Development and validation of the simplified Chinese version of EORTC QLQ-H&N35 for patients with head and neck cancer

A simplified Chinese version of EORTC QLQ-H&N35 was developed using strict translation procedures according to EORTC translation guidelines. Psychometric properties were evaluated. Three instruments (QLQ-H&N35, QLICP-HN, and FACT-H&N) were used in a sample of 133 patients with head and neck cancer at the time of their admission to the hospital. Each patient was assessed for the second time 1-2 days after hospitalization so that the test-retest reliability could be calculated. A sub-sample of patients was sampled and measured for the third time at discharge in order to evaluate the responsiveness. Correlation analysis among domains and items of the three instruments showed good construct validity and criterion-related validity. Comparisons of QLQ-H&N35 between treatment groups and age groups supported clinical validity. The internal consistency reliability measured by Cronbach's coefficient alpha was greater than 0.70 for all multi-item domains, and test-retest reliability coefficients for all domains were greater than 0.80, ranging from 0.88 to 0.95. Score changes between pre- and post-treatment were observed in 6 out of 18 domains, with effect size SRM ranging from 0.27 to 0.87. The simplified Chinese version of QLQ-H&N35 demonstrates good validity, reliability, and responsiveness and can be used to measure QOL for Chinese patients with head and neck cancer.