Reliability and Validity of Health-Related Quality of Life Instruments for Breast Cancer Patients in Asia: A Systematic Review and Meta-Analysis

Health-related quality of life (HRQoL) instruments are crucial for assessing breast cancer patients' well-being. This research reviewed and meta-analyzed the reliability and validity of widely used HRQoL instruments, including EORTC QLQ-C30, QLQ-BR23, and FACIT-Sp12, in Asian breast cancer populations. Searches in PubMed, Embase, and Web of Science up to November 2024 identified five studies with 818 patients. Reliability was assessed using Cronbach’s alpha, with pooled values calculated via a random-effects model. EORTC QLQ-C30 and QLQ-BR23 showed strong reliability, with pooled Cronbach’s alpha values of 0.881 (I² = 93%) and 0.860 (I² = 90%), respectively, while FACIT-Sp12 demonstrated excellent reliability (? = 0.87). High heterogeneity in EORTC QLQ-C30 and QLQ-BR23 results likely stemmed from population and research design variations. Validity data were inconsistently reported but highlighted QLQ-BR23's superior item discriminant validity and QLQ-C30's strong construct validity (CVI = 0.98). These instruments are reliable tools for HRQoL assessment in Asian breast cancer populations. However, variability in validity reporting and significant heterogeneity limit their universal applicability. To enhance their use in Asia, future studies should standardize validity methodologies, address heterogeneity sources, and consider cultural diversity. Additionally, digital adaptations and resource-sensitive approaches are needed to make these tools more accessible in diverse and resource-limited settings. This will ensure more accurate and equitable assessments of HRQoL across Asia.