COSMIN database

Measuring quality of life in patients with breast cancer: a systematic review of reliable and valid instruments available in Japan

Okamoto, T., Shimozuma, K., Katsumata, N., Koike, M., Hisashige, A., Tanaka, K., Ohsumi, S., Saito, M., Shikama, N., Mitsumori, M., Yamauchi, C., Watanabe, T., and Task Force of the Japanese Breast Cancer Society for 'The Development of Guidelines for Quality of Life Assessment Studies of Breast Cancer, Patients
BACKGROUND: Little is known about the availability and psychometric properties of instruments to measure quality of life (QOL) in clinical research on Japanese patients with breast cancer. The purpose of this systematic review is to find reliable and valid instruments available in Japan, and to summarize their characteristics.

METHODS: Instruments available in Japan were found through a systematic search of the literature. Each instrument identified was evaluated for item development, reliability, validity, interpretability and utility.

RESULTS: Six questionnaires to measure health-related QOL (the QOL-ACD, the EORTC QLQ-C30, the EORTC QLQ-BR23, the FACT-B, the SF-36, the WHO/QOL-26) and five scales to quantify the psychological burden (the STAI, the POMS, the SDS, the HADS, the GHQ), for which reliability and validity have been documented, are available in Japanese. All instruments were developed in foreign countries except for the QOL-ACD. Two of the QOL questionnaires were specific to breast cancer (the EORTC QLQ-BR23, the FACT-B). Though the measurements can be interpreted in some manner, the meaning of change scores over time has been documented for only three instruments (the EORTC QLQ-C30, the FACT-B, and the GHQ).

CONCLUSIONS: The review provides grounds for designing and implementing quantitative research on QOL of breast cancer patients in Japan. Methodological challenges, however, continue, particularly for validating instruments with regard to various study populations of Japanese people and demonstrating the clinical importance of change scores.
Breast Cancer
1340-6868 (Print)
Publication year:
General health perceptions / HRQoL:
Health-related quality of life
Adults (18-65)
Seniors (65+)
Neoplasms and related symptoms
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
6 - Clinical rating scales
EORTC QLQ-BR23 - European Organization for Research and Treatment of Cancer Quality of Life Questionnaires, specific module to Breast cancer
EORTC QLQ-C30 - European Organization for Research and Treatment of Cancer Quality of Life Questionnaires Core-30 item (ALSO shortened version)   
FACT-B - Functional Assessment of Cancer Therapy-Breast cancer
FLIC - Functional Living Interview questionnaire for Cancer
GHQ - General Health Questionnaire
HADS - Hospital Anxiety and Depression Scale   
POMS - Profile of Mood States
QLICP-BR - Quality of Life Instruments for Cancer Patients-Breast Cancer
QOL-ACD - Quality of Life Questionnaire for Cancer Patients treated with AntiCancer Drugs
SDS - Zung Self-rating Depression Scale
SF-36 - 36-item Short Form Health Survey [alias: RAND-36][alias: Medical Outcomes Study (MOS) SF-36]]    |  | also see:
STAI - State-Trait Anxiety Inventory
WHO/QOL-26 - World Health Organization/Quality of Life-26 items