title: Assessing health-related quality of life in patients with breast cancer: a systematic and standardized comparison of available instruments using the EMPRO tool.
abstract: The objective was to obtain a standardized evaluation of available specific and generic breast cancer health-related quality-of-life instruments.
  
  
  
  We carried out systematic literature reviews in the PubMed and EMBASE databases to identify manuscripts which contained information regarding either the development process or metric properties of health-related quality-of-life instruments used among breast cancer patients. Each instrument was evaluated independently by two researchers, and occasionally a third one, using the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. An overall score and seven attribute-specific EMPRO scores were calculated (range 0-100, worst to best): concept and measurement model, reliability, validity, responsiveness, interpretability, burden, and alternative forms.
  
  
  
  FACT-B was the instrument with the best global performance, obtaining an overall EMPRO score of 79.27. It was also the most accurate instrument on the Concept and Measurement Model, Reliability, and Interpretability attributes. Four more instruments scored over 50 points on the overall score, which summarizes the five attribute-specific scores: EORTC BR-23, IBCSG, WHO-QOL BREF, and SF-36. An overall score of at least 50 points implies that the use of these instruments could be recommended for assessing health-related quality of life in breast cancer patients.
  
  
  
  The FACT-B scored the highest on overall on our EMPRO evaluation of instruments measuring health-related quality of life among breast cancer patients. However, depending on the purpose of the study, several instruments (EORTC BR-23, IBCSG, SF-36, and WHO-QOL BREF) have shown good performance in some of the specific individual dimensions included in the EMPRO.
authors.affiliation: Universidad Carlos III, Getafe, Madrid, Spain.
authors.forename: Stefano
authors.initials: S
authors.lastname: Maratia
authors.affiliation: Universidad Carlos III, Getafe, Madrid, Spain. sergio.cedillo@pfizer.com.|TFS People, Trial Form Support Spain, Arturo Soria 336-7° izquierda, 28033, Madrid, Spain. sergio.cedillo@pfizer.com.
authors.forename: Sergio
authors.initials: S
authors.lastname: Cedillo
authors.affiliation: Health Economics and Outcomes Research Department, Pfizer, S.L.U., Alcobendas, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Rejas
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology*; D005260:Female; D006801:Humans; D000071066:Patient Reported Outcome Measures; D011594:Psychometrics / Q000295:instrumentation*; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires
keywords: Breast cancer; EMPRO; Health-related quality of life; Patient-reported outcomes; Psychometrics; Validation studies