International Psychometric Validation of an EORTC Quality of Life Module Measuring Cancer Related Fatigue (EORTC QLQ-FA12)

Joachim Weis*, Krzysztof A. Tomaszewski, Eva Hammerlid, Juan Ignacio Arraras, Thierry Conroy, Anne Lanceley, Heike Schmidt, Markus Wirtz, Susanne Singer, Monica Pinto, Mohamed Alm El-Din, Inge Compter, Bernhard Holzner, Dirk Hofmeister, Wei-Chu Chie, Marek Czeladzki, Amelie Harle, Louise Jones, Sabrina Ritter, Hans-Henning FlechtnerAndrew Bottomley, EORTC Quality Life Grp

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: The European Organisation for Research and Treatment of Cancer (EORTC) Group has developed a new multidimensional instrument measuring cancer-related fatigue to be used in conjunction with the quality of life core questionnaire (EORTC QLQ-C30). The module EORTC QLQ-FA13 assesses physical, cognitive, and emotional aspects of cancer-related fatigue.

Methods: The methodology follows the EORTC guidelines for phase IV validation of modules. This paper focuses on the results of the psychometric validation of the factorial structure of the module. For validation and cross-validation confirmatory factor analysis (maximum likelihood estimation), intraclass correlation and Cronbach alpha for internal consistency were employed. The study involved an international multicenter collaboration of 11 European and non-European countries.

Results: A total of 946 patients with various tumor diagnoses were enrolled. Based on the confirmatory factor analysis, we could approve the three-dimensional structure of the module. Removing one item and reassigning the factorial mapping of another item resulted in the EORTC QLQ-FA12. For the revised scale, we found evidence supporting good local (indicator reliability >= 0.60, factor reliability >= 0.82) and global model fit (GFI(t1 vertical bar t2) = 0.965/0.957, CFIt1 vertical bar t2 = 0.976/0.972, RMSEA(t1 vertical bar t2) = 0.060/0.069) for both measurement points. For each scale, test-retest reliability proved to be very good (intraclass correlation: Rt1-t2 = 0.905-0.921) and internal consistency proved to be good to high (Cronbach alpha = .79-.90).

Conclusion: Based on the former phase III module, the multidimensional structure was revised as a phase IV module (EORTC FA12) with an improved scale structure. For a comprehensive validation of the EORTC FA12, further aspects of convergent and divergent validity as well as sensitivity to change should be determined.

Original languageEnglish
Article number273
Number of pages8
JournalJournal of the National Cancer Institute
Issue number5
Publication statusPublished - May 2017



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