Assessment Tools for Health-Related Quality of Life in Patients With Nasopharyngeal Carcinoma: A Systematic Review of Psychometric Properties

Objectives: Self-reported health-related quality of life (HRQoL) is a critical metric for evaluating clinical outcomes. Although the HRQoL of patients with nasopharyngeal carcinoma (NPC) has been widely studied, the performance of these assessments in clinical practice remains uncertain, and there is a significant gap in the quality evaluation of the scales used. This review aimed to systematically evaluate self-reported HRQoL scales for patients with NPC, thereby providing guidelines for the informed selection of assessment tools.

Design: A systematic review based on the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology and following the PRISMA guidelines.

Methods: PubMed, Web of Science, Embase, CINAHL, PsycINFO, CNKI, SinoMed, and WanFang databases were systematically searched from their inception until August 2024. The included studies must report the assessment of measurement properties of HRQoL scales designed for NPC. Two authors independently screened the eligible literature, extracted data, and evaluated their methodological and psychometric quality. The measurement properties of HRQoL scales for NPC were evaluated according to COSMIN systematic review guidelines. Additionally, the GRADE approach was used to grade the quality of evidence.

Results: Among 17 instruments across 19 studies, all demonstrated adequate content validity, construct validity, and internal consistency. However, information on cross-cultural validity, criterion validity, reliability, hypothesis testing, and responsiveness was limited. High-quality evidence on psychometric properties was provided for HRQoL instruments for Cancer Patients-Nasopharyngeal Cancer (QLICP-NA), the Functional Assessment of Cancer Therapy-Nasopharyngeal (FACT-NP), and the Quality of Life Scale for Nasopharyngeal Carcinoma Patients Version 2 (QoL-NPC V2).

Conclusion: The measurement characteristics of QLICP-NA, FACT-NP, and QoL-NPC V2 scales were comprehensively assessed, exhibiting good methodological quality, strong measurement attributes, and robust supporting evidence. Therefore, these scales are recommended for evaluating the quality of life of patients with NPC. However, further validation of the remaining assessment tools is required.

Relevance to Clinical Practice: Our findings will help healthcare professionals select suitable instruments for patients with NPC.