Skip to main content
Top
Published in: BMC Urology 1/2017

Open Access 01-12-2017 | Research article

Psychometric properties of the expanded prostate cancer index composite - 26 instrument in a cohort of radical prostatectomy patients: theoretical and practical examinations

Authors: Karol Axcrona, Rasmus Nilsson, Bjørn Brennhovd, Øystein Sørebø, Sophie D. Fosså, Alv A. Dahl

Published in: BMC Urology | Issue 1/2017

Login to get access

Abstract

Background

Recently, the Expanded Prostate Cancer Index Composite 26-item version (EPIC-26) was recommended for the assessment of adverse effects after the treatment of prostate cancer without clear reasons. This decision encouraged us to review the questionnaire development from the UCLA Prostate Cancer Index (UCLA-PCI) to the EPIC-16 CP with a focus on psychometric properties. We also reviewed PubMed for papers concerning such properties of the EPIC-26 since 2012 (latest review in 2011). Finally, we examined the psychometric properties of the EPIC-26 in a sample of Norwegian males treated with robot-assisted laparoscopic prostatectomy (RALP).

Methods

This study used three methods: (1) Comparison of the content of the UCLA-PCI, EPIC-50, EPIC-26, and EPIC-16 CP; (2) Review of EPIC-26 and EPIC-16 CP papers in PubMed from 2012 to 2016, identifying papers reporting on the psychometric properties of these questionnaires; and (3) Psychometric examination of the EPIC-26 rating in 651 Norwegian men treated with RALP at a mean of 3.2 years post-surgery.

Results

The questionnaire development showed a significant increase in bother versus function items, and the EPIC-26 contains eight function and 18 bother items. Twelve papers concerning the EPIC-26 available on PubMed since 2012 support the psychometric properties of the EPIC-26. The Norwegian EPIC-26 findings supported the psychometric properties of the EPIC-26, but suggested six subdomains both by exploratory and confirmatory factor analyses.

