COSMIN database

Assessing quality of life in patients with prostate cancer: a systematic and standardized comparison of available instruments

Schmidt, S., Garin, O., Pardo, Y., Valderas, J. M., Alonso, J., Rebollo, P., Rajmil, L., Garcia-Forero, C., Ferrer, M., and Group, Empro
PURPOSE: The objective was to obtain a standardized evaluation of available prostate cancer-specific quality of life instruments used in patients with early-stage disease.

METHODS: We carried out systematic literature reviews in the PubMed database to identify manuscripts which contained information regarding either the development process or metric properties of prostate cancer-specific quality of life instruments. Each instrument was evaluated by two experts, independently, using the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. An overall and seven attribute-specific EMPRO scores were calculated (range 0-100, worst to best): measurement model, reliability, validity, responsiveness, interpretability, burden and alternative forms.

RESULTS: Eight instruments and 57 manuscripts (2-15 per instrument) were identified. The Expanded Prostate Cancer Index Composite (EPIC) was the best rated (overall EMPRO score 83.1 points). Good results were also obtained by University of California Los Angeles-Prostate Cancer Index (UCLA-PCI), Patient-Oriented Prostate Utility Scale (PORPUS) and Prostate Cancer Quality of Life Instrument (PC-QoL) with 77.3, 70.5 and 64.8 points, respectively. These four instruments passed with distinction the validity and responsiveness evaluation. Insufficient reliability results were observed for UCLA-PCI and PORPUS.

CONCLUSIONS: Current evidence supports the choice of EPIC, PORPUS or PC-QoL. Attribute-specific EMPRO results facilitate selecting the adequate instrument for every purpose. For longitudinal studies or clinical trials, where responsiveness is the priority, EPIC or PC-QoL should be considered. We recommend the PORPUS for economic evaluations because it allows cost-utility analysis, and EPIC short versions to minimize administration burden.
Qual Life Res
1573-2649 (Electronic)
Publication year:
Symptom status:
Physical state
General health perceptions / HRQoL:
Health-related quality of life
Overall quality of life:
Overall 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
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
ESCAP-CDV - Estudio sobre la Calidad de Vida en el Cáncer de Próstata- Calidad de Vida
FACT-P - Functional Assessment of Cancer Therapy Prostate
PC-QoL - Prostate Cancer Quality of Life
PCSI - Prostate Cancer-Specific Instrument
PORPUS - Patient-Oriented Prostate Utility Scale
UCLA-PCI - University of California Los Angeles-Prostate Cancer Index