Development and validation of an abbreviated version of the expanded prostate cancer index composite instrument for measuring health-related quality of life among prostate cancer survivors

Urology. 2010 Nov;76(5):1245-50. doi: 10.1016/j.urology.2010.01.027. Epub 2010 Mar 28.


Objectives: Widespread implementation of health-related quality-of-life (HRQOL) measurement in prostate cancer practice and research requires concise instruments. With 50 questions, the full-length Expanded Prostate Cancer Index Composite (EPIC) is cumbersome to administer outside of studies focusing exclusively on HRQOL. To facilitate HRQOL measurement in a broad range of prostate cancer research and practice settings, we developed and validated an abbreviated version of the EPIC.

Methods: The 50 questions that constitute the full-length EPIC-50 were evaluated to identify the items suitable for elimination while retaining the ability to measure the 5 prostate cancer-specific HRQOL domains of the EPIC-50. The resulting abbreviated version (EPIC-26) was validated using question responses from 252 subjects who had undergone brachytherapy, external beam radiotherapy, or prostatectomy for prostate cancer. The EPIC-26 internal consistency was measured by Cronbach's α coefficient and reliability using test-retest correlation.

Results: Using the high item-scale correlations, clinically relevant content, and preservation of domain psychometrics, 26 items were retained in the EPIC-26 from the 50 questions in the full-length EPIC-50. A high correlation was observed between the EPIC-50 and EPIC-26 versions for the urinary incontinence, urinary irritation/obstruction, bowel, sexual, and vitality/hormonal domain scores (all r ≥ 0.96). The correlations between the different domains were low, confirming that EPIC-26 retained the ability to discern the 5 distinct HRQOL domains. The internal consistency and test-retest reliability for EPIC-26 (Cronbach's α ≥ 0.70 and r ≥ 0.69, respectively for all 5 HRQOL domains) supported its validity.

Conclusions: EPIC-26 is a brief, valid, and reliable subjective measure of health quality among patients with prostate cancer and is suitable for measuring the HRQOL among patients undergoing treatment of early-stage prostate cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Validation Study

MeSH terms

  • Health Status
  • Humans
  • Male
  • Prostatectomy
  • Prostatic Neoplasms / radiotherapy
  • Prostatic Neoplasms / therapy*
  • Quality of Life*
  • Surveys and Questionnaires*
  • Survivors