Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer
Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer
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DOI：
10.1016/s0090-4295(00)00858-x
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发表时间：
2000-12-01
期刊：
影响因子：
2.1
通讯作者：
Sanda, MG
中科院分区：
文献类型：
--
作者：
Wei, JT;Dunn, RL;Sanda, MG
目标。健康相关生活质量（HRQOL）是前列腺癌治疗中越来越重要的终点。然而，现有HRQOL工具没有充分评估的关键问题包括刺激性尿路症状、激素症状以及量化尿路、性、肠和激素领域之间的麻烦的多项评分。我们寻求开发一种新的工具来促进更全面的评估前列腺癌相关HRQOL。仪器的开发是基于专家小组和前列腺癌患者的建议，这导致将20项加利福尼亚大学洛杉矶分校前列腺癌指数（UCLA-PCI）扩展到50项扩展前列腺指数综合（EPIC）。通过内容分析和因子分析得出总结和分量表得分。信度和效度通过重测相关、Cronbach’s alpha系数、量表间相关和EPIC与其他验证仪器的相关来评估。EPIC尿、肠、性和激素领域总结得分（每个r大于等于0.80,Cronbach’s alpha大于等于0.82）和大多数领域特定子量表的重测信度和内部一致性很高。功能与干扰子量表在域内的相关性较高（r = 0.60）。不同主域之间的相关性一直较低，表明这些域评估不同的HRQOL成分。EPIC域与医学结果研究12项简短健康调查（SF-12）有弱至中度相关性，表明它们同时使用的理由。与癌症治疗功能评估前列腺模块（FACT-P）相关的EPIC域与美国泌尿协会症状指数（AUA-SI）之间存在适度的一致性，提供了标准的有效性，没有过多的重叠。EPIC是一种强大的前列腺癌HRQOL仪器，通过测量广泛的泌尿、肠道、性和激素症状来补充先前的仪器，从而为全面评估当代前列腺癌管理中重要的HRQOL问题提供了独特的工具。泌尿外科56(6):899- 905,2000。(C) 2000, Elsevier Science Inc.；
Objectives. Health-related quality of life (HRQOL) is an increasingly important endpoint in prostate cancer care. However, pivotal issues that are not fully assessed in existing HRQOL instruments include irritative urinary symptoms, hormonal symptoms, and multi-item scores quantifying bother between urinary, sexual, bowel, and hormonal domains, We sought to develop a novel instrument to facilitate more comprehensive assessment of prostate cancer-related HRQOL.Methods. Instrument development was based on advice from an expert panel and prostate cancer patients, which led to expanding the 20-item University of California-Los Angeles Prostate Cancer Index (UCLA-PCI) to the 50-item Expanded Prostate Index Composite (EPIC). Summary and subscale scores were derived by content and factor analyses. Reliability and validity were assessed by test-retest correlation, Cronbach's alpha coefficient, interscale correlation, and EPIC correlation with other validated instruments.Results. Test-retest reliability and internal consistency were high for EPIC urinary, bowel, sexual, and hormonal domain summary scores (each r greater than or equal to0.80 and Cronbach's alpha greater than or equal to0.82) and for most domain-specific subscales. Correlations between function and bother subscales within domains were high (r > 0.60). Correlations between different primary domains were consistently lower, indicating that these domains assess distinct HRQOL components. EPIC domains had weak to modest correlations with the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12), indicating rationale for their concurrent use. Moderate agreement was observed between EPIC domains relevant to the Functional Assessment of Cancer Therapy Prostate module (FACT-P) and the American Urological Association Symptom Index (AUA-SI), providing criterion validity without excessive overlap.Conclusions. EPIC is a robust prostate cancer HRQOL instrument that complements prior instruments by measuring a broad spectrum of urinary, bowel, sexual, and hormonal symptoms, thereby providing a unique tool for comprehensive assessment of HRQOL issues important in contemporary prostate cancer management. UROLOGY 56: 899-905, 2000. (C) 2000, Elsevier Science Inc.