Validating cancer-specific and generic quality of life (QoL) instruments among patients with head and neck cancers: incorporating the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck Module with generic QoL instruments

PURPOSE: Head and neck cancers can significantly affect health-related quality of life (QoL). Using a novel approach, the present study validated a Taiwanese version of the revised European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Head and Neck Module (QLQ-HN43). METHODS: The present study was a cross-sectional study with the data collected from November 2021 to March 2022, and included 290 participants (82.7% males, mean age = 58.9 years SD = 11.03) from a medical center. Internal consistency was examined using Cronbach's α. Confirmatory factor analysis (CFA) was conducted testing different models. Two generic QoL measures (the World Health Organization Quality of Life Questionnaire Brief version WHOQOL-BREF and EuroQol Five-Dimension EQ-5D), were used to assess concurrent validity. Known-groups validity was used to indicate how the QLQ-HN43 could differentiate individuals with mild-to-moderate problems from those with severe problems associated with QoL. RESULTS: Internal consistency was acceptable for QLQ-HN43 subscales (.68 < α < .94). CFA results showed appropriate fit indices, particularly for each individual model and the incorporated model containing both QLQ-HN43 and WHOQOL-BREF. The concurrent validity of the QLQ-HN43 was supported by the significant correlations with WHOQOL-BREF (r=-.111 to - .508; p-values<.05) and EQ-5D utility in CFA findings (r=.276 to .655; p-values<.01). Significant differences were found between those at the initial stages of the disease and those at the advanced stage, supporting known-group validity. CONCLUSION: The QLQ-HN43 scale has acceptable psychometric properties for Taiwanese individuals with head or neck cancers. The feasibility of incorporating EQ-5D with the QLQ-HN43 needs further investigation.