Thresholds for clinical importance to improve interpretation of the EORTC QLQ-COMU26 communication questionnaire

This study defined thresholds for clinical importance (TCIs) for the European Organisation for Research and Treatment of Cancer Communication Questionnaire (EORTC QLQ-COMU26). TCIs support the clinical evaluation of individual patients' communication with professionals.

In this cross-sectional study, an international sample of cancer patients with mixed diagnoses and treatments completed the EORTC QLQ-COMU26, which comprises six scales and four individual items. Item 26, which evaluates patients' satisfaction with communication with professionals, served as the anchor for detecting a negative event (unsatisfactory communication). Diagnostic accuracy for each domain was determined using ROC analysis, and the sensitivity of the TCIs was evaluated. Sensitivity analyses using multivariate binary logistic regression explored potential variability in TCIs across patient groups.

A total of 988 patients from 13 countries participated (mean age, 60.7; 50.0% female). TCIs ranged from 80.3 to 92.5 on the 0-100 metric of the QLQ-COMU26 scales. All TCIs demonstrated sensitivity of at least 0.75, and ROC AUC values ranged from 0.80 to 0.90. Separate TCIs were identified for communication with nurses and doctors, with thresholds > 4 points higher for nurses in five QLQ-COMU26 domains. No evidence supported separate thresholds by age, gender, or treatment intention.

This study established TCIs with high diagnostic accuracy for the EORTC QLQ-COMU26, supporting its use in clinical practice and research. The findings suggest that the questionnaire can identify patients who report low communication for specific domains and help improve communication in clinical settings.