Current evidence about MIDs for QLQ-C30
The Minimally important difference (MID) can be defined as “the smallest difference in score in the domain of interest that patients perceive as important, either beneficial or harmful, and which would lead the clinician to consider a change in the patient’s management”9
King (2011) summarises the definitions, terms and methods for calculating MIDs. For more information about MIDs in general, please read the QOL office Frequently Asked Question “what is a minimally important difference or MID?”
We reviewed 23 papers that calculated MIDs for the QLQ-C30. The methods used for determining MIDs fell under two broad classes: anchor-based and distribution-based approaches. Six of the papers used both anchor- and distribution-based methods with the intention of comparing and confirming results. The majority of papers calculated effect size and used Cohen’s guide to determine their MID. Table 1 summarises the types of cancer and methods these papers used to determine MIDs.
Table 1 The types of cancer and methods used for determining MIDs in 23 papers using QLQ-C30
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References
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Number (%)
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Type of cancer
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Mixed
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1, 10, 15, 16, 22
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5(22%)
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Bone
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25
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1(4%)
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Breast
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13, 21, 22
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3(13%)
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Cervical
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23
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1 (4%)
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Endometrial
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7
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1(4%)
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Gastric
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11, 12
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2(9%)
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Head & Neck
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6
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1(4%)
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Liver
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2
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1 (4%)
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Lung
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20, 21
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2(9%)
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Multiple Myeloma
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3, 8, 17-19, 24
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6 (26%)
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Pancreatic
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5
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1(4%)
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Prostate
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4
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1(4%)
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Method(s) used to determine MID (can be >1)
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Anchor based
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1) Patient rating of change
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1, 10, 17, 18, 21, 25
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6(26%)
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2) Clinical rating (eg ECOG Performance Status)
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2, 3, 7, 8, 16, 20
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6 (26%)
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Distribution based
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1) Effect Size (Cohen’s d)
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1, 4-6, 8, 11-13, 15, 17-19, 21-23, 25
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16 (70%)
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2) Standard Error of Mean (SEM)
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1, 24, 25
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3(13%)
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References:
1. Bedard, G., Zeng, L., Zhang, L. et al. 2014. Minimal important differences in the EORTC QLQ-C30 in patients with advanced cancer. Asia-Pacific Journal of Clinical Oncology 10(2) 109-117.
2. Chie, W.C., Blazeby, J.M., Hsiao, C.F. et al. 2012. International cross-cultural field validation of an European Organization for Research and Treatment of Cancer questionnaire module for patients with primary liver cancer, the European Organization for Research and Treatment of Cancer quality-of-life questionnaire HCC18. Hepatology 55(4) 1122-1129.
3. Cocks, K., Cohen, D., Wisloff, F. et al. 2007. An international field study of the reliability and validity of a disease-specific questionnaire module (the QLQ-MY20) in assessing the quality of life of patients with multiple myeloma. European Journal of Cancer 43(11) 1670-1678.
4. Conaglen, H.M., de Jong, D., Hartopeanu, C. et al. 2013. The Effect of High Dose Rate Brachytherapy in Combination with External Beam Radiotherapy on Men's Health-related Quality of Life and Sexual Function over a 2 Year Time Span. Clinical Oncology 25(3) 197-204.
5. Eshuis, W.J., de Bree, K., Sprangers, M.A. et al. 2015. Gastric emptying and quality of life after pancreatoduodenectomy with retrocolic or antecolic gastroenteric anastomosis. The British journal of surgery 102(9) 1123-1132.
6. Fang, F.M., Tsai, W.L., Lee, T.F. et al. 2010. Multivariate analysis of quality of life outcome for nasopharyngeal carcinoma patients after treatment. Radiotherapy and Oncology 97(2) 263-269.
7. Greimel, E., Nordin, A., Lanceley, A. et al. 2011. Psychometric validation of the European organisation for research and treatment of cancer quality of life questionnaire-endometrial cancer module (EORTC QLQ-EN24). European Journal of Cancer 47(2) 183-190.
