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- Title
Assessing measurement invariance of a health-related quality-of-life questionnaire in radiotherapy patients.
- Authors
King-Kallimanis, Bellinda; ter Hoeven, Claartje; Haes, Hanneke; Smets, Ellen; Koning, Caro; Oort, Frans
- Abstract
Objective: If the assumption of measurement invariance is not tested, we cannot be sure whether differences observed are due to true differences in health-related quality-of-life (HRQoL), or are measurement artifacts. We aim to investigate this assumption in a sample of heterogeneous cancer patients, focusing on whether age, sex, previous treatment for cancer, and information regarding treatment preferences result in biased HRQoL scores. Methods: 155 cancer patients who were about to begin their first session of radiotherapy were included. HRQoL was measured using the EORTC QLQ-C30. Structural equation modeling was applied to assess whether there was a violation of the assumption of invariance. Results: A satisfactory single construct (Functioning HRQoL) measurement model was found and two violations of invariance were identified. Irrespective of patients' Functioning HRQoL, older patients reported worse physical functioning and patients who had received treatment prior to radiotherapy reported worse emotional functioning than we would otherwise expect. Conclusions: In the present study, accounting for measurement bias lead to a substantial improvement in the overall fit of the model. By ignoring the bias, we would have concluded that the model fit was unsatisfactory. The findings underline the importance of investigating measurement invariance in scales designed for heterogeneous samples.
- Subjects
CANCER radiotherapy; QUALITY of life; CANCER patients; PATIENT satisfaction; EMOTIONS; MEDICAL care; FACTOR analysis
- Publication
Quality of Life Research, 2012, Vol 21, Issue 10, p1745
- ISSN
0962-9343
- Publication type
Article
- DOI
10.1007/s11136-011-0094-2