Coverage of harm reduction services and HIV infection: a multilevel analysis of five Chinese cities.

BACKGROUND: Since 2003, a harm reduction program for injecting drug users has been rolled out countrywide in China. It entails services for condom promotion, a needle and syringe program (NSP), and methadone maintenance treatment (MMT). However, it remains unknown if and to what extent the coverage of these services at city level is related to a reduced risk of HIV infection among drug users. METHODS: We wished to quantify the extent to which city-level characteristics (such as NSP and MMT service coverage) and individual-level determinants (e.g., self-reported exposure to NSP and MMT services, knowledge, motivation, and skills) were associated with the risk of HIV infection among drug users. In 2006, we conducted an integrated serological and behavioral survey among drug users in five cities of Yunnan Province, China (N = 685), constructing a multilevel logistic regression model with drug users clustered within these cities. RESULTS: Drug users who reported having received NSP or MMT services were about 50% less likely to be infected with HIV than those who reported not having received them (OR 0.45, 95% CI, 0.26-0.83 for NSP and 0.48, 95% CI, 0.31-0.73 for MMT). Despite a between-city variation of HIV infection risk (ICC 0.24, 95% CI 0.08-0.54), none of the city-level factors could explain this difference. Individual-level determinants such as perceived risk of infection and use of condoms were not associated with HIV infection. CONCLUSIONS: Although people who had used NSP or MMT services were less likely to be HIV infected, this study found no relationship between city-level coverage of HIV prevention programs and variations in HIV infection between cities. This may have been due to the low number of cities in the analysis. Future research should include the analysis of data from a larger number of cities, which are collected widely in China through integrated behavioral and serological surveys.

Identifying unusual human exposures to pesticides: Qilu Lake Basin as an overlooked source.

Although common exposure pathways of pesticides (e.g., crop consumption) have been intensively studied, we noticed that some unusual occupational exposures to pesticides were overlooked and could lead to unacceptable health risks. In this study, we presented information on the occurrence of 5 triazine pesticides (TRIs) and 3 neonicotine pesticides (NEOs) detected in water samples of Qilu Lake Basin in China. We identified the unusual occupational exposure scenarios as (i) adult females washing the harvested vegetables, and (ii) adult males catching fish in Qilu Lake; next, the health risk assessment was conducted using collected data. The results showed that the mean Σ5 TRI concentrations ranged from 505.87 ng/L in spring to 864.04 ng/L in summer, and the river water samples around Qilu Lake had the highest concentrations. The mean concentrations of Σ3 NEOs ranged from 885.86 ng/L in winter to 2593.04 ng/L in summer. Occupational exposed populations were bearing one to two orders of magnitude higher exposure doses than local adults. Although the carcinogenic risks caused by atrazine in water were at acceptable levels for local residents, all the occupational exposed males were at moderate risks, and 15.78 %-43.50 % of occupational exposed females in different seasons were even at high risks. The non-carcinogenic risks caused by pesticides in water were all at negligible levels, but the occupational exposed population were facing up to two orders of magnitude higher risks than local residents. This study established a sound basis for further decision-making to take necessary action on protection of sensitive population groups.

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

GOALS: A simplified Chinese version of EORTC QLQ-H&N35 was developed using strict translation procedures according to EORTC translation guidelines. Psychometric properties were evaluated. PATIENTS AND METHODS: 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. RESULTS: 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 α 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. CONCLUSIONS: 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.

Pesticide degradation in an integrated constructed wetland: Insights from compound-specific isotope analysis and 16S rDNA sequencing.

