Abstract
PurposeThe objective was to obtain a standardized evaluation of available prostate cancer-specific quality of life instruments used in patients with early-stage disease.MethodsWe carried out systematic literature reviews in the PubMed database to identify manuscripts which contained information regarding either the development process or metric properties of prostate cancer-specific quality of life instruments. Each instrument was evaluated by two experts, independently, using the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. An overall and seven attribute-specific EMPRO scores were calculated (range 0–100, worst to best): measurement model, reliability, validity, responsiveness, interpretability, burden and alternative forms.ResultsEight instruments and 57 manuscripts (2–15 per instrument) were identified. The Expanded Prostate Cancer Index Composite (EPIC) was the best rated (overall EMPRO score 83.1 points). Good results were also obtained by University of California Los Angeles-Prostate Cancer Index (UCLA-PCI), Patient-Oriented Prostate Utility Scale (PORPUS) and Prostate Cancer Quality of Life Instrument (PC-QoL) with 77.3, 70.5 and 64.8 points, respectively. These four instruments passed with distinction the validity and responsiveness evaluation. Insufficient reliability results were observed for UCLA-PCI and PORPUS.ConclusionsCurrent evidence supports the choice of EPIC, PORPUS or PC-QoL. Attribute-specific EMPRO results facilitate selecting the adequate instrument for every purpose. For longitudinal studies or clinical trials, where responsiveness is the priority, EPIC or PC-QoL should be considered. We recommend the PORPUS for economic evaluations because it allows cost-utility analysis, and EPIC short versions to minimize administration burden.Electronic supplementary materialThe online version of this article (doi:10.1007/s11136-014-0678-8) contains supplementary material, which is available to authorized users.
Highlights
Prostate cancer is currently the most frequent solid neoplasm and the third cause of death in European men [1]
Good results were obtained by University of California Los Angeles-Prostate Cancer Index (UCLA-PCI), Patient-Oriented Prostate Utility Scale (PORPUS) and Prostate Cancer Quality of Life Instrument (PC-QoL) with 77.3, 70.5 and 64.8 points, respectively
Current evidence supports the choice of EPIC, PORPUS or PC-QoL
Summary
Prostate cancer is currently the most frequent solid neoplasm and the third cause of death in European men [1]. The first prostate cancer-specific HRQL instruments, such as the prostate module of the European Organization for Research and Treatment of Cancer (EORTC QLM-P14) [6] or the Prostate Cancer-Specific Quality of Life Instrument (PROSQOLI) [7], were designed mainly for patients in advanced disease stages and present significant limitations when used in patients with localized disease. The need for tools capable of capturing all relevant aspects in patients diagnosed at early stages of disease led to the development of several prostate cancer-specific instruments. Several share a similar content and applicability, which makes it a complicated task to select the right instrument for a specific purpose and setting, calling for the need to evaluate those measures considering their strengths and weaknesses. A comparative evaluation among instruments would be of great value to facilitate this selection task
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