Clinical Project Development Committee (CDC)
The Clinical Project Development Committee (CDC) is intended to support the collaboration between the EORTC Quality of Life Group (QLG) and the Disease-Oriented Groups (DOGs) in implementing quality of life in clinical trials as well as developing clinically relevant research projects. Members of the QLG as well as members of DOGs are welcome to discuss their ideas with the newly established Committee. In the near future, more priority will be given to developing intergroup projects related to clinically important research questions such as the short- and long-term effects of various types of cancer and its treatment on quality of life of patients with cancer and cancer survivors.
Health technology assessment (HTA)
Health technology assessment (HTA) is a multidisciplinary approach that systematically investigates medical, economic, societal and other issues related to the use of a “health technology”, e.g., a new drug, a medical device or a clinical procedure. Due to the scarcity of financial resources in the health sector, HTA has gained increasingly in importance in recent years and there is a growing demand to complement randomized clinical trials by health-economic evaluations.
To represent the issue of HTA and health economics in the EORTC QLG, a working group on HTA has been founded, led by Georg Kemmler and Eva Gamper. At present, the main aim of the working group lies in the development of utility weights for the EORTC QLQ-C30. This is vital in order to make this core EORTC QOL instrument applicable for use in health-economic evaluations. The new utility instrument (scoring algorithm) will be based on ten QLQ-C30 key items and will hence be called EORTC QLU-C10D. In a first step the determination of national utility weights for several European countries based on general population samples is planned within a project funded by the EORTC QLG. Discrete choice experiments will be used as the method to obtain utility weights. The project is carried out in close collaboration with Prof. Madeleine King from Sydney, Australia, the leader of the MAUCa (Multi-Attribute Utility in Cancer) project, dealing with the determination of utility weights for cancer-specific quality of life instruments.
In the future we will develop and release a new version of the CHES.EORTC web platform providing new areas of application. CHES.EORTC will contribute to enhance the scientific standards of the development of EORTC QOL measures (incl. modules and CAT) and facilitate data collection in EORTC QLG module development studies by providing online questionnaire administration and completion of case report forms. This objective reflects the strategy of the Module Development Committee to extend the Data Repository Project.
In addition, CHES.EORTC will allow QLG group members as well as researchers outside the group interested in the use of the EORTC CAT measures to become familiar with computer-adaptive QOL assessments, administer the CATs on electronic devices, store the data and download it in a common file format.
Assessing QoL of cancer survivors
Many of the QoL questionnaires designed for cancer patients, such as the EORTC QLQ-C30 and the FACT-G, with their supplementary condition-specific or symptom-specific modules, may not be entirely appropriate or sufficient for assessing the experience of cancer survivors. On the one hand, they include items assessing acute, treatment-related symptoms (e.g. vomiting or hair loss) that are probably not relevant in the post-treatment survivorship period. On the other hand, they may not address many of the mid- and long-term problems confronting cancer survivors.
This project on development of a cancer survivorship module represents the first step in a longer process of developing an appropriate EORTC measurement model and assessment strategy for assessing the QoL of cancer survivors. A central question that will be answered in this first phase is whether it is possible to develop one generic questionnaire covering all relevant survivorship issues or, rather, whether it is necessary to develop condition-specific survivorship modules. More specifically, two measurement models or strategies are possible: (1) development of a generic cancer survivorship module that could be used in conjunction with the current QLQ-C30 and the current portfolio of modules; or (2) development of a generic cancer survivorship questionnaire and cancer site-specific survivorship modules. The latter model/strategy would most likely involve modification of both the QLQ-C30 and the extant condition-specific modules.
Computer-adaptive testing for EORTC QLQ-C30
The EORTC Quality of Life Group (QLG) is developing a dynamic, computer-adaptive version of the EORTC QLQ-C30 based on modern psychometric theory and techniques. The basic idea of computer-adaptive testing (CAT) is to tailor the questionnaire to the individual respondent. Based on the responses to the preceding items it is estimated which item should be asked next to obtain maximal information. CAT item banks have been developed for all 14 scales in the QLQ-30 (not of overall quality of life). Large scale testing of the last two item banks and a large scale field study of the instrument are underway. The CAT is expected to improve the measurement of HRQOL in clinical trials to make it more concise, more relevant to patients, and more sensitive to differences and changes over time. The CAT item banks are available for use (see QLG website).