Conclusions

In general our examinations supported the adequate psychometric properties of the EPIC-26, although the factor structure, construct and predictive validity of the instrument should be examined further.
Literature
1.
go back to reference Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciotto S, Nelen V, et al. Screening and prostate cancer mortality in a randomized European study. N Engl J Med. 2009;360(13):1320–8.CrossRefPubMed Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciotto S, Nelen V, et al. Screening and prostate cancer mortality in a randomized European study. N Engl J Med. 2009;360(13):1320–8.CrossRefPubMed
2.
go back to reference Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciotto S, Nelen V, et al. Prostate cancer mortality at 11 years of follow-up. N Engl J Med. 2012;366(11):981–90.CrossRefPubMed Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciotto S, Nelen V, et al. Prostate cancer mortality at 11 years of follow-up. N Engl J Med. 2012;366(11):981–90.CrossRefPubMed
3.
go back to reference Steinsvik EA, Fosså SD, Axcrona K, Fransson P, Widmark A, Dahl AA. Do perceptions of adverse events differ between patients and physicians? Findings from a randomized controlled trial of radical treatment of prostate cancer. J Urol. 2010;184(2):525–31.CrossRefPubMed Steinsvik EA, Fosså SD, Axcrona K, Fransson P, Widmark A, Dahl AA. Do perceptions of adverse events differ between patients and physicians? Findings from a randomized controlled trial of radical treatment of prostate cancer. J Urol. 2010;184(2):525–31.CrossRefPubMed
4.
go back to reference Fayers PM, Machin P. Quality of life. The assessment, analysis and interpretation of patient-reported outcomes. 2nd ed. Chichester, UK: Wiley; 2007. Fayers PM, Machin P. Quality of life. The assessment, analysis and interpretation of patient-reported outcomes. 2nd ed. Chichester, UK: Wiley; 2007.
5.
go back to reference Storås AH, Sanda MG, Boronat OG, Chang P, Patil D, Crociani C, et al. Erectile dysfunction and sexual problems two to three years after prostatectomy among American, Norwegian, and Spanish patients. Clin Genitourin Cancer. 2016;14(3):e265–73.CrossRefPubMed Storås AH, Sanda MG, Boronat OG, Chang P, Patil D, Crociani C, et al. Erectile dysfunction and sexual problems two to three years after prostatectomy among American, Norwegian, and Spanish patients. Clin Genitourin Cancer. 2016;14(3):e265–73.CrossRefPubMed
6.
go back to reference Hamoen EH, De Rooij M, Witjes JA, Barentsz JO, Rovers MM. Measuring health-related quality of life in men with prostate cancer: A systematic review of the most used questionnaires and their validity. Urol Oncol. 2015;33(2) 69.e19–28 Hamoen EH, De Rooij M, Witjes JA, Barentsz JO, Rovers MM. Measuring health-related quality of life in men with prostate cancer: A systematic review of the most used questionnaires and their validity. Urol Oncol. 2015;33(2) 69.e19–28
7.
go back to reference Szymanski KM, Wei JT, Dunn L, Sanda MG. Development and validation of an abbreviated version of the expanded prostate index composite instrument for measuring health-related quality of life among prostate cancer survivors. Urology. 2010;76(5):1245–50.CrossRefPubMedPubMedCentral Szymanski KM, Wei JT, Dunn L, Sanda MG. Development and validation of an abbreviated version of the expanded prostate index composite instrument for measuring health-related quality of life among prostate cancer survivors. Urology. 2010;76(5):1245–50.CrossRefPubMedPubMedCentral
8.
go back to reference Martin NE, Masey L, Stowell C, Bangma C, Briganti A, Bill-Axelson A, et al. Defining a standard set of patient-centered outcomes for men with localized prostate cancer. Eur Urol. 2015;67(3):460–7.CrossRefPubMed Martin NE, Masey L, Stowell C, Bangma C, Briganti A, Bill-Axelson A, et al. Defining a standard set of patient-centered outcomes for men with localized prostate cancer. Eur Urol. 2015;67(3):460–7.CrossRefPubMed
9.
go back to reference Morgans AK, van Bommel AC, Stowell C, Abrahm JL, Basch E, Bekelmann JE, et al. Development of a standardized set of patient-centered outcomes for advanced prostate cancer: an international effort for a unified approach. Eur Urol. 2015;68(5):891–8.CrossRefPubMed Morgans AK, van Bommel AC, Stowell C, Abrahm JL, Basch E, Bekelmann JE, et al. Development of a standardized set of patient-centered outcomes for advanced prostate cancer: an international effort for a unified approach. Eur Urol. 2015;68(5):891–8.CrossRefPubMed
10.
go back to reference Chang P, Szymanski KM, Dunn RL, Chipman JJ, Litwin MS, Nguyen PL, et al. Expanded prostate cancer index composite for clinical practice: development and validation of a practical health related quality of life instrument for use in the routine clinical care of patients with prostate cancer. J Urol. 2011;186(3):865–72.CrossRefPubMed Chang P, Szymanski KM, Dunn RL, Chipman JJ, Litwin MS, Nguyen PL, et al. Expanded prostate cancer index composite for clinical practice: development and validation of a practical health related quality of life instrument for use in the routine clinical care of patients with prostate cancer. J Urol. 2011;186(3):865–72.CrossRefPubMed