Carbon isotope analysis and the 16S rDNA sequencing were adopted to investigate the degradation process of chlorpyrifos during its transport in the integrated constructed wetland (ICW). Firstly, the extent of concentration decrease of chlorpyrifos was examined, and the removal efficiency in the first 36 h was found to be the highest. The removal rate reached 96.83 % after 96 h, and this process fit to the first-order kinetic model, with a kinetic constant (k) of 0.066 h-1. A significant carbon isotope fractionation was observed, with a change of the δ13C values from -26.54 ± 0.07 ‰ to -25.41 ± 0.08 ‰. The average chlorpyrifos biodegradation proportion reached 71.23 % (60.42 %-85.04 %), and it was predicted that about 11.79 %-36.41 % of chlorpyrifos removal in the ICW was attributed to abiotic factors. The outlet of the subsurface flow constructed wetland saw the highest D∗/B∗ value (1.38-3.88), indicating that the remaining fraction of dilution was much more significant than that of degradation in this period. The top 20 phyla of microbial community were identified in the ICW. Proteobacteria was the most dominant phylum, accounting for >40 % of the bacterial communities in all sampling locations. Acidobacteria and Bacteroidetes were the second and third dominant phyla. At the genus level, the microbial community composition differed more greatly in every stage of the ICW, and the spatial distribution difference was quite significant in the ICW. This study is important to figure out the migration and transformation of chlorpyrifos when the ICW was adopted as a removal tool for organic micro-pollutants, and more similar studies could be carried out in the future to promote the evaluation of pollutant removal capacity of the ICWs, and to further develop the application of stable isotope analysis of compounds in the natural environment.

Efficacy of a large-scale integrated constructed wetland for pesticide removal in tail water from a sewage treatment plant.

The higher and higher detection frequencies of micro-pollutants such as pesticides in water are nowadays intensifying the investigation for strategies to provide effective engineering methods that could mitigate such substances. Traditional sewage treatment plants (STP) do not design specific processes for micro-pollutants removal in water. As an environmentally-friendly measure, some laboratory-scale wetlands have been proved to be effective in the removal of pesticides in water, but such studies are rarely carried out in large-scale wetlands, especially when they are adopted as a polishing step of STPs. Therefore, the further removals of micro-pollutants in tail water of STPs through the large-scale wetlands and the relevant removal mechanism are still knowledge gaps. In this study, 44 target pesticides were detected in the water of a large-scale integrated constructed wetland (ICW) for four seasons. The ICW was established to further process the tail water from a STP, whose drainage was from domestic sewage of local residents. There were 19, 16, 17, and 19 pesticides detected in spring, summer, autumn, and winter, respectively. The removal values for Σ19 pesticides ranged from 49.99% to 84.96% during the study period, and the removal of these pesticides followed significant seasonal trends, which was likely because the microorganisms responsible for biotic degradation were markedly influenced by seasonal temperature fluctuations. Proteobacteria, Chloroflexi, Acidobacteria, Planctomycetes, and Bacteroidetes were the dominant phyla, and might be associated with the biodegradation of organic pollutants in the ICW. Removal of pesticides by the ICW resulted in overall toxicity reductions in water, but butachlor and chlorpyrifos were still at non-ignorable ecological risks. This study highlights the potential of constructed wetlands for micro-pollutants removal in water as a polishing step in STPs.

Spatio-temporal variations and ecological risks of organochlorine pesticides in surface waters of a plateau lake in China.

Qilu Lake is one of the 9 plateau lakes in Yunnan, China, with a lake surface altitude of 1796.62 m above sea level. In spite of the importance and agriculturally-intensive phenomenon in Qilu Lake Basin, few studies have provided a modern evaluation of pesticide residues and potential effects to local aquatic organisms. The primary goal of this study was to determine the spatio-temporal variations of organochlorine pesticides (OCPs) in this area, and to further assess the related ecological risks. Of the 25 OCPs analyzed, 14 were detected, and the concentrations of ∑25OCPs were highest in the upstream of rivers, followed by regions close to the lake shore, and the lowest concentrations were found in Qilu Lake in every season except winter. The concentrations of ∑25OCPs were the highest in summer, and the lowest in winter. OCP concentrations in spring and in autumn were similar. 4,4'-DDD, γ-HCH, HCB, trans-chlordane, and cis-chlordane were 5 OCPs with relatively high risk in Qilu Lake Basin. Interestingly, higher OCP concentrations do not necessarily correspond to higher ecological risk levels. Low predicted no-effect concentration (PNEC) values and relatively high toxicity of these OCPs led to their high risk quotient (RQ) values. This work further illustrated that although OCPs have been banned for many years, they were still frequently detected in surface waters, and caused risks to aquatic animals.

The Effects of Elevated Tropospheric Ozone on Carbon Fixation and Stable Isotopic Signatures of Durum Wheat Cultivars with Different Biomass and Yield Stability.

