Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Sep 20, 2023; 13(4): 259-271
Published online Sep 20, 2023. doi: 10.5662/wjm.v13.i4.259
External validation of the Moroccan Arabic version of the European Organization for Research and Treatment of Cancer colorectal (CR29) module: Monocentric study
Houda Bachri, Hajar Essangri, Nezha El Bahaoui, Amine Benkabbou, Raouf Mohsine, Anass Mohammed Majbar, Amine Souadka
Houda Bachri, Hajar Essangri, Nezha El Bahaoui, Amine Benkabbou, Raouf Mohsine, Anass Mohammed Majbar, Amine Souadka, Surgical Oncology Department, National Institute of Oncology, Mohammed Vth University in Rabat, Rabat 10100, Morocco
Hajar Essangri, Gynecology oncology Department, Royal London Hospital, Barts NHS Health, London SE18 6EY, United Kingdom
Author contributions: Souadka A and Bachri H have contributed to the conception and design of the study, acquisition of the data, the analysis and the interpretation of data; Souadka A, Bachri H and Essangri H wrote the first draft; El Bahaoui N, Majbar AM and Benkabbou A critically reviewed the draft for important intellectual content; Mohsine R was involved in revising critically the corrected manuscript and all authors read and gave the final approval of the version to be published.
Institutional review board statement: The Approval of the study protocol was obtained from the institutional ethics review board (number: 79/17) and all patients enrolled in the study provided a written, informed consent allowing the use of their data for clinical studies at the time of their initial visit.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: Derived data supporting the findings of this study are available from the corresponding author a.souadka@um5r.ac.ma upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amine Souadka, MD, PhD, Professor, Surgical Oncology Department, National Institute of Oncology, Mohammed Vth University in Rabat, Hay riad Souissi, Rabat 10100, Morocco. a.souadka@um5r.ac.ma
Received: April 22, 2023
Peer-review started: April 22, 2023
First decision: June 14, 2023
Revised: July 26, 2023
Accepted: September 1, 2023
Article in press: September 1, 2023
Published online: September 20, 2023
ARTICLE HIGHLIGHTS
Research background

Health-related quality of life is an abstract and multidimensional concept which can be assessed by the European Organization for Research and Treatment of Cancer (EORTC) questionnaires. Core measurement tools examine issues common to different cancer sites and can be used as a stand-alone questionnaire or in combination with disease specific modules.

Research motivation

The EORTC Quality of Life Questionnaire (QLQ) CR29 questionnaire specific to colorectal cancer (CRC) and its psychometric properties have been tested in several languages and contexts. Recently, The QLQ-CR29 has just been only translated for Moroccan Arabic dialect. However this adaptation was performed on a very limited sample size of 120 patients under the usual requests of the EORTC organization.

Research objectives

The aim of this study is to externally validate this version and assess its psychometric properties on larger Moroccan CRC patients.

Research methods

In order to externally validate the QLQ CR-29, Both Moroccan Arabic modules of QLQ CR-29 and QLQ C-30 were administered to Moroccan colorectal cancer (CRC). Psychometric properties were retested by measuring Cronbach’s alpha coefficient for reliability and Intraclass correlation coefficient (ICC) to examine test-retest reproducibility. The multitrait-scaling analysis was performed to demonstrate the validity of the instrument and known-groups comparison was used to test the score’s ability to discriminate between different groups of patients. All statistical analyses were performed using SPSS 26.0 (SPSS Inc., Chicago,IL, USA). Statistically significant results were defined with a P < 0.05.

Research results

In total, 221 patients were included in the study and 34 patients completed the questionnaire twice. The urinary Frequency scale and Stool Frequency scale had good internal consistency with alpha Cronbach coefficients of 0.79 and 0.83 respectively, while the same coefficients were moderately lower for the Blood and Mucus in Stool scale (0.61) and the Body Image scale (0.67). The ICCs ranged from 0.88 to 1 indicating good to excellent reproducibility. In multitrait scaling analyses, the criterion for item convergent and divergent validity was satisfactory. The known-group comparison showed statistically significant differences between patients according to age, gender, stoma status, tumor location, and radiotherapy.

Research conclusions

The Moroccan Arabic version of the EORTC QLQ-CR29 is a valid and reliable tool that can be used safely for research and clinical purposes in Moroccan CRC patients.

Research perspectives

This tool can safely be used in research and clinical purpose and can be also used in the validation of other patient-reported outcome measure tools.