Development of computerised adaptive testing (CAT) for the EORTC QLQ-C30 dimensions - general approach and initial...

Area of Science:

• Oncology
• Psychometrics
• Health Services Research

Background:

• Health-related quality of life (HRQOL) assessment requires instruments adaptable to individual patients while maintaining score comparability.
• Computerised adaptive testing (CAT) offers a solution by tailoring item selection to patient responses.
• The European Organisation for Research and Treatment of Cancer Quality of Life Group (EORTC QLG) is developing a CAT version of the EORTC QLQ-C30 to leverage existing frameworks and ensure backward compatibility.

Purpose of the Study:

• To outline the EORTC QLG's strategy for developing a CAT for the EORTC QLQ-C30.
• To illustrate the development process using the physical functioning (PF) dimension as an example.
• To create a backward-compatible CAT for assessing HRQOL in cancer patients.

Main Methods:

• A comprehensive strategy involving literature search, item conceptualization, formulation, expert review, patient evaluation, and psychometric analysis.
• Systematic identification and relevance assessment of existing literature items for specific HRQOL dimensions.
• Iterative refinement of item pools through expert and patient feedback.

Main Results:

• An initial literature search yielded 975 potential items for physical functioning.
• After relevance screening and expert review, 51 items were selected for the CAT item pool.
• Expert and patient evaluations led to item revision and further reduction of the item pool.

Conclusions:

• The developed strategy is effective in generating relevant and appropriate item pools for cancer patients.
• The resulting item pools will form the foundation for a backward-compatible CAT.
• This CAT aims to improve the precision and efficiency of HRQOL assessment in cancer clinical trials.