Tropospheric ozone (O3) enrichment caused by human activities can reduce important crop yields with huge economic loss and affect the global carbon cycle and climate change in the coming decades. In this study, two Italian cultivars of durum wheat (Claudio and Mongibello) were exposed to O3 (80 ppb, 5 h day-1 for 70 consecutive days), with the aim to investigate the changes in yield and biomass, ecophysiological traits, and stable carbon and nitrogen isotope values in plants, and to compare the stable isotope responses under environmental stressors. Both cultivars showed a relative O3 tolerance in terms of photosynthetic performance, but in cultivar Mongibello, O3 was detrimental to the grain yield and plant biomass. The δ13C values in the leaves of plants identified that the impact of O3 on CO2 fixation by RuBisCO was dominant. The δ15N value showed significant differences between treatments in both cultivars at seven days from the beginning of the exposure, which could be considered an early indicator of ozone pollution. Under increasingly frequent extreme climates globally, the relationships among stable isotope data, ecophysiological traits, and agronomic parameters could help breed future cultivars.

Rapid Genetic Diagnosis of Citrin Deficiency by Multicolor Melting Curve Analysis.

Citrin deficiency caused by SLC25A13 genetic mutations is an autosomal recessive disease, and four prevalent mutations including c.851_854del, c.1638_1660dup, IVS6+5G>A, and IVS16ins3kb make up >80% of total pathogenic mutations within the Chinese population. However, suitable assays for detection of these mutations have not yet been developed for use in routine clinical practice. In the current study, a real-time PCR-based multicolor melting curve analysis (MMCA) was developed to detect the four prevalent mutations in one closed-tube reaction. The analytical and clinical performances were evaluated using artificial templates and clinical samples. All four mutations in the test samples were accurately genotyped via their labeling fluorophores and Tm values, and the standard deviations of Tm values were indicated to be <0.2°C. The limit of detection was estimated to be 500 diploid human genomes per reaction. The MMCA assay of 5,332 healthy newborns from southern China identified a total of 107 SLC25A13-mutation carriers, indicating a carrier rate of 2%. The genotypes of 107 carriers and 112 random non-carriers were validated using direct sequencing and Long-range PCR with 100% concordance. In conclusion, the assay developed in this study may potentially serve as a rapid genetic diagnostic tool for citrin deficiency.

Development and validation of the system of quality of life instruments for cancer patients: lung cancer (QLICP-LU).

Using the structured group methods (nominal and focus group) and the theory in instrument development, the quality of life instrument for lung cancer (QLICP-LU) with Chinese cultural background was developed, and evaluated based on the data from a sample of 85 in-patients of lung cancer. Statistical methods used were correlation analysis, factor analysis and paired t-test, etc. The results showed that test-retest reliability of the overall scale was 0.78, and test-retest reliability and internal consistency alpha for most domains were higher than 0.70; correlation and factor analysis demonstrated good construct validity; criterion-related validity were confirmed given FACT-L and QLQ-LC43 (QLQ-C30 plus QLQ-LC13) as the criterions; statistically significant changes were found for each domain and the overall scale with standardized response mean SRM being greater than 0.80 except for the social function domain. We conclude that the QLICP-LU can be used to measure QOL for patients with lung cancer with better validity, reliability and responsiveness in China.

Validation of the simplified Chinese version of the quality of life instrument EORTC QLQ-LC43 for patients with lung cancer.

PURPOSE: To validate the simplified Chinese version of the EORTC QLQ-LC43 for lung cancer patients. METHODS: The simplified Chinese version of the QLQ-LC43 was used to measure quality of life (QOL) of 181 in-patients with lung cancer at three time points before and after treatment. Psychometric properties of the instrument were evaluated based on the QOL data collected from the patients using correlation analysis, factor analysis and paired t-test. RESULTS: The test-retest reliability r for most domains was higher than 0.60 with a range from 0.53 to 0.80. The internal consistency alpha for all domains was higher than 0.65 except for cognitive functioning (0.32). Correlation analysis and factor analysis demonstrated good construct validity. The instrument reflected the differences in QOL scores among different age groups, indicating known-groups validity, and revealed good criterion-related validity when FACT-L was used as the criterion. The instrument detected changes of QOL with higher standardized response mean for the patients before and after treatment. CONCLUSION: The Chinese version of QLQ-LC43 can be used to measure QOL for Chinese patients with lung cancer with good validity, reliability and responsiveness.

Psychometric properties of the Chinese version of the FACT-L for measuring quality of life in patients with lung cancer.

A Simplified Chinese version of the FACT-L was evaluated using responses from 181 patients with lung cancer in China by assessing the construct, discriminative and criterion-related validity, internal consistency, test-retest reliability, and responsiveness as measured by score changes of the scales. Correlation and factor analysis among domains and items showed good construct validity, correlation analysis of domain scores between FACT-L and Quality of Life Instruments for Cancer Patients-Lung cancer (QLICP-LU) displayed good criterion-related validity, and comparison of two age groups demonstrated discriminative validity. Test-retest reliability and Internal consistency coefficients for all domains were greater than 0.75 with the exception of the domain of additional concerns (alpha=0.56). Score changes over time were statistically significant in the overall scale and all domains: standardized response mean (SRM) for physical well-being is 1.56, social/ family well-being 0.70, emotional well-being 0.93, and functioning well-being 1.51. Therefore, the Simplified Chinese version of FACT-L can be used to measure quality of life (QOL) for Chinese patients with lung cancer with good validity, reliability, and responsiveness.

Effect of adherence on daytime sleepiness, fatigue, depression and sleep quality in the obstructive sleep apnea/hypopnea syndrome patients undertaking nasal continuous positive airway pressure therapy.

OBJECTIVES: The aims of this study were to describe changes in day- and nighttime symptoms and the adherence to nasal continuous positive airway pressure (nCPAP) during the first 3-month nCPAP therapy among newly diagnosed patients with obstructive sleep apnea/hypopnea syndrome (OSAS) and to identify the effect of adherence on the changes in day- and nighttime symptoms during the first 3 months. METHODS: Newly diagnosed OSAS patients were consecutively recruited from March to August 2013. Baseline clinical information and measures of the Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Zung's Self-Rating Depression Scale (SDS) and the Pittsburgh Sleep Quality Index (PSQI) at baseline and the end of 3rd, 6th, 9th and 12th week of therapy were collected. Twelve weeks' adherence was calculated as the average of each 3-week period. Mixed model was used to explore the effect of adherence to nCPAP therapy on ESS, FSS, SDS and PSQI in each 3-week phase. RESULTS: Seventy-six patients completed the 12-week follow-up. The mixed-effects models showed that under the control of therapy phase adherence in the range of <4 hours per night, using nCPAP could independently improve daytime sleepiness, in terms of ESS (coefficient, [95% confidence interval] unit; -4.49 [-5.62, -3.36]). Adherence at 4-6 hours per night could independently improve all variables of day- and nighttime symptoms included in this study, namely ESS -6.69 (-7.40, -5.99), FSS -6.02 (-7.14, -4.91), SDS -2.40 (-2.95, -1.85) and PSQI -0.20 (-0.52, -0.12). Further improvement in symptoms could be achieved at ≥6 hours per night using nCPAP, which was ESS -8.35 (-9.26, -7.44), FSS -10.30 (-11.78, -8.83), SDS -4.42 (-5.15, -3.68) and PSQI -0.40 (-0.82, -0.02). The interaction between adherence level and therapy phase was not significant in day- and nighttime symptoms. CONCLUSION: The effect of adherence on the above-mentioned symptoms is stable through the first 3 months. Under the control of therapy phase, the nCPAP therapy effectively improves day- and nighttime symptoms with ≥4 hours adherence, and the patients can achieve a further improvement with ≥6 hours adherence.

Pre- and in-therapy predictive score models of adult OSAS patients with poor adherence pattern on nCPAP therapy.

OBJECTIVES: To identify patterns of adherence to nasal continuous positive airway pressure (nCPAP) use in the first 3 months of therapy among newly diagnosed adult patients with obstructive sleep apnea/hypopnea syndrome (OSAS) and their predictors. To develop pretherapy and in-therapy scores to predict adherence pattern. METHODS: Newly diagnosed adult OSAS patients were consecutively recruited from March to August 2013. Baseline clinical information and measures such as Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Zung's Self-Rating Depression Scale (SDS), and The Pittsburgh Sleep Quality Index (PSQI) at baseline and at the end of 3rd-week therapy were collected. Twelve weeks' adherence data were collected from the nCPAP memory card, and K-means cluster analysis was used to explore adherence patterns. Predictive scores were developed from the coefficients of cumulative logit models of adherence patterns using variables available at baseline and after 3 weeks of therapy. Performance of the score was validated using 500 bootstrap resamples. RESULTS: Seventy six patients completed a 12-week follow-up. Three patterns were revealed. Patients were identified as developing an adherence pattern that was poor (n=14, mean ± SD, 2.3±0.9 hours per night), moderate (n=19, 5.3±0.6 hours per night), or good (n=43, 6.8±0.3 hours per night). Cumulative logit regression models (good → moderate → poor) revealed independent baseline predictors to be ESS (per unit increase) (OR [95% CI], 0.763 [0.651, 0.893]), SDS (1.461 [1.238, 1.724]), and PSQI (2.261 [1.427, 3.584]); and 3-week therapy predictors to be ESS (0.554 [0.331, 0.926]), PSQI (2.548 [1.454, 4.465]), and the changes (3rd week-baseline data) in ESS (0.459 [0.243, 0.868]), FSS (3.556 [1.788, 7.070]), and PSQI (2.937 [1.273, 6.773]). Two predictive score formulas for poor adherence were developed. The area under the curve (AUC) of the receiver operating characteristics (ROC) curves for baseline and 3-week formulas were 0.989 and 0.999, respectively. Bootstrap analysis indicated positive predictive values of baseline and 3-week predictive scores in our patient population of 0.82 (95% CI [0.82, 0.83]) and 0.94 (95% CI [0.93, 0.94]), respectively. CONCLUSION: A high level of prediction of poor adherence pattern is possible both before and at the first 3 weeks of therapy. The predictive scores should be further evaluated for external validity.

Development and validation of the system of quality of life instruments for cancer patients: head and neck cancer (QLICP-HN).

Quality of life for patients with head and neck is now concerned worldwide, but the available QOL instruments are seldom and lack of Chinese culture. Therefore, this paper aimed to develop and validate a QOL instrument for patients with head and neck cancer, QLICP-HN. Using the programmed decision methods and the theory in instrument development, the QLICP-HN was developed and evaluated based on the data measuring QOL three times before and after treatment from a sample of 133 in-patients of head and neck cancer. The psychometric properties of the scale were evaluated by indicators such as validity and reliability coefficients: Cronbach α, Pearson r, standardized response mean. The statistical methods included Pearson correlation, multi-trait scaling analysis, factor analysis, cluster analysis and paired t test. The internal consistency α for the overall scale and domains is above 0.70 with the exception of the social function (0.65) and common symptom and side effect (0.66); the test-retest reliability for each domain and the overall scale is higher than 0.80; most correlation coefficients between each item and its domain are above 0.40; the scores differences between pre-treatment and post-treatment have statistical significance for three domains of physical, psychological, the specific, and the overall instrument, with higher SRM of 0.33, 0.59, 0.44 and 0.53. The QLICP-HN is of good validity, reliability and responsiveness, and can be used to assess quality of life for patients with head and neck cancer in China.

Development and validation of a quality of life instrument for patients with liver cancer QOL-LC.

OBJECTIVE: To develop a self-administered quality of life instrument for patients with liver cancer. METHODS: The programmed decision procedure, the theory and methodology in developing rating scale were used to establish the instrument. On the basis of the data from 105 liver cancer patients, the psychometric properties of the scale were evaluated by indicators of validity, reliability coefficients, and statistical methods like structural equation modeling. RESULTS: The test-retest coefficients for physical, psychological, symptom/side effects, social domains, and the overall scale are 0.76, 0.86, 0.71, 0.80, and 0.84, respectively. The α coefficients for the above 4 domains are 0.78, 0.81, 0.75, and 0.68, respectively. The correlation analysis and the structural equation model showed good construct validity. The criterion-related was confirmed by using the functional living index-cancer simultaneously. The scale can reflect the changes of patients' quality of life after treatment. CONCLUSIONS: The instrument is of good validity, reliability, and responsiveness and has been broadly used in China.

[Development of the system of quality of life instruments for cancer patients: stomach cancer (QLICP-ST)].

