JMIR Publications

ABSTRACT

Background:

Breast cancer remains the most common neoplasm diagnosed amongst women in China and globally. Health-related questionnaire assessments in research and clinical oncology settings have gained prominence. National Comprehensive Cancer Network-Functional Assessment of Cancer Therapy-Breast Cancer Symptom Index (NFBSI-16) is a rapid and powerful tool to help evaluate the disease or treatment-related symptoms, both physical and emotional, in patients with breast cancer for clinical and research need. Prevalence of individual smartphones provides a potential web-based approach to administrating questionnaire; however, the reliability of NFBSI-16 in electronic format has not been assessed.

Objective:

This study aimed to assess the reliability of web-based NFBSI-16 questionnaire in breast cancer patients undergoing systematic treatment with a prospective open-label randomised crossover study design.

Methods:

We recruited random patients from the central hospital registry with breast cancer under systematic treatment to complete both paper- and web-based versions of the questionnaires. Both versions of the questionnaires were self-assessed. Patients were randomly assigned to group A (paper- based first and web-based second) or group B (web- based first and paper-based second). A total of 354 patients were included in the analysis (group A: n= 177, group B: n=177). Descriptive sociodemographic characteristics, reliability and agreement rates for single items, subscale, and total score were analysed using Wilcoxon test. Lin’s concordance correlation coefficient (CCC), Spearman and Kendall tau rank correlation were used to assess test-retest reliability.

Results:

Test-retest reliability was measured with CCCs was 0.94 for the total NFBSI-16 score. Significant correlations (Spearman's rho) were documented for all 4 subscales: DRS-P (rho=0.93), DRS-E (rho=0.85), TSE (rho=0.95), and FWB (rho=0.91) and total NFBSI-16 score (rho=0.94). Mean differences of the test and re-test were all close to zero (≤0.06). The parallel test-retest reliability of subscales with Wilcoxon test comparing individual items found GP3 (Item 5) to be significantly different (P=0.02). A majority of the participants in this study preferred the web-based (72%, n=255) over the paper-based version.

Conclusions:

The web-based version of the NFBSI-16 questionnaire is an excellent tool for monitoring individual breast cancer patients under treatment, with majority of participants preferring it over paper-based version.