O1-4-6 - A Systematic Review of Measurement Properties of Quality of Life Instruments Used in Patients with Colorectal Cancer

Abstract

Background: To critically appraise the measurement properties of standardized health-related quality of life (HRQOL) instruments for colorectal cancer (CRC) patients, and to provide recommendations on the use of HRQOL instrument through collective evidence from previous studies.Materials: Systematic review of English-language literature published between January 1985 and December 2011 was conducted through the database search of Pubmed, Web of Science, Embase, and OVID Medline. Methodological quality of each eligible study and overall levels of evidence per measurement property and per HRQOL instrument were rated using a COSMIN checklist.Results: Thirty-nine studies reporting 27 standardized HRQOL instruments for CRC patients were identified. Methodological quality of hypothesis testing and internal consistency was evaluated most frequently. The Functional Assessment of Cancer Therapy-Colorectal (FACT-C) in Functional Assessment of Chronic Illness Therapy (FACIT) was the most extensively evaluated in eight out of nine measurement properties. The highest number of positive sign in the overall level of evidence was obtained in the colorectal cancer-specific quality of life questionnaire module (QLQ-CR38) in European Organisation for Research and Treatment of Cancer (EORTC) module, the FACT-C in FACIT module, Quick-FLIC and MSKCC Bowel Function instruments.Conclusion: For clinical use, the FACT-C was suggested to assess HRQOL in patients with CRC regardless of disease stage whereas the measurement property of MSKCC Bowel Function instrument was satisfactory in measuring HRQOL in rectal cancer patients. To facilitate the proper access to the overall level of evidence of HRQOL instruments, this review emphasized the need for high-quality and standard reporting of measurement properties of the existing and newly-developed HRQOL instruments for CRC patients.