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Comparing higher order models for the EORTC QLQ-C30.

Gundy CM, Fayers PM, Groenvold M, Petersen MA, Scott NW, Sprangers MA, Velikova G, Aaronson NK - Qual Life Res (2011)

Bottom Line: All chi-square tests were significant.One of the Physical/Mental models had fit indices superior to the other models considered.The Physical/Mental health model had the best fit of the higher order models considered, and enjoys empirical and theoretical support in comparable instruments and applications.

View Article: PubMed Central - PubMed

Affiliation: Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.

ABSTRACT

Purpose: To investigate the statistical fit of alternative higher order models for summarizing the health-related quality of life profile generated by the EORTC QLQ-C30 questionnaire.

Methods: A 50% random sample was drawn from a dataset of more than 9,000 pre-treatment QLQ-C30 v 3.0 questionnaires completed by cancer patients from 48 countries, differing in primary tumor site and disease stage. Building on a "standard" 14-dimensional QLQ-C30 model, confirmatory factor analysis was used to compare 6 higher order models, including a 1-dimensional (1D) model, a 2D "symptom burden and function" model, two 2D "mental/physical" models, and two models with a "formative" (or "causal") formulation of "symptom burden," and "function."

Results: All of the models considered had at least an "adequate" fit to the data: the less restricted the model, the better the fit. The RMSEA fit indices for the various models ranged from 0.042 to 0.061, CFI's 0.90-0.96, and TLI's from 0.96 to 0.98. All chi-square tests were significant. One of the Physical/Mental models had fit indices superior to the other models considered.

Conclusions: The Physical/Mental health model had the best fit of the higher order models considered, and enjoys empirical and theoretical support in comparable instruments and applications.

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Related in: MedlinePlus

Seven hypothesized modelsa: a standard model, b physical health, mental health and QL, c physical burden, mental function and QL, d symptom burden, function and QL, e HRQL and QL, f formative symptom burden (free weights), function and QL, g formative symptom burden (fixed weights) function and QL. aModels are described in text. Item thresholds, means, (error) variances, and correlations between first-order latent variables (in the standard model) are not represented, for clarity’s sake
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Fig1: Seven hypothesized modelsa: a standard model, b physical health, mental health and QL, c physical burden, mental function and QL, d symptom burden, function and QL, e HRQL and QL, f formative symptom burden (free weights), function and QL, g formative symptom burden (fixed weights) function and QL. aModels are described in text. Item thresholds, means, (error) variances, and correlations between first-order latent variables (in the standard model) are not represented, for clarity’s sake

Mentions: These 7 models are described in more detail below. (See Fig. 1 for a graphical representation of the models. (Straight lines, with one-sided arrows, represent regression coefficients; arced lines, with two-sided arrows, represent correlation coefficients.)Fig. 1


Comparing higher order models for the EORTC QLQ-C30.

Gundy CM, Fayers PM, Groenvold M, Petersen MA, Scott NW, Sprangers MA, Velikova G, Aaronson NK - Qual Life Res (2011)

Seven hypothesized modelsa: a standard model, b physical health, mental health and QL, c physical burden, mental function and QL, d symptom burden, function and QL, e HRQL and QL, f formative symptom burden (free weights), function and QL, g formative symptom burden (fixed weights) function and QL. aModels are described in text. Item thresholds, means, (error) variances, and correlations between first-order latent variables (in the standard model) are not represented, for clarity’s sake
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Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3472059&req=5

Fig1: Seven hypothesized modelsa: a standard model, b physical health, mental health and QL, c physical burden, mental function and QL, d symptom burden, function and QL, e HRQL and QL, f formative symptom burden (free weights), function and QL, g formative symptom burden (fixed weights) function and QL. aModels are described in text. Item thresholds, means, (error) variances, and correlations between first-order latent variables (in the standard model) are not represented, for clarity’s sake
Mentions: These 7 models are described in more detail below. (See Fig. 1 for a graphical representation of the models. (Straight lines, with one-sided arrows, represent regression coefficients; arced lines, with two-sided arrows, represent correlation coefficients.)Fig. 1

Bottom Line: All chi-square tests were significant.One of the Physical/Mental models had fit indices superior to the other models considered.The Physical/Mental health model had the best fit of the higher order models considered, and enjoys empirical and theoretical support in comparable instruments and applications.

View Article: PubMed Central - PubMed

Affiliation: Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.

ABSTRACT

Purpose: To investigate the statistical fit of alternative higher order models for summarizing the health-related quality of life profile generated by the EORTC QLQ-C30 questionnaire.

Methods: A 50% random sample was drawn from a dataset of more than 9,000 pre-treatment QLQ-C30 v 3.0 questionnaires completed by cancer patients from 48 countries, differing in primary tumor site and disease stage. Building on a "standard" 14-dimensional QLQ-C30 model, confirmatory factor analysis was used to compare 6 higher order models, including a 1-dimensional (1D) model, a 2D "symptom burden and function" model, two 2D "mental/physical" models, and two models with a "formative" (or "causal") formulation of "symptom burden," and "function."

Results: All of the models considered had at least an "adequate" fit to the data: the less restricted the model, the better the fit. The RMSEA fit indices for the various models ranged from 0.042 to 0.061, CFI's 0.90-0.96, and TLI's from 0.96 to 0.98. All chi-square tests were significant. One of the Physical/Mental models had fit indices superior to the other models considered.

Conclusions: The Physical/Mental health model had the best fit of the higher order models considered, and enjoys empirical and theoretical support in comparable instruments and applications.

Show MeSH
Related in: MedlinePlus