EORTC-QLQ-C30 Clinical Workflow

Introduction

The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group (QLG) develops and validates PRO instruments for use in oncology. Their quality of life (QoL) core questionnaire, the QLQ-C30, was developed more than 25 years ago and is one of the most widely used cancer-specific PRO instruments [1]. The ICHOM standard sets for malignant neoplasms frequently recommends the use of the QLQ-C30 as part of the clinical routine  (e.g. [2]).

The EORTC-QLQ-C30 flow contains the EORTC-QLQ-C30 questionnaire and associated calculation. After form submission, the EORTC-QLQ-C30 calculation is executed automatically. It's easy to extend this flow with conditional logic based on the interpretation of the EORTC-QLQ-C30 calculation.

EORTC-QLQ-C30 questionnaire

Questions and Scoring

The QLQ-C30 is composed of both multi-item scales and single-item measures. These include five functional scales, three symptom scales, a global health status / QoL scale, and six single items. Each of the multi-item scales includes a different set of items - no item occurs in more than one scale [3]. As shown below:

Scale

• Global health status/ QoL (Global)
• Physical functioning (Functional)
• Role functioning (Functional)
• Emotinal functioning (Functional)
• Cognitive functioning (Functional)
• Social functioning (Functional)
• Fatigue (Symptom)
• Nausea and vomiting (Symptom)
• Pain (Symptom)
• Dyspnoea (Symptom)
• Insomnia (Symptom)
• Appetite loss (Symptom)
• Constipation (Symptom)
• Diarrhoea (Symptom)
• Financial difficulties (Symptom)

Remarks:

• “Item range” is the difference between the possible maximum and the minimum response to individual items. All items are scored 1 to 4, giving range = 3

Interpretation

A high scale score represents a higher response level. Thus a high score for a functional scale represents a high / healthy level of functioning, a high score for the global health status / QoL represents a high QoL, but a high score for a symptom scale / item represents a high level of symptomatology / problems [3].

References

[1] Aaronson NK, Ahmedzai S, Bergman B, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365-376. doi:10.1093/jnci/85.5.365\
[2] Ong WL, Schouwenburg MG, van Bommel ACM, et al. A Standard Set of Value-Based Patient-Centered Outcomes for Breast Cancer: The International Consortium for Health Outcomes Measurement (ICHOM) Initiative. JAMA Oncol. 2017;3(5):677-685. doi:10.1001/jamaoncol.2016.4851\
[3] https://drive.google.com/file/d/1GwwqedEOj6pfzzSCU1ihrQbxABL3db3M/view?usp=sharing