Psychometric Properties of the European Organization for Research and Treatment of Cancer Head and Neck (EORTC QLQ H&N 43) Quality of Life Tool for Use in the Eastern India Population

欧洲癌症研究与治疗组织头颈癌(EORTC QLQ H&N 43)生活质量工具在印度东部人群中的心理测量特性

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Abstract

Head and neck cancer (HNC) and its treatment outcomes have a substantial impact on the quality of life of the patients. This study aimed to translate and psychometrically validate the European Organization for Research and Treatment of Cancer head and neck cancer-specific quality of life module, updated version (EORTC QLQ-H&N43) in Odia language for use in Eastern India. Forward-backward translation and pilot testing of the pre-final Odia version of the EORTC QLQ-H&N43 was done according to the EORTC quality of life group questionnaire translation guidelines. The psychometric properties were tested in a sample of 120 HNC patients attending a public tertiary hospital in Odisha. The patients filled in both the EORTC QLQ H&N 43 module and the EORTC QLQ C 30 questionnaire. Internal consistency was tested using Cronbach's alpha and the test-retest reliability using interclass correlation coefficients (ICC). The known group validity by disease stage was assessed and the convergent and discriminant validity were explored using the Spearman's correlation coefficient test. Exploratory factor analysis was performed to obtain information about the loading of the items and factor naming of the potential constructs was done. The Cronbach's Alpha of the scales ranged from 0.68 to 0.89 and was > 0.70 in 11 out of the 12 multi-item scales indicating good internal consistency. The ICC = 0.79 (95% confidence interval of 0.71-0.93) indicates a 'moderate' to 'good' test-retest reliability. The magnitude of the correlation of each item with its scale exceeded the correlation with another scale confirming item discriminant validity. All QLQ-H&N43 scales correlated negatively as predicted with all QLQ-C30 functioning scales. Significant known-group differences were observed between those in different stages of the disease. The factor analysis resulted in 3 different components namely oral/mouth-related symptoms, general functional disturbances, and psychosocial issues. The results suggest that the Odia version of EORTC QLQ-H&N43 is a reliable and valid tool for measuring the symptom burden of HNC patients in India. Future research on larger sample sizes can employ confirmatory factor analysis to further substantiate the findings of the present study. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12070-025-05549-7.

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