11.
go back to reference Rnic K, Linden W, Tudor I, Pullmer R, Vodermaier A. Measuring symptoms in localized prostate cancer: a systematic review of assessment instruments. Prost Cancer Prost Dis. 2013;16(2):111–22. Rnic K, Linden W, Tudor I, Pullmer R, Vodermaier A. Measuring symptoms in localized prostate cancer: a systematic review of assessment instruments. Prost Cancer Prost Dis. 2013;16(2):111–22.
12.
go back to reference Litwin MS, Hays RD, Fink A, Ganz PA, Leake B, Brook RH. The UCLA prostate index: development, reliability, and validity of a health-related quality of life measure. Med Care. 1998;36(7):1002–12.CrossRefPubMed Litwin MS, Hays RD, Fink A, Ganz PA, Leake B, Brook RH. The UCLA prostate index: development, reliability, and validity of a health-related quality of life measure. Med Care. 1998;36(7):1002–12.CrossRefPubMed
13.
go back to reference Wei JT, Dunn RL, Litwin MS, Sandler HM, Sanda MG. Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology. 2000;56(6):899–905.CrossRefPubMed Wei JT, Dunn RL, Litwin MS, Sandler HM, Sanda MG. Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology. 2000;56(6):899–905.CrossRefPubMed
14.
go back to reference Schmidt S, Garin O, Pardo Y, Valderas JM, Alonso J, Rebollo P, et al. Assessing quality of life in patients with prostate cancer: a systematic and standardized comparison of available instruments. Qual Life Res. 2014;23(8):2169–81.CrossRefPubMedPubMedCentral Schmidt S, Garin O, Pardo Y, Valderas JM, Alonso J, Rebollo P, et al. Assessing quality of life in patients with prostate cancer: a systematic and standardized comparison of available instruments. Qual Life Res. 2014;23(8):2169–81.CrossRefPubMedPubMedCentral
15.
go back to reference Chipman JJ, Sanda MG, Dunn RL, Wei JT, Litwin MS, Crociani CM, et al. Measuring and predicting prostate cancer related quality of life changes using EPIC for clinical practice. J Urol. 2014;191(3):638–45.CrossRefPubMed Chipman JJ, Sanda MG, Dunn RL, Wei JT, Litwin MS, Crociani CM, et al. Measuring and predicting prostate cancer related quality of life changes using EPIC for clinical practice. J Urol. 2014;191(3):638–45.CrossRefPubMed
16.
go back to reference Korzeniowski M, Kalyvas M, Mahmud A, Shenfield C, Tong C, Zaza K, et al. Piloting prostate cancer patient-reported outcomes in clinical practice. Support Care Cancer. 2016;24(5):1983–90.CrossRefPubMed Korzeniowski M, Kalyvas M, Mahmud A, Shenfield C, Tong C, Zaza K, et al. Piloting prostate cancer patient-reported outcomes in clinical practice. Support Care Cancer. 2016;24(5):1983–90.CrossRefPubMed
17.
go back to reference Sharma P, Dunn RL, Wei JT, Monite JE, Gilbert SM. Evaluation of point-of-care PRO assessment in clinical settings: integration, parallel-forms reliability, and patient acceptability of electronic QOL measures during clinical visits. Qual Life Res. 2016;25(3):575–83.CrossRefPubMed Sharma P, Dunn RL, Wei JT, Monite JE, Gilbert SM. Evaluation of point-of-care PRO assessment in clinical settings: integration, parallel-forms reliability, and patient acceptability of electronic QOL measures during clinical visits. Qual Life Res. 2016;25(3):575–83.CrossRefPubMed
18.
go back to reference Skolarus TA, Holmes-Rovner M, Hawley ST, Dunn RL, Barr KL, Willard NR, et al. Monitoring quality of life among prostate cancer survivors: the feasibility of automated telephone assessment. Urology. 2012;80(5):1021–6.CrossRefPubMed Skolarus TA, Holmes-Rovner M, Hawley ST, Dunn RL, Barr KL, Willard NR, et al. Monitoring quality of life among prostate cancer survivors: the feasibility of automated telephone assessment. Urology. 2012;80(5):1021–6.CrossRefPubMed
19.
go back to reference Sampurno F, Ruseckaite R, Millar JL, Evans SM. Comparison of patient-reported quality-of-life and complications in men with prostate cancer, between two modes of administration. Clin Genitourin Cancer. 2016;14(4):284–9.CrossRefPubMed Sampurno F, Ruseckaite R, Millar JL, Evans SM. Comparison of patient-reported quality-of-life and complications in men with prostate cancer, between two modes of administration. Clin Genitourin Cancer. 2016;14(4):284–9.CrossRefPubMed
20.
go back to reference Fosså SD, Holck Storås A, Steinsvik EA, Myklebust TA, Eri LM, Loge JH, et al. Psychometric testing of the Norwegian version of the expanded prostate cancer index composite 26-item version (EPIC-26). Scand J Urol. 2016;50(4):280–5.CrossRefPubMed Fosså SD, Holck Storås A, Steinsvik EA, Myklebust TA, Eri LM, Loge JH, et al. Psychometric testing of the Norwegian version of the expanded prostate cancer index composite 26-item version (EPIC-26). Scand J Urol. 2016;50(4):280–5.CrossRefPubMed
21.
