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Effects of mode of administration (MOA) on the measurement properties of the EORTC QLQ-C30: a randomized study

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While modern electronic data collection methods (e.g., computer touch-screen or web-based) hold much promise, most current studies continue to make use of more traditional data collection techniques, including paper-and-pencil administration and telephone interviews. The present randomized trial investigated the measurement properties of the EORTC QLQ-C30 under three different modes of administration (MOA's). Methods A heterogeneous sample of 314 cancer patients undergoing treatment at a specialized treatment center in Amsterdam were randomized to one of three MOA's for the QLQ-C30: paper-and-pencil at home via the mail, telephone interview, and paper-and-pencil at the hospital clinic. Group differences in internal consistency reliabilities (Cronbach's alpha coefficient) for the scale scores were compared. Differences in mean scale scores were also compared by means of ANOVA, with adjustment for potential confounders. Results Only one statistically significant, yet minor, difference in Cronbach's alpha between the MOA groups was observed for the Role Functioning scale (all 3 alphas >0.80). Significant differences in group means -after adjustment- were found for the Emotional Functioning (EF) scale. Patients completing the written questionnaire at home had significantly lower levels of EF as compared to those interviewed via the telephone; EF scores of those completing the questionnaire at the clinic fell in-between those of the other two groups. These differences, however, were small in magnitude. Conclusions MOA had little effect on the reliability or the mean scores of the EORTC QLQ-C30, with the possible exception of the EF scale.
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Gundy and AaronsonHealth and Quality of Life Outcomes2010,8:35 http://www.hqlo.com/content/8/1/35
R E S E A R C H
Open Access
Effects of mode of administration (MOA) on the measurement properties of the EORTC QLQC30: a randomized study *Chad M Gundy , Neil K Aaronson
Abstract Background:While modern electronic data collection methods (e.g., computer touchscreen or webbased) hold much promise, most current studies continue to make use of more traditional data collection techniques, including paperandpencil administration and telephone interviews. The present randomized trial investigated the measurement properties of the EORTC QLQC30 under three different modes of administration (MOAs). Methods:A heterogeneous sample of 314 cancer patients undergoing treatment at a specialized treatment center in Amsterdam were randomized to one of three MOAs for the QLQC30: paperandpencil at home via the mail, telephone interview, and paperandpencil at the hospital clinic. Group differences in internal consistency reliabilities (Cronbachs alpha coefficient) for the scale scores were compared. Differences in mean scale scores were also compared by means of ANOVA, with adjustment for potential confounders. Results:Only one statistically significant, yet minor, difference in Cronbachs alpha between the MOA groups was observed for the Role Functioning scale (all 3 alphas >0.80). Significant differences in group means after adjustment were found for the Emotional Functioning (EF) scale. Patients completing the written questionnaire at home had significantly lower levels of EF as compared to those interviewed via the telephone; EF scores of those completing the questionnaire at the clinic fell inbetween those of the other two groups. These differences, however, were small in magnitude. Conclusions:MOA had little effect on the reliability or the mean scores of the EORTC QLQC30, with the possible exception of the EF scale.
Background Healthrelated quality of life (HRQoL) questionnaires can be administered using a variety of methods, includ ing facetoface or telephone interviews, pencil and paper, computer touchscreen, or webbased. However, not all researchers may have equal access to all modes of administration (MOA). For example, despite the attractiveness of hightech electronic methods, none of the 107 abstracts cited in PubMed for 2007 concerning the EORTC QLCC30 HRQoL questionnaire reported having used a computer for data collection. In addition, various MOA may not be equally practical for all respondents. For example, lack of language or
* Correspondence: n.aaronson@nki.nl Contributed equally Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, 121 Plesmanlaan, 1066 CX Amsterdam, The Netherlands
computer skills may preclude the use of written ques tionnaires, whether pencil and paper or computerbased. It may also be sometimes necessary to combine multiple modes of administration in the same study, for example when conducting longitudinal research or combining data from various sources. For these reasons, it is important to consider whether the measurement characteristics of various MOAs are equivalent, because, if this is not the case, then it would be difficult to compare outcomes across MOAs within or between studies. Many studies of varying designs, sizes, populations, and instruments have considered this issue, with generally similar results [19]. Namely, the effects of MOA on questionnaire measurement charac teristics are generally not large. However, only two stu dies have investigated the effect of MOA on the EORTC QLQC30, one of the most widely used HRQoL
© 2010 Gundy and Aaronson; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.