Translation and validation of the Swedish version of the EORTC LMC-21, the disease-specific questionnaire for assessing health-related quality of life in patients with colorectal liver metastases

TL;DR

This study translated and validated a quality-of-life questionnaire for Swedish patients with colorectal liver metastases, showing it is reliable and effective.

Contribution

The study provides a validated Swedish version of the EORTC QLQ-LMC21 questionnaire for assessing health-related quality of life in CRC liver metastases patients.

Findings

The Swedish version of QLQ-LMC21 showed good internal consistency with Cronbach's alpha ranging from 0.84 to 0.89.

Test-retest reliability was strong, with ICC values between 0.67 and 0.93.

The questionnaire demonstrated adequate convergent and discriminant validity.

Abstract

The aim of this study was to translate the health-related quality-of-life questionnaire EORTC QLQ-LMC21 into Swedish and to test its clinical and psychometric reliability and validity in patients with liver metastases from colorectal cancer (CRC) undergoing surgical treatment.

The Swedish versions of the EORTC QLQ-C30 and EORTC QLQ-LMC21 were administered to 250 patients with liver metastases from CRC in four Swedish hospitals before and 3 months after surgical treatment. Psychometric validation of the questionnaire´s structure, reliability, and convergent and divergent validity was performed.

Data from 242 (97%) patients were suitable for analysis. The QLQ-LMC21 was found to be sensitive to changes over time. Cronbach´s alpha coefficient indicated good internal consistency, ranging from 0.84 to 0.89. Test–retest reliability was evaluated in 120 patients (49%), and the intraclass correlation coefficient (ICC) indicated good reproducibility, ranging from 0.67 to 0.93. Convergent and discriminant validity were demonstrated adequately in the multitrait scaling analysis. There were weak correlations between the QLQ-C30 and QLQ-LMC21, which confirms that the health problems addressed by the QLQ-LMC21 are different from those addressed by the QLQ-C30.

The Swedish version of the EORTC QLQ-LMC21 proved to be a valid and reliable questionnaire to use in conjunction with the EORTC QLQ-C30.

The online version contains supplementary material available at 10.1186/s12876-025-03835-w.