title: Health related quality of life in patients with bladder cancer: a cross-sectional survey and validation study of the Hungarian version of the Bladder Cancer Index.
abstract: Health-related quality of life (HRQoL) is an important outcome in oncology care although an underexplored area in bladder cancer (BC). Our aims were to assess HRQoL of patients with BC, analyse relationships between diverse HRQoL measures and validate the Hungarian version of the Bladder Cancer Index (BCI) questionnaire. A cross-sectional survey was performed among patients with BC (N = 151). Validated Hungarian versions of the FACT-Bl, SF-36 and EQ-5D were applied and SF-6D was derived. Psychometric analysis of the Hungarian BCI was performed. Pearson correlations between the five measures were analysed. Deterioration in SF-36 Physical Functioning was detected among patients aged 45-64 years. The EQ-5D score did not differ significantly from the age-matched population norm. Correlations between the FACT-Bl, EQ-5D and SF-6D utility measures were strong (r > 0.6). Cronbach alpha coefficients of the Hungarian BCI ranged from 0.75 to 0.97 and factor analysis confirmed that data fit to the six predefined subdomains. Test-retest correlations (reliability, N = 50) ranged from 0.67 to 0.87 and interscale correlations between urinary, bowel and sexual BCI domains were weak or moderate (r = 0.29 to 0.49). Convergent validity revealed a stronger correlation with FACT-Bl (r = 0.126 to 0.719) than with generic health state scores (r = 0.096 to 0.584). Results of divergent validity of the Hungarian BCI by treatment groups by Kruskal Wallis test were promising although limited by low sample sizes in cystectomy subgroups. Generic health state measures have limited capacity to capture HRQoL impact of BC. Validity tests yielded favourable results for the Hungarian BCI. Mapping studies to estimate utility scores from FACT-Bl are encouraged but less recommendable with the BCI.
authors.affiliation: Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary.
authors.forename: Noémi V
authors.initials: NV
authors.lastname: Hevér
authors.forename: Márta
authors.initials: M
authors.lastname: Péntek
authors.forename: András
authors.initials: A
authors.lastname: Balló
authors.forename: László
authors.initials: L
authors.lastname: Gulácsi
authors.forename: Petra
authors.initials: P
authors.lastname: Baji
authors.forename: Valentin
authors.initials: V
authors.lastname: Brodszky
authors.forename: Miklós
authors.initials: M
authors.lastname: Damásdi
authors.forename: Zita
authors.initials: Z
authors.lastname: Bognár
authors.forename: György
authors.initials: G
authors.lastname: Tóth
authors.forename: István
authors.initials: I
authors.lastname: Buzogány
authors.forename: Árpád
authors.initials: Á
authors.lastname: Szántó
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D006814:Hungary; D008297:Male; D015233:Models, Statistical; D011379:Prognosis; D011594:Psychometrics; D019984:Quality Indicators, Health Care; D011788:Quality of Life; D011795:Surveys and Questionnaires; D001749:Urinary Bladder Neoplasms / Q000523:psychology* / Q000628:therapy