• Johannes M Giesinger, Morten Aa Petersen, Mogens Groenvold, Neil K Aaronson, Juan I Arraras, Thierry Conroy, Eva M Gamper, Georg Kemmler, Madeleine T King, Anne S Oberguggenberger, Galina Velikova, Teresa Young, Bernhard Holzner, and European Organisation for Research and Treatment of Cancer Quality of Life Group (EORTC-QLG).
• Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Innsbruck, Austria.
• Health Qual Life Out. 2011 Jan 1;9:19.

IntroductionWithin an ongoing project of the EORTC Quality of Life Group, we are developing computerized adaptive test (CAT) measures for the QLQ-C30 scales. These new CAT measures are conceptualised to reflect the same constructs as the QLQ-C30 scales. Accordingly, the Fatigue-CAT is intended to capture physical and general fatigue.MethodsThe EORTC approach to CAT development comprises four phases (literature search, operationalisation, pre-testing, and field testing). Phases I-III are described in detail in this paper. A literature search for fatigue items was performed in major medical databases. After refinement through several expert panels, the remaining items were used as the basis for adapting items and/or formulating new items fitting the EORTC item style. To obtain feedback from patients with cancer, these English items were translated into Danish, French, German, and Spanish and tested in the respective countries.ResultsBased on the literature search a list containing 588 items was generated. After a comprehensive item selection procedure focusing on content, redundancy, item clarity and item difficulty a list of 44 fatigue items was generated. Patient interviews (n = 52) resulted in 12 revisions of wording and translations.DiscussionThe item list developed in phases I-III will be further investigated within a field-testing phase (IV) to examine psychometric characteristics and to fit an item response theory model. The Fatigue CAT based on this item bank will provide scores that are backward-compatible to the original QLQ-C30 fatigue scale.

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