title: The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study.
abstract: OBJECTIVE
  To construct a breast cancer-specific quality-of-life questionnaire (QLQ) module to be used in conjunction with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and to test its reliability and validity cross-culturally.
  
  
  METHODS
  Module construction took place after the EORTC guidelines for module development. The module--the QLQ-BR23--consists of 23 items covering symptoms and side effects related to different treatment modalities, body image, sexuality, and future perspective. This module was tested in 170 Dutch, 168 Spanish, and 158 American cancer patients at two points in time. The timing for the Dutch and Spanish patients was before and during treatment with radiotherapy or chemotherapy. For the American patients, the questionnaire was administered at admission at the breast clinic and 3 months after the first assessment.
  
  
  RESULTS
  Multitrait scaling analysis confirmed the hypothesized structure of four of the five scales. Cronbach's alpha coefficients were, in general, lowest in Spain (range; .46 to .94) and highest in the United States (range; .70 to .91). On the basis of known-groups comparisons, selective scales distinguished clearly between patients differing in disease stage, previous surgery, performance status, and treatment modality, according to expectation. Additionally, selective scales detected change over time as a function of changes in performance status and treatment-induced change.
  
  
  CONCLUSIONS
  These results lend support to the clinical and cross-cultural validity of the QLQ-BR23 as a supplementary questionnaire for assessing specific quality-of-life issues relevant to patients with breast cancer.
authors.affiliation: Netherlands Cancer Institute, Amsterdam, The Netherlands. M.A.Sprangers@AMC.UVA.NL
authors.forename: M A
authors.initials: MA
authors.lastname: Sprangers
authors.forename: M
authors.initials: M
authors.lastname: Groenvold
authors.forename: J I
authors.initials: JI
authors.lastname: Arraras
authors.forename: J
authors.initials: J
authors.lastname: Franklin
authors.forename: A
authors.initials: A
authors.lastname: te Velde
authors.forename: M
authors.initials: M
authors.lastname: Muller
authors.forename: L
authors.initials: L
authors.lastname: Franzini
authors.forename: A
authors.initials: A
authors.lastname: Williams
authors.forename: H C
authors.initials: HC
authors.lastname: de Haes
authors.forename: P
authors.initials: P
authors.lastname: Hopwood
authors.forename: A
authors.initials: A
authors.lastname: Cull
authors.forename: N K
authors.initials: NK
authors.lastname: Aaronson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology*; D003431:Cross-Cultural Comparison; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007802:Language; D008875:Middle Aged; D010358:Patient Participation; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires