[Quality of life in patients with prostate cancer: validation of an instrument for clinical practice]. / Calidad de vida en pacientes con cáncer de próstata: la validación de un instrumento para la práctica clínica.

OBJECTIVES: Currently there are instruments to evaluate the different features of the impact on quality of life in those patients with prostate cancer undergoing any type of treatment, but most of them have 50 or more questions and they are difficult to apply in clinical practice. An English validation of a shortened version of the EPIC (Expanded Prostate Cancer Composite), the most used instrument to measure the quality of life in patients with prostate cancer, has been published recently. This version called EPIC-CP (Expanded Prostate Cancer Composite-Clinical Practice) consists of 16 questions arranged in a page, for easy and rapid clinical application. The objective of this work is to validate a Spanish version of the EPIC-CP. METHOD: An inversa-directa Spanish translation of the original version was performed. The EPIC-CP and EQ5D questionnaires were applied to 46 patients eligible to be subjected to different treatments - open prostatectomy (OP), Robotic Prostatectomy (RP), brachytherapy (Br) or conformational radiotherapy (CR) - and 82 patients already treated (9 OP, 13 RP, 7 Br, 4 CR). For reliability evaluation, the Cronbach's alpha was used to test the internal consistency for each domain of the EPIC-CP. Treated and untreated patients' scores were compared with the Wilcoxon range sum test to assess the sensitivity to change. RESULTS: Cronbach's alpha was elevated in all the EPIC-CP domains (near or greater than 0.7), indicating a high internal consistency. There was no significant difference in age and educational level between treated and untreated patients. We found significant differences between treated and untreated patients in the total EPIC CP score, in the domains of urinary incontinence, bowel function, sexual function and hormonal function. CONCLUSION: The Spanish version of the EPIC-CP is reliable and valid, so it is a useful tool to measure the quality of life in patients with prostate cancer, as well as the impact of different treatments.

Calidad de vida en pacientes con cáncer de próstata: Validación de un instrumento para la práctica clínica / Quality of life in patients with prostate cancer: validation of an instrument for clinical practice

OBJETIVO: Actualmente existen instrumentos para evaluar los distintos aspectos en el impacto sobre la calidad de vida en aquellos pacientes portadores de cáncer de próstata que son sometidos a algún tipo de tratamiento, pero la mayoría son de 50 o más preguntas y de difícil aplicación en la práctica clínica. Recientemente se ha publicado la validación en inglés de una versión acortada del instrumento más utilizado para medir la calidad de vida en pacientes con cáncer de próstata: EPIC (Expanded Prostate Cancer Composite). Esta versión denominada EPIC-CP (Expanded Prostata Cancer Composite-Clinical Practice) consiste en 16 preguntas dispuestas en una página, de fácil y rápida aplicación clínica. El objetivo primario de este trabajo fue desarrollar y validar el cuestionario EPIC-CP en español como instrumento de evaluación de calidad de vida en pacientes con cáncer de próstata (CaP). Un objetivo secundario fue la observación de las diferencias de los aspectos que impactan en la calidad de vida entre los pacientes tratados y los candidatos a tratamiento. MÉTODOS: Se realizó una traducción inversa-directa al español de la versión original de la encuesta. Se aplicaron 128 cuestionarios de calidad de vida EPIC-CP y EQ5D (cuestionario de salud del EuroQuol Group Association) a 46 (40%) pacientes candidatos a ser sometidos a diferentes tratamientos - Prostatectomía abierta (PA), Prostatectomía robótica (PR), Braquiterapia (Br) o Radioterapia Conformacional (RC)- y a 82 (64%) pacientes ya tratados (9 PA, 13 PR, 7 Br y 4 RC). Para evaluar la confiabilidad se evaluó la consistencia interna a través del Coeficiente Alfa de Cronbach para cada categoría de la EPIC-CP. Para valorar la sensibilidad al cambio se compararon las puntuaciones en pacientes tratados y no tratados con el test de Suma de Rangos de Wilcoxon. RESULTADOS: En todos los dominios de la EPIC-CP, se obtuvo un consistencia interna elevada (alfa de Cronbach 0,66-0,9). No se encontraron diferencias significativas en la edad ni en el nivel educacional entre pacientes tratados y no tratados. Se encontraron diferencias significativas en la puntuación total de la EPIC CP entre pacientes tratados y no tratados en los dominios incontinencia urinaria (p = 0,0002), función intestinal (p = 0,04), sexual (p < 0,0001) y función hormonal (p = 0,002). CONCLUSIÓN: La versión en del EPIC-CP es confiable y válida, por lo que resulta una herramienta útil para medir la calidad de vida en pacientes con CaP, así como el impacto de distintos tratamientos en ella

OBJECTIVES: Currently there are instruments to evaluate the different features of the impact on quality of life in those patients with prostate cancer undergoing any type of treatment, but most of them have 50 or more questions and they are difficult to apply in clinical practice. An English validation of a shortened version of the EPIC (Expanded Prostate Cancer Composite), the most used instrument to measure the quality of life in patients with prostate cancer, has been published recently. This version called EPIC-CP (Expanded Prostate Cancer Composite-Clinical Practice) consists of 16 questions arranged in a page, for easy and rapid clinical application. The objective of this work is to validate a Spanish version of the EPIC-CP. METHOD: An inversa-directa Spanish translation of the original version was performed. The EPIC-CP and EQ5D questionnaires were applied to 46 patients eligible to be subjected to different treatments - open prostatectomy (OP), Robotic Prostatectomy (RP), brachytherapy (Br) or conformational radiotherapy (CR) - and 82 patients already treated (9 OP, 13 RP, 7 Br, 4 CR). For reliability evaluation, the Cronbach's alpha was used to test the internal consistency for each domain of the EPIC-CP. Treated and untreated patients' scores were compared with the Wilcoxon range sum test to assess the sensitivity to change. RESULTS: Cronbach's alpha was elevated in all the EPIC-CP domains (near or greater than 0.7), indicating a high internal consistency. There was no significant difference in age and educational level between treated and untreated patients. We found significant differences between treated and untreated patients in the total EPIC CP score, in the domains of urinary incontinence, bowel function, sexual function and hormonal function. CONCLUSIÓN: The Spanish version of the EPIC-CP is reliable and valid, so it is a useful tool to measure the quality of life in patients with prostate cancer, as well as the impact of different treatments