Have you ever taken a computer adaptive language test like the TOEFL? Have you ever thought that quality of life can be examined in this way? Professor Wei-Chu Chie of the Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University has been working with the Quality of Life Group and the Quality of Life Unit of the European Organisation for Research and Treatment of Cancer (EORTC) for about 20 years.
Quality of life for patients with cancer is measured with questionnaires, usually a core questionnaire and a supplementary questionnaire. The core questionnaire the EORTC QLQ-C30 was first published in 1993. It contains 15 different domains measuring 15 different aspects of quality of life for patients with cancer: physical, emotional, cognitive, social, and role functioning; fatigue, nausea and vomiting, pain, dyspnea, diarrhea, constipation, lack of appetite, insomnia, financial difficulty, and overall quality of life.
At first, the questionnaire was designed with 30 questions of Likert’s scale 1 to 4 for each question based on the classical test theory. To make scores based on each domain of the items (questions) on the same metric and directly comparable, professor Morten Petersen from Denmark started a team to establish a large item bank and collect patients’ responses from different countries for each domain, based on the item response theory (IRT) in 2010. Dr. Chie participated in the team from the very beginning and provided patients’ responses from Taiwan. The team examined 14 domains (except the overall quality of life) one by one, modified the item bank accordingly, and published a series of papers in different academic journals. The team finished the overall testing and published the final results in European Journal of Cancer in September 2018.
To conduct the test, the patient will see an average question on a desk-top o lap-top computer, if his or her response is of a higher score, the computer will present a higher request, or a more extreme condition, and vice versa. After a couple of questions, the result will converge, and the patient will be given a quality of life score of this domain. This tool is convenient and useful in assessing patients’ quality of life of different aspects. Because of technical problem, few domains of Chinese translation are to be completed in 2019. Users may visit the website of the EORTC and submit applications: https://qol.eortc.org/cat/