Abstract
PurposeThe association of chronic lymphocytic leukemia (CLL) with health-related quality of life (HRQoL) is rarely studied globally. This study evaluated the psychometric properties of the EORTC-Chronic Lymphocytic Leukaemia (CLL17 [phase III]) module, a newly developed assessment on CLL patients’ HRQoL, among Chinese CLL patients.MethodsThe Chinese CLL17, comprised of three subscales (symptom burden [SB], physical condition [PC] and worries/fears [WF]), was provided by the developer team through EORTC. A cross-sectional online survey was conducted to collect data. The classical traditional theory (CTT) and the item response theory (IRT) were used to evaluate the psychometric properties of CLL17. Internal consistency reliability was determined by the Cronbach’s alpha and item-total correlation. Dimensionality was verified through confirmatory factor analysis (CFA). Convergent validity was also assessed. The generalized partial credit model was used for the IRT. The difficulty, discrimination, item fit, and differential item functioning (DIF) were calculated to assess the instrument’s psychometric properties.ResultsIn all, 318 patients, aged between 26 and 82 years, completed the questionnaire. A good level of internal reliability was achieved (Cronbach’s alpha = 0.92). The item-total correlation coefficient ranged from 0.46 to 0.72. There was a mid-to-high correlation between CLL17 and domains of EQ-5D and QLQ-C30. The IRT model showed a satisfactory homogeneity, item fit and good discrimination of items, except for item 4, 6 and 16 (< 1.0). low information provided by item 16 and 17. SB and PC provided more information with theta > 0, whereas WF provided more information with theta < 0. Item 17 perform inconsistently for respondents from different age groups (DIF).ConclusionThe EORTC-CLL17 Chinese version shows acceptable reliability and validity, making it a valuable instrument to evaluate the impact on the HRQoL of Chinese CLL patients.
Highlights
Chronic lymphocytic leukemia (CLL) is the most common leukemia among adults, affecting the white blood cells that develop slowly over time [1]
In Asian countries, including China, the CLL was less common than western countries, the prevalence is increasing dramatically in recent years
No item violated the assumption that α would be smaller without a particular item
Summary
Chronic lymphocytic leukemia (CLL) is the most common leukemia among adults, affecting the white blood cells that develop slowly over time [1]. In the United States, the National Cancer Institute reported that the number of new cases of CLL was 4.9 per 100,000 that annually caused 1.2 per 100,000 deaths [2]. Cancer Research United Kingdom stated that between 2014 and 2016, nearly 1% of the total cancer cases reported in the UK included people living with CLL [3]. In Asian countries, including China, the CLL was less common than western countries, the prevalence is increasing dramatically in recent years. According to the latest research reported by China’s National Cancer Centre, lymphoma was found to be one of the top ten causes of cancer death in cities, and one of the top ten most common cancers among men. CLL, as one of the most common lymphomas, is estimated to affect an increasing number of the Chinese population [4]. Even though the prevalence of CLL is not “high” for it still deserves attention and research from academia
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