Abstract
BackgroundThe Expanded Prostate Index Composite for Clinical Practice (EPIC-CP) is a short version of the original EPIC, developed to facilitate the instrument’s use in routine care. This study aimed to validate the EPIC-CP Portuguese version, and evaluate its role in presenting early functional outcomes of surgically treated prostate cancer patients at a Latin American referral center.MethodsThe EPIC-CP was self-administered prospectively and individually by all localized prostate cancer patients, before and after robotic-assisted radical prostatectomy, from March 2017 to June 2018 at a single institution. For validation, we used the Cronbach’s alpha coefficient to evaluate internal consistency. The EPIC-CP domains were compared before surgery, and 6 months and 12 months after surgery. Statistical analyses were performed using the student’s t test, and Wilcoxon and Friedman tests, with p values < 0.05 considered significant.ResultsOne hundred and fifty two patients answered the EPIC-CP. The patients had a median age of 62.7 (± 8.5) years and prostate specific antigen level of 6.3 (± 4.6) ng/ml. The Cronbach’s alpha varied from 0.75 to 0.77 for all domains with good internal consistency, except for the “vitality/hormonal” domain, which had a score of 0.35. The domain evolution for the preoperative and 6-month postoperative groups revealed that the domains related to urinary continence and bowel worsened, and were increased during the first 6 months; however, this variation had no obvious clinical implications, and the irritative symptoms improved. Regarding the sexual domain, the scores worsened, and also increased over the first 6 months. The results of the confirmatory factor analysis were robust, with an explained variance of 0.951 and covariance of 0.929.ConclusionsThe Portuguese version of the EPIC-CP is a reliable and valid questionnaire for postoperative patients, and very useful to improve the knowledge of the early functional outcomes of men treated for prostate cancer.
Highlights
The Expanded Prostate Index Composite for Clinical Practice (EPIC-CP) is a short version of the original Expanded Prostate Cancer Composite Index (EPIC), developed to facilitate the instrument’s use in routine care
The lack of an instrument with an international perspective led the World Health Organization (WHO) to form a Quality of Life Group. This group developed a questionnaire composed of 100 questions to assess general quality of life, called the World Health Organization Quality of Life (WHOQOL) [6]
We conducted a prospective study in partnership with the EPIC and EPIC-CP authors and creators, who discussed the study design and methodology, and authorized the validation of the Portuguese version
Summary
The Expanded Prostate Index Composite for Clinical Practice (EPIC-CP) is a short version of the original EPIC, developed to facilitate the instrument’s use in routine care. This study aimed to validate the EPIC-CP Portuguese version, and evaluate its role in presenting early functional outcomes of surgically treated prostate cancer patients at a Latin American referral center. A large variety of treatments is available; patient expectations and quality of life (QoL) have become essential tools that guide the decision-making of the medical staff regarding clinical management and treatment [2]. The lack of an instrument with an international perspective led the World Health Organization (WHO) to form a Quality of Life Group. This group developed a questionnaire composed of 100 questions to assess general quality of life, called the World Health Organization Quality of Life (WHOQOL) [6]. The need for short instruments led the WHOQOL Group to develop an abbreviated version of the WHOQOL-100, the WHOQOL-bref [7]
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