FACE-Q Skin Cancer Module for measuring patient-reported outcomes following facial skin cancer surgery Journal Article


Authors: Lee, E. H.; Klassen, A. F.; Cano, S. J.; Nehal, K. S.; Pusic, A. L.
Article Title: FACE-Q Skin Cancer Module for measuring patient-reported outcomes following facial skin cancer surgery
Abstract: Background: The patient's perspective of their facial scar after skin cancer surgery influences perception of care and quality of life (QoL). Appearance satisfaction after surgery is also an important but often overlooked treatment outcome. Objectives: To report the psychometric validation of the FACE-Q Skin Cancer Module consisting of five scales, measuring appearance satisfaction (Satisfaction with Facial Appearance, Appraisal of Scars), QoL (Cancer Worry, Appearance-related Psychosocial Distress) and the patient experience (Satisfaction with Information: Appearance). Methods: Participants underwent Mohs surgery for facial basal or squamous cell carcinoma or excision of early facial melanoma. Cohort 1 received a set of scales before and after surgery. Cohort 2 received the scales on two occasions in the postoperative period for test–retest reliability. Rasch measurement theory was used to select (item-reduce) the most clinically meaningful items for the scales. Reliability, validity, floor and ceiling effects and responsiveness were also analysed. Results: Of 334 patients, 209 (response rate 62·6%) were included. Rasch analysis reduced the total scale items from 77 to 41. All items had ordered thresholds and good psychometric fit. Reliability was high (Person separation index and Cronbach's α ≥ 0·90) and scales measuring similar constructs were correlated. High floor and ceiling effects were seen for the scales. The Cancer Worry scale demonstrated responsiveness (P = 0·004). Conclusions: The FACE-Q Skin Cancer Module meet the requirements of the Rasch model providing linearized measurement. Discriminating between patients with minimal appearance or worry impairment may be a limitation. The scales can be used for larger validation studies, clinical practice and research. © 2018 British Association of Dermatologists
Journal Title: British Journal of Dermatology
Volume: 179
Issue: 1
ISSN: 0007-0963
Publisher: Blackwell Publishing  
Date Published: 2018-07-01
Start Page: 88
End Page: 94
Language: English
DOI: 10.1111/bjd.16671
PROVIDER: scopus
PUBMED: 29654700
PMCID: PMC6115303
DOI/URL:
Notes: Article -- Export Date: 1 August 2018 -- Source: Scopus
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  1. Kishwer S Nehal
    278 Nehal
  2. Erica H Lee
    135 Lee