subjects with glaucoma; group 3 included 36 subjects with age-related macular degeneration (ARMD); and group 4 included 48 subjects with diabetic retinopathy. Thirty-four individuals with uncorrected refractive error comprised the control group. NEI-VFQ scores (mean +/- SD) for the cataract, glaucoma, ARMD, diabetic retinopathy and control groups were: 73.5 +/- 17.1, 69.2 +/- 20.4, 62.3 +/- 23.7, 63.7 +/- 20.8 and 80.7 +/- 12.0, respectively. Item analysis revealed moderate data skewing. Cronbach's alpha coefficients of subscales ranged from 0.956 (mental health) to 0.964 (near activities). Intraclass correlation coefficients ranged from 0.41 (driving) to 0.846 (distance activities). All items passed the convergent and discriminant validity tests. Moderate correlations were detected between visual acuity and the 'general vision', 'distance activities' and 'near activities' subscales. Significant correlations were detected between visual field deficits and the vision associated subscales., Conclusion: This study revealed that the Taiwan Chinese version of the NEI-VFQ 25 is a valid and reliable instrument to measure vision-related quality of life in patients with visual impairment.

The purpose of this study was to test the validity and reliability of the Taiwan Chinese translation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30, version 3) and Quality of Life Questionnaire Lung Cancer-13 (QLQ-LC13) questionnaires. Consecutively 51 patients with lung cancer undergoing active chemotherapy and 48 such patients undergoing regular follow-up completed the questionnaires. The intraclass correlation between test and retest ranged from 0.46 to 0.85 for the QLQ-C30 and was 0.76 for dyspnea for the QLQ-LC13. The kappa coefficients between test and retest ranged from 0.51 to 0.73 for single items of the QLQ-C30 and 0.49-0.68 for five of the nine items in the QLQ-LC13. The Cronbach's alpha coefficients were > or = 0.70 for all scales of the two questionnaires apart from that of cognitive functioning. The correlation coefficients between indices measuring similar dimensions of the EORTC QLQ-C30 and the SF-36 questionnaires ranged from 0.43 to 0.73, and that between the dyspnea scales of the two EORTC questionnaires was 0.70. Patients in the follow-up group revealed higher scores of global status/quality of life, and lower scores of nausea/vomiting, as also physical functioning. The questionnaires could also detect expected adverse effects of radiotherapy, cisplatin, and paclitaxel.