Use of item response theory to develop a shortened version of the EORTC QLQ-C30 emotional functioning scale

J. Bjorner (Corresponding Author), M. A. Petersen, M. Groenvold, N. Aaoronson, M. Ahlner-Elmqvist, J. I. Arraras, A. Bredart, Peter Fayers, M. S. Jordhøy, M. Sprangers, M. Watson, T. Young, European Organisation for Research and Treatment of Cancer

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51 Citations (Scopus)


Background: As part of a larger study whose objective is to develop an abbreviated version of the EORTC QLQ-C30 suitable for research in palliative care, analyses were conducted to determine the feasibility of generating a shorter version of the 4-item emotional functioning (EF) scale that could be scored in the original metric. Methods: We used data from 24 European cancer studies conducted in 10 different languages (n = 8242). Item selection was based on analyses by item response theory (IRT). Based on the IRT results, a simple scoring algorithm was developed to predict the original 4-item EF sum scale score from a reduced number of items. Results: Both a 3-item and a 2-item version ( item 21 'Did you feel tense?' and item 24 'Did you feel depressed?') predicted the total score with excellent agreement and very little bias. In group comparisons, the 2-item scale led to the same conclusions as those based on the original 4-item scale with little or no loss of measurement efficiency. Conclusion: Although these results are promising, confirmatory studies are needed based on independent samples. If such additional studies yield comparable results, incorporation of the 2-item EF scale in an abbreviated version of the QLQ-C30 for use in palliative care research settings would be justified. The analyses reported here demonstrate the usefulness of the IRT-based methodology for shortening questionnaire scales.

Original languageEnglish
Pages (from-to)1683-1697
Number of pages15
JournalQuality of Life Research
Issue number10
Publication statusPublished - Dec 2004

Bibliographical note

This work was supported by grants from the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Group. The study was based on data contributed by the following individuals: Neil Aaronson, Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Marianne Ahlner-Elmqvist, ENT Department, Malmo University Hospital MAS, Malmo, Sweden; Juan I. Arraras, Department of Oncology, Hospital of Navarre, Pamplona, Spain; Jane Blazeby, Department of Surgery, Bristol Royal Infirmary, Bristol, UK; Yvonne Brandberg, Psychosocial Unit, Department of Oncology, Karolinska Hospital, Stockholm, Sweden; Anne Bre´dart, Institut Curie, Psychiatry and PsychoOncology Unit, Paris, France; Thierry Conroy, Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre les Nancy, France; Ann Cull, ICRF Psychology Research Group, Western General Hospital, Edinburgh, UK; Alexander de Graeff, Department of Internal Medicine, University Medical Centre, Utrecht, The Netherlands; Mogens Groenvold, Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark; Marianne Hjermstad, Department of Oncology, Norwegian Radium Hospital, Oslo, Norway; Marit Jordhoy, Unit of Applied Clinical Research, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Marianne Sullivan, Health Care Research Unit, Institute of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden; Craig Vickery, Royal Devon & Exeter Hospital, Exeter, UK; Maggie Watson, Psychological Medicine, Royal Marsden NHS Trust, Sutton, UK; Teresa Young, Lynda Jackson Macmillan Centre, Mount Vernon Hospital, Middlesex, UK.


  • cancer
  • IRT
  • palliative care
  • prediction
  • quality of life
  • shortening of scales


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