EORTC-QLQ-BR45 Clinical Workflow

Introduction

A group of researchers published in the February 2020 issue of the Annals of Oncology about process of updating and testing of the European Organization for Research and Treatment of Cancer (EORTC) questionnaire to assess quality of life (QoL) in breast cancer patients. The EORTC QLQ-BR23 was one of the first disease-specific questionnaires developed in 1996 to assess QoL in patients with breast cancer [1]. However due to changes in breast cancer treatment it needed an update.

The final updated module (EORTC QLQ-BR45) contains a total of 45 items from which 22 are new [2]. The EORTC QLQ-BR45 is available for use in research and clinical practice. It provides a more accurate and comprehensive assessment of the impact of new treatments on patients' QoL.

The EORTC-QLQ-BR45 flow contains the EORTC-QLQ-BR45 questionnaire and associated calculation. After form submission, the EORTC-QLQ-BR45 calculation is executed automatically. It's easy to extend this flow with conditional logic based on the interpretation of the EORTC-QLQ-BR45 calculation.

EORTC-QLQ-BR45 questionnaire

Questions and Scoring

The EORTC QLQ-BR45 incorporates nine multi-item scales to assess body image, sexual functioning, breast satisfaction, systemic therapy side effects, arm symptoms, breast symptoms, endocrine therapy symptoms, skin mucosis symptoms, endocrine sexual symptoms [3]. In addition, single items assess sexual enjoyment, future perspective and being upset by hair loss.

As shown below:

Scale:

• Body Image (Functional)
• Future Perspective (Functional)
• Sexual Functioning (Functional)
• Sexual Enjoyment (Functional)
• Breast Satisfaction (Functional)
• Systemic Therapy Side Effects (Symptom)
• Upset by Hair Loss (Symptom)
• Arm Symptoms (Symptom)
• Breast Symptoms (Symptom)
• Endocrine Therapy Symptoms
• Skin Mucosis Symptoms
• Endocrine Sexual Symptoms

Remarks:

• “Item range” is the difference between the possible maximum and the minimum response to individual items. All items are scored 1 to 4, giving range = 3
• SE and HU are not applicable if item 45 is “not at all” and item 34 "is not at all", respectively

Interpretation

All of the scales and single item measures range in score from 0 to 100. A high score for the functional scales and functional single items represents a high/healthy level of functioning, whereas a high score for the symptom scales and symptom item represents a high level of symptomatology or problems [3].

References

[1] Sprangers MA, Groenvold M, Arraras JI, et al. The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: first results from a three-country field study. J Clin Oncol. 1996;14(10):2756-2768. doi:10.1200/JCO.1996.14.10.2756\
[2] Bjelic-Radisic V, Cardoso F, Cameron D, et al. An international update of the EORTC questionnaire for assessing quality of life in breast cancer patients: EORTC QLQ-BR45 [published correction appears in Ann Oncol. 2020 Apr;31(4):552]. Ann Oncol. 2020;31(2):283-288. doi:10.1016/j.annonc.2019.10.027\
[3] https://drive.google.com/file/d/1qWloecXkud3DZXiWcMtSv9DDb3LXmIIS/view?usp=sharing