COSMIN database

Measuring health-related quality of life in men with prostate cancer: A systematic review of the most used questionnaires and their validity

Hamoen, E. H., De, Rooij M., Witjes, J. A., Barentsz, J. O., and Rovers, M. M.
OBJECTIVES: To identify and study the psychometric properties of the most used health-related quality-of-life (HRQoL) instruments in men with prostate cancer.

METHODS: We performed a literature search using PubMed and EMBASE to identify all studies on prostate cancer using a HRQoL instrument. The most often used HRQoL instruments were investigated in detail by 2 independent reviewers. Data were extracted regarding the characteristics and psychometric values of the instruments, i.e., content validity, internal consistency, criterion validity, construct validity, reproducibility, responsiveness, floor and ceiling effects, and interpretability. Good psychometric outcomes indicate a high methodological quality of the instrument.

RESULTS: Our systematic search revealed 13,812 potential relevant articles, of which 2,258 appeared relevant after screening the titles and reading the abstracts. We studied the psychometric properties of the 20 most often used HRQoL instruments, the first 3 of which were the Expanded Prostate Index Composite, University of California-Los Angeles Prostate Cancer Index, and Short Form-36 (SF-36). Content validity, internal consistency (alpha>0.70), criterion validity, construct validity, and reproducibility were good in 60%, 90%, 10%, 35%, and 65% of the 20 instruments, respectively. Responsiveness was not reported for 12 of 20 instruments (60%). Floor and ceiling effects and the interpretability of the questionnaires were only reported in 3 (15%) and 6 (30%) instruments.

CONCLUSIONS: Considering the psychometric properties, we advise to use the SF-12 as a generic instrument, the Cancer Rehabilitation Evaluation System-SF or the Functional Assessment of Cancer Therapy-General as cancer-specific HRQoL instruments, and the University of California-Los Angeles Prostate Cancer Index, the QUFW94, or the Functional Assessment of Cancer Therapy-Prostate as prostate cancer-specific instruments
Publication year:
General health perceptions / HRQoL:
Health-related quality of life
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the genitourinary system
Neoplasms and related symptoms
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
CARES-SF - Cancer Rehabilitation Evaluation System-Short Form
EORTC QLQ-C30 - European Organization for Research and Treatment of Cancer Quality of Life Questionnaires Core-30 item (ALSO shortened version)   
EORTC QLQ-PR25 - European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire in patients with prostate cancer 25 item
EPIC - Expanded Prostate Cancer Index Composite
FACT-G - Functional Assessment of Cancer Therapy-General
FACT-P - Functional Assessment of Cancer Therapy Prostate
FLIC - Functional Living Interview questionnaire for Cancer
MOS-20 - 20-Item Medical Outcome Study Short-Form General Health Survey
PC-QoL - Prostate Cancer Quality of Life
PORPUS - Patient-Oriented Prostate Utility Scale
Prostate Cancer Symptom Scale [alias: QUFW94]
QLI Padilla - Quality of Life Index by Padilla
QLI - Quality of Life Index [alias: Ferrans and Powers Quality of Life Index]
SF-12 - 12-item Short Form Health Survey [alias: RAND-12]
SF-36 - 36-item Short Form Health Survey [alias: RAND-36][alias: Medical Outcomes Study (MOS) SF-36]]    |  | also see:
SWLS - Satisfaction With Life Scale
UCLA-PCI - University of California Los Angeles-Prostate Cancer Index
WHOQOL - World Health Organization Quality of Life Assessment