go back to reference Ellison JS, He C, Wood DP. Stratification of postprostatectomy urinary function using expanded prostate cancer index composite. Urology. 2013;81(1):56–60.CrossRefPubMed Ellison JS, He C, Wood DP. Stratification of postprostatectomy urinary function using expanded prostate cancer index composite. Urology. 2013;81(1):56–60.CrossRefPubMed
22.
go back to reference Punnen S, Cowan JE, Dunn LB, Shumay DM, Carroll PR, Cooperberg MRA. Longitudinal study of anxiety, depression and distress as predictors of sexual and urinary quality of life in men with prostate cancer. BJU Int. 2013;112(2):E67–75.CrossRefPubMed Punnen S, Cowan JE, Dunn LB, Shumay DM, Carroll PR, Cooperberg MRA. Longitudinal study of anxiety, depression and distress as predictors of sexual and urinary quality of life in men with prostate cancer. BJU Int. 2013;112(2):E67–75.CrossRefPubMed
23.
go back to reference Evans JR, Zhao S, Daignault S, Sanda MG, Michalski J, Sandler HM, et al. Patient-reported quality of life after stereotactic body radiotherapy (SBRT), intensity modulated radiotherapy (IMRT), and brachytherapy. Radiother Oncol. 2015;116(2):179–84.CrossRefPubMed Evans JR, Zhao S, Daignault S, Sanda MG, Michalski J, Sandler HM, et al. Patient-reported quality of life after stereotactic body radiotherapy (SBRT), intensity modulated radiotherapy (IMRT), and brachytherapy. Radiother Oncol. 2015;116(2):179–84.CrossRefPubMed
24.
go back to reference Watson E, Shinkins B, Frith E, Neal D, Hamdy F, Walter F, et al. Symptoms, unmet needs, psychosocial well-being and health status in survivors of prostate cancer: implications for redesigning follow-up. BJU Int. 2016;117(6B):E10–9.CrossRefPubMed Watson E, Shinkins B, Frith E, Neal D, Hamdy F, Walter F, et al. Symptoms, unmet needs, psychosocial well-being and health status in survivors of prostate cancer: implications for redesigning follow-up. BJU Int. 2016;117(6B):E10–9.CrossRefPubMed
25.
go back to reference Schofield P, Gough K, Lotfi-Jam K, Aranda S. Validation of the supportive care needs survey-short form 34 with a simplified response format in men with prostate cancer. Psycho-Oncologia. 2012;21(10):1107–12.CrossRef Schofield P, Gough K, Lotfi-Jam K, Aranda S. Validation of the supportive care needs survey-short form 34 with a simplified response format in men with prostate cancer. Psycho-Oncologia. 2012;21(10):1107–12.CrossRef
26.
go back to reference Recklitis CJ, Zhou ES, Zwerner EK, JC H, Kantoff PW. Suicidal ideation in prostate cancer survivors: understanding the role of physical and psychological health outcomes. Cancer. 2014;120(21):3393–400.CrossRefPubMed Recklitis CJ, Zhou ES, Zwerner EK, JC H, Kantoff PW. Suicidal ideation in prostate cancer survivors: understanding the role of physical and psychological health outcomes. Cancer. 2014;120(21):3393–400.CrossRefPubMed
27.
go back to reference Skolarus TA, Dunn RL, Sanda MG, Chang P, Greenfield TK, Litwin MS, et al. Minimally important difference for the expanded prostate cancer index composite short form. Urology. 2015;85(1):101–6.CrossRefPubMedPubMedCentral Skolarus TA, Dunn RL, Sanda MG, Chang P, Greenfield TK, Litwin MS, et al. Minimally important difference for the expanded prostate cancer index composite short form. Urology. 2015;85(1):101–6.CrossRefPubMedPubMedCentral
28.
go back to reference Tavlarides AM, Ames SC, Thiel DD, Diehl NN, Parker AS. Baseline and follow-up association of the MAX-PC in men with newly diagnosed prostate cancer. Psycho-Oncologia. 2015;24(4):451–7.CrossRef Tavlarides AM, Ames SC, Thiel DD, Diehl NN, Parker AS. Baseline and follow-up association of the MAX-PC in men with newly diagnosed prostate cancer. Psycho-Oncologia. 2015;24(4):451–7.CrossRef
29.
go back to reference Brennhovd B, Axcrona K, Fosså SD, Giercksky KE, Vlatkovic L, Dahl AA. Robot- assisted radical prostatectomy of clinical high-risk patients with prostate cancer: a controlled study of operative and short-term post-operative events. Scand J Urol. 2013;47(6):449–55.CrossRefPubMed Brennhovd B, Axcrona K, Fosså SD, Giercksky KE, Vlatkovic L, Dahl AA. Robot- assisted radical prostatectomy of clinical high-risk patients with prostate cancer: a controlled study of operative and short-term post-operative events. Scand J Urol. 2013;47(6):449–55.CrossRefPubMed
30.
go back to reference Østby-Deglum M, Brennhovd B, Axcrona K, Fosså SD, Dahl AAA. Comparative study of erectile function and use of erectile aids in high-risk prostate cancer patients after robot-assisted laparoscopic prostatectomy. Scand J Urol. 2015;49(6):433–9.CrossRef Østby-Deglum M, Brennhovd B, Axcrona K, Fosså SD, Dahl AAA. Comparative study of erectile function and use of erectile aids in high-risk prostate cancer patients after robot-assisted laparoscopic prostatectomy. Scand J Urol. 2015;49(6):433–9.CrossRef
31.