BACKGROUND & OBJECTIVE: We have previously developed and reported the general module of the system of quality of life instruments for cancer patients (QLICP-GM). This study was to develop and evaluate the quality of life instrument for patients with stomach cancer (QLICP-ST). METHODS: The QLICP-ST was developed using the structured group methods applicable to Chinese populations. The system of QLICP-ST was evaluated by analyzing data from 86 stomach cancer patients using statistical description, Pearson's correlation, exploratory factor analysis, and paired student's t test. RESULTS: The test-retest reliability of the overall scale was 0.98 and that of each domain was greater than 0.90. The internal consistency coefficient alpha of the overall scale was 0.91 and that of each domain was higher than 0.65. Correlation analysis and the exploratory factor analysis revealed good construct validity of the QLICP-ST. Differences of the quality of life scores before and after the treatment in physical domain, psychological domain, common symptom and side effect domain, specific domain and the overall scale were significant. Moreover, the standardized response mean(SRM) of these domains were greater than 0.30. CONCLUSION: The system of QLICP-ST can be used in clinical evaluation of the quality of life for stomach cancer patients with sound validity, reliability and responsiveness.

[Development of the general module of the system of quality of life instruments for cancer patients: reliability and validity analysis].

BACKGROUND & OBJECTIVE: The general module of the system of quality of life instruments for cancer patients (QLICP-GM) has been developed by us, but its psychologic properties need to be evaluated. This study was to evaluate the reliability and validity of QLICP-GM. METHODS: The QOL data of 600 patients with lung cancer, breast cancer, colorectal cancer, gastric cancer, and head and neck cancer were analyzed by paired t-tests, correlation analysis, equivalence tests, and structural equation models to evaluate QLICP-GM. RESULTS: The test-retest reliability for all domains and the overall scale was above 0.85. Internal consistency alpha values for all domains except social function domain were above 0.70. The alpha value and split-half reliability of the overall scale were 0.88 and 0.93, respectively. Correlation analyses and structural equation models displayed good construction validity of the scale. It also showed good criterion-related validity when FACT-G was used as the criterion. CONCLUSION: QLICP-GM can be used to measure QOL for cancer patients with good reliability and validity.

[Development of the general module of the system of quality of life instruments for cancer patients: item selection and structure of the general module].

BACKGROUND & OBJECTIVE: The researches on quality of life (QOL) of cancer patients are concerned worldwide. Two QOL instrument systems for cancer patients, Functional Assessment of Cancer Therapy (FACT) and Quality of Life Questionnaires (QLQ), have been developed and used widely in the US and Europe, but no one has been developed in China. This study was to develop the general module of the system of quality of life instruments for cancer patients (QLICP-GM) used in China. METHODS: The structured group (nominal group and focus group) methods and the qualitative combined quantitative theory and methodology was used to develop rating scales. The items were preliminarily screened, evaluated, and modified. The QOL data of 448 cancer patients were analyzed by the methods of coefficient of variation, factor analysis, clustering analysis, and correlation analysis. RESULTS: QLICP-GM was developed and evaluated. The module, including 32 items, was consisted of 4 domains: physical function, psychologic function, social function, and general symptoms and side effects. CONCLUSION: QLICP-GM possesses a reasonable content validity because it reflects the WHO definition and connotation of QOL, and common issues of cancer patients as well.

[Development of the general module of the system of quality of life instruments for cancer patients: responsiveness analysis].

BACKGROUND & OBJECTIVE: The general module of the system of quality of life instruments for cancer patients, QLICP-GM, has been developed and its reliability and validity has been evaluated by us. This study was to analyze its responsiveness. METHODS: The quality of life of 600 patients with 5 kinds of cancer was measured using QLICP-GM before and after treatment. Traditional significance tests with some indices, such as effect size, standardized response mean and equivalence, were applied to evaluate responsiveness. RESULTS: The quality of life score changed significantly after treatment on 3 domains: physical function, psychologic function, and general symptoms and side effects. The standardized response mean of the overall instrument ranged from 0.16 to 0.67. Equivalence test showed no equivalence on quality of life score changes of these domains and the overall instrument. CONCLUSION: QLICP-GM possesses reasonable responsiveness and can be used in clinical measurement of quality of life for cancer patients.