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. 2022 Mar;31(3):889-901.
doi: 10.1007/s11136-021-02961-8. Epub 2021 Jul 29.

Assessing measurement invariance in the EORTC QLQ-C30

Janneke van Roij  1   2   3 , Jacobien M Kieffer  4 , Lonneke van de Poll-Franse  5   6   4 , Olga Husson  4   7 , Natasja J H Raijmakers  5   8 , John Gelissen  9
Affiliations

Assessing measurement invariance in the EORTC QLQ-C30

Janneke van Roij et al. Qual Life Res. 2022 Mar.

Abstract

Purpose: We aimed to investigate measurement invariance (MI) in the European Organisation for research and treatment of cancer quality of life questionnaire core 30 (EORTC QLQ-C30) in a heterogeneous sample of patients with cancer.

Methods: Data from 12 studies within the PROFILES registry were used for secondary analyses (n = 7007). We tested MI by successive restrictions on thresholds, loadings, and intercepts across subgroups based on primary cancer sites, age, sex, time since diagnosis, and life stage, using multigroup confirmatory factor analysis (MGCFA) for ordered categorical measures. We also evaluated the impact of potentially miss-specified parameter equality across groups on latent factor means by releasing threshold and loading equality constraints for each item at a time.

Results: Results showed that the highest level of MI (invariance of thresholds, loadings, and intercepts) was found across groups based on time since diagnosis and life stage and to a lesser extent across groups based on sex, age, and primary tumor site. On item level, however, changes in the item's associated factor means were relatively small and in most cases canceled each other out to some extent.

Conclusions: Given only a few instances of non-invariance in our study, there is reason to be confident that valid conclusions can be drawn from between-group comparisons of QLQ-C30 latent means as operationalized in our study. Nonetheless, further research into MI between other subgroups for the QLQ-C30 (i.e., treatment effects and ethnicity) is warranted. We stress the importance of including MI evaluations in the development and validation of measurement instruments.

Keywords: Measurement invariance; Medical oncology; Palliative care; Patient-reported outcomes; Quality of life; Validation studies.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Measurement model of European Organisation for research and treatment of cancer quality of life questionnaire core 30 (EORTC QLQ-C30)
See this image and copyright information in PMC

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