title: Development of an item bank for the EORTC Role Functioning Computer Adaptive Test (EORTC RF-CAT).
abstract: BACKGROUND
  Role functioning (RF) as a core construct of health-related quality of life (HRQOL) comprises aspects of occupational and social roles relevant for patients in all treatment phases as well as for survivors. The objective of the current study was to improve its assessment by developing a computer-adaptive test (CAT) for RF. This was part of a larger project whose objective is to develop a CAT version of the EORTC QLQ-C30 which is one of the most widely used HRQOL instruments in oncology.
  
  
  METHODS
  In accordance with EORTC guidelines, the development of the RF-CAT comprised four phases. Phase I involved the conceptualization of RF. In Phase II, a provisional list of items was defined and revised by experts in the field. In phase III, feedback was obtained from cancer patients in various countries. Phase IV comprised field testing in an international sample, calibration of the item bank, and evaluation of the psychometric performance of the RF-CAT.
  
  
  RESULTS
  Phases I-III yielded a list of 12 items eligible for phase IV field-testing. The field-testing sample included 1,023 patients from Austria, Denmark, Italy, and the UK. Psychometric evaluation and item response theory analyses yielded 10 items with good psychometric properties. The resulting item bank exhibits excellent reliability (mean reliability = 0.85, median = 0.95). Using the RF-CAT may allow sample size savings from 11 % up to 50 % compared to using the QLQ-C30 RF scale.
  
  
  CONCLUSIONS
  The RF-CAT item bank improves the precision and efficiency with which RF can be assessed, promoting its integration into oncology research and clinical practice.
authors.affiliation: Department for Psychiatry and Psychotherapy and Department for Nuclear Medicine, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria. eva.gamper@uki.at.|Department for Psychiatry, Psychotherapy and Psychosomatic Medicine, Medical University of Innsbruck, Anichstraßé 35, 6020, Innsbruck, Austria. eva.gamper@uki.at.
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Gamper
authors.affiliation: The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.
authors.forename: Morten Aa
authors.initials: MA
authors.lastname: Petersen
authors.affiliation: Netherlands Cancer Institute, Psychosocial Research and Epidemiology, Plesmanlaan 121, 1066 CX, Amsterdam, Netherlands.
authors.forename: Neil
authors.initials: N
authors.lastname: Aaronson
authors.affiliation: Psychoncology Unit, Sant'Andrea Hospital Sapienza University of Rome, Via di Grottarossa 1035, 00189, Rome, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Costantini
authors.affiliation: Department for Psychiatry and Psychotherapy, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
authors.forename: Johannes M
authors.initials: JM
authors.lastname: Giesinger
authors.affiliation: Department for Psychiatry and Psychotherapy, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.|Department for Psychiatry, Psychotherapy and Psychosomatic Medicine, Medical University of Innsbruck, Anichstraßé 35, 6020, Innsbruck, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Holzner
authors.affiliation: Department for Psychiatry and Psychotherapy, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.|Department for Psychiatry, Psychotherapy and Psychosomatic Medicine, Medical University of Innsbruck, Anichstraßé 35, 6020, Innsbruck, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Kemmler
authors.affiliation: Department for Psychiatry and Psychotherapy, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.|Department for Psychiatry, Psychotherapy and Psychosomatic Medicine, Medical University of Innsbruck, Anichstraßé 35, 6020, Innsbruck, Austria.
authors.forename: Anne
authors.initials: A
authors.lastname: Oberguggenberger
authors.affiliation: Department of Medical Biostatistics, Epidemiology, and Informatics, University of Mainz, Saarstraße 21, 55122, Mainz, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Singer
authors.affiliation: Mount Vernon Cancer Centre, Lynda Jackson Macmillan Centre, Northwood, Middlesex, HA6 2RN, UK.
authors.forename: Teresa
authors.initials: T
authors.lastname: Young
authors.affiliation: The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark.|Department of Public Health, Institute of Health Services Research, University of Copenhagen, Norregade 10, 1165, Copenhagen, Denmark.
authors.forename: Mogens
authors.initials: M
authors.lastname: Groenvold
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D003201:Computers; D003718:Denmark; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D010361:Patients / Q000523:psychology*; D016730:Program Development; D011594:Psychometrics / Q000295:instrumentation*; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D012380:Role; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D006113:United Kingdom
keywords: Cancer; Computer-adaptive test; Health related quality of life; Oncology; QLQ-C30; Role functioning