go back to reference Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the hospital anxiety depression scale. An updated literature review. J Psychosom Res. 2002;52(2):69–77.CrossRefPubMed Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the hospital anxiety depression scale. An updated literature review. J Psychosom Res. 2002;52(2):69–77.CrossRefPubMed
32.
go back to reference Gandek B, Ware JE, Aaronson NK, Apolone B, Bjorner JB, Bullinger M, et al. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol. 1998;51(11):1171–8.CrossRefPubMed Gandek B, Ware JE, Aaronson NK, Apolone B, Bjorner JB, Bullinger M, et al. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol. 1998;51(11):1171–8.CrossRefPubMed
33.
go back to reference Grov EK, Fosså SD, Bremnes RM, Dahl O, Klepp O, Wist E, et al. The personality trait of neuroticism is strongly associated with long-term morbidity in testicular cancer survivors. Acta Oncol. 2009;48(6):842–9.CrossRefPubMed Grov EK, Fosså SD, Bremnes RM, Dahl O, Klepp O, Wist E, et al. The personality trait of neuroticism is strongly associated with long-term morbidity in testicular cancer survivors. Acta Oncol. 2009;48(6):842–9.CrossRefPubMed
34.
go back to reference Hooper D. Exploratory factor analysis. In: Chen H, editor. Approaches to quantitative research – theory and its practical application: a guide to dissertation students. Cork, Ireland: Oak Tree Press; 2012. Hooper D. Exploratory factor analysis. In: Chen H, editor. Approaches to quantitative research – theory and its practical application: a guide to dissertation students. Cork, Ireland: Oak Tree Press; 2012.
35.
go back to reference Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equat Model. 1999;6:1–55.CrossRef Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equat Model. 1999;6:1–55.CrossRef
36.
go back to reference Jacobsen SJ, Girman CJ, Guess HA, Panser LA, Chute CB, Oesterling JE, et al. Natural history of prostatism: factors associated discordance between frequency and bother of urinary symptoms. Urology. 1993;42(6):663–71.CrossRefPubMed Jacobsen SJ, Girman CJ, Guess HA, Panser LA, Chute CB, Oesterling JE, et al. Natural history of prostatism: factors associated discordance between frequency and bother of urinary symptoms. Urology. 1993;42(6):663–71.CrossRefPubMed
37.
go back to reference Litwin MS. Measuring health related quality of life in men with prostate cancer. J Urol. 1994;152(5 Pt 2):1882–7.CrossRefPubMed Litwin MS. Measuring health related quality of life in men with prostate cancer. J Urol. 1994;152(5 Pt 2):1882–7.CrossRefPubMed
38.
go back to reference Briganti A, Gallina A, Suardi N, Capitanio U, Tutolo M, Bianci M, et al. Predicting erectile function recovery after bilateral nerve sparing radical prostatectomy: a proposal of a novel preoperative risk stratification. J Sex Med. 2010;7(7):2521–31.CrossRefPubMed Briganti A, Gallina A, Suardi N, Capitanio U, Tutolo M, Bianci M, et al. Predicting erectile function recovery after bilateral nerve sparing radical prostatectomy: a proposal of a novel preoperative risk stratification. J Sex Med. 2010;7(7):2521–31.CrossRefPubMed
39.
go back to reference D’Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA, et al. Biochemical outcome after radical prostatectomy, external beam therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA. 1998;280(11):969–74.CrossRefPubMed D’Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA, et al. Biochemical outcome after radical prostatectomy, external beam therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA. 1998;280(11):969–74.CrossRefPubMed
40.
go back to reference Crook J, Ots AF. Prognostic factors for newly diagnosed prostate cancer and their role in treatment selection. Sem. Radiat Oncol. 2013;23(3):165–72.CrossRef Crook J, Ots AF. Prognostic factors for newly diagnosed prostate cancer and their role in treatment selection. Sem. Radiat Oncol. 2013;23(3):165–72.CrossRef
42.
go back to reference Braun DP, Gupta D, Staren ED. Predicting survival in prostate cancer: the role of quality of life assessment. Support Care Cancer. 2012;20(6):1267–74.CrossRefPubMed Braun DP, Gupta D, Staren ED. Predicting survival in prostate cancer: the role of quality of life assessment. Support Care Cancer. 2012;20(6):1267–74.CrossRefPubMed
43.
go back to reference American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder. 3rd ed. Washington, DC: American Psychiatric Press; 2010. American Psychiatric Association. Practice guideline for the treatment of patients with major depressive disorder. 3rd ed. Washington, DC: American Psychiatric Press; 2010.
Metadata
Title
Psychometric properties of the expanded prostate cancer index composite - 26 instrument in a cohort of radical prostatectomy patients: theoretical and practical examinations
Authors
Karol Axcrona
Rasmus Nilsson
Bjørn Brennhovd
Øystein Sørebø
Sophie D. Fosså
Alv A. Dahl
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2017
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-017-0302-7

Other articles of this Issue 1/2017

BMC Urology 1/2017 Go to the issue