8. Gulbrandsen, N., Hjermstad, M.J., Wisloff, F. et al. 2004. Interpretation of quality of life scores in multiple myeloma by comparison with a reference population and assessment of the clinical importance of score differences. European Journal of Haematology 72(3) 172-180.
9. Guyatt, G.H., Osoba, D., Wu, A.W. et al. 2002. Methods to explain the clinical significance of health status measures. Mayo Clin Proc 77(4) 371-383.
10. Hong, F., Bosco, J.L., Bush, N. et al. 2013. Patient self-appraisal of change and minimal clinically important difference on the European organization for the research and treatment of cancer quality of life questionnaire core 30 before and during cancer therapy. BMC Cancer 13(165).
11. Im, M.H., Kim, J.W., Kim, W.S. et al. 2014. The impact of esophageal reflux-induced symptoms on quality of life after gastrectomy in patients with gastric cancer. Journal of Gastric Cancer 14(1) 15-22.
12. Karanicolas, P.J., Graham, D., Gonen, M. et al. 2013. Quality of life after gastrectomy for adenocarcinoma: A prospective cohort study. Annals of Surgery 257(6) 1039-1046.
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14. King, M. 2011. A point of minimal important difference (MID): a critique of terminology and methods. Expert Review of Pharmacoeconomics & Outcomes Research 11(2) 171-184.
15. King, M.T. 1996. The interpretation of scores from the EORTC quality of life questionnaire QLQ-C30. Quality of Life Research 5(6) 555-567.
16. Koukouli, S., Stamou, A., Alegakis, A. et al. 2009. Psychometric properties of the QLQ-C30 (version 3.0) in a sample of ambulatory Cretan cancer patients: Original article. European Journal of Cancer Care 18(5) 447-456.
17. Kvam, A.K., Fayers, P. and Wisloff, F. 2010. What changes in health-related quality of life matter to multiple myeloma patients? A prospective study. European Journal of Haematology 84(4) 345-353.
18. Kvam, A.K., Fayers, P.M. and Wisloff, F. 2011. Responsiveness and minimal important score differences in quality-of-life questionnaires: A comparison of the EORTC QLQ-C30 cancer-specific questionnaire to the generic utility questionnaires EQ-5D and 15D in patients with multiple myeloma. European Journal of Haematology 87(4) 330-337.
19. Kvam, A.K., Wisloff, F. and Fayers, P.M. 2010. Minimal important differences and response shift in health-related quality of life; a longitudinal study in patients with multiple myeloma. Health and Quality of Life Outcomes 8(79).
20. Maringwa, J.T., Quinten, C., King, M. et al. 2011. Minimal important differences for interpreting health-related quality of life scores from the EORTC QLQ-C30 in lung cancer patients participating in randomized controlled trials. Supportive Care in Cancer 19(11) 1753-1760.
21. Osoba, D., Rodrigues, G., Myles, J. et al. 1998. Interpreting the significance of changes in health-related quality-of-life scores. Journal of Clinical Oncology 16(1) 139-144.
22. Perez-San-Gregorio, M., Fernandez-Jimenez, E., Martin-Rodriguez, A. et al. 2013. Quality of life in women following various surgeries of body manipulation: Organ transplantation, mastectomy, and breast reconstruction. Journal of Clinical Psychology in Medical Settings 20(3) 373-382.
23. Sang, Y.P., Bae, D.S., Joo, H.N. et al. 2007. Quality of life and sexual problems in disease-free survivors of cervical cancer compared with the general population. Cancer 110(12) 2716-2725.
24. Weisel, K., Dimopoulos, M., Song, K.W. et al. 2015. Pomalidomide and Low-Dose Dexamethasone Improves Health-Related Quality of Life and Prolongs Time to Worsening in Relapsed/Refractory Patients With Multiple Myeloma Enrolled in the MM-003 Randomized Phase III Trial. Clinical lymphoma, myeloma & leukemia 15(9 // (GSK) *Novartis* // *Novartis*) 519-530.
25. Zeng, L., Chow, E., Zhang, L. et al. 2012. An international prospective study establishing minimal clinically important differences in the EORTC QLQ-BM22 and QLQ-C30 in cancer patients with bone metastases. Supportive Care in Cancer 20(12) 3307-3313.