Accuracy of recall in health-related quality-of-life assessment among men treated for prostate cancer

Purpose: To determine the accuracy of patient recall of health-related qual ity of life (HRQOL) in men who have undergone radical prostatectomy for ear ly-stage prostate cancer. Patients and Methods: Patients enrolled onto a longitudinal, observational cohort study of HRQOL after radical prostatectomy for early-stage prostate cancer were asked to assess their baseline HRQOL before surgery. They were later asked to recall their baseline HRQOL at intervals of 7 to 37 months a fter surgery. The two views of baseline HRQOL (actual and recall) were comp ared, HRQOL was measured with established instruments (the RAND 12-item Sho rt-Form Health Survey and a validated short form of the University of Calif ornia Los Angeles Prostate Cancer Index) that addressed impairment in the p hysical, mental, urinary, bowel, and sexual domains. Results: Overall, recall was poor. Patients tended to remember their baseli ne HRQOL as being better than it actually was. This effect was particularly striking for urinary and sexual function. Greater education and younger ag e diminished this effect in some domains. The effect did not vary with time since surgery. Conclusion: Men undergoing radical prostatectomy for early-stage prostate c ancer do not accurately recall their pretreatment HRQOL when asked several months or years later. This recall bias is constant throughout a period of 6 months to 3 years after surgery. By collecting data before treatment and observing subjects longitudinally, investigators can ensure that HRQOL chan ges are analyzed in the context of any impairment that may have been presen t at baseline. If a longitudinal study is not feasible, then greet caution must be used if patients are asked ta recall their Pretreatment HRQOL. (C) 1999 by American Society of Clinical Oncology.