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International student mobility has been rising as a global phenomenon in the last few decades, while its impact could be various in different contexts. For the European Union (EU), studying in another EU member country could be regarded as an important factor for the solidarity and integrity of the Union. The current study elaborates on the role of studying abroad regarding the attitudes of people toward immigration in the EU. It shows that people who are studying in an EU member country, belonging to higher social classes and from EU15 countries, are more likely to have positive attitudes toward immigration. But after controlling several socio-demographic variables studying abroad still contributes positively to the attitudes of EU citizens toward immigration. Accordingly, current study provides promising pieces of evidence on the social contribution of studying abroad for both future research and policymakers.

The purpose of this study was to examine the studies related to augmented reality applications in sports science and to discuss the results based on this. Articles selected for analysis were found through searches journals in the Web of Science database from 1975 to 2018 were examined and searched using the keywords ("physical education" or "physical activity" or "sport$") and ("augmented reality"). As a result of the search, 44 articles were reached, and 11 articles were excluded from the research because they were not related to augmented reality applications or sports science. The publication classification form consists of the titles "Years, Authors Number, Country, Journals, Age, Sample Size, Variables, Sample Method, Research Method, Data Collection Method and Data Analysis Method." There are a limited number of studies where sports and augmented reality technology are used and interacted together. With the spread of the use of augmented reality and similar technologies in the field of sports sciences, it is thought that such fields as health and education will be positively affected.

Interest in higher education institutions (HEIs) as instruments for development has increased in recent years. The main objective of this paper is to address the contribution of HEIs to development through their missions, models, and challenges. With this purpose, we perform a historical analysis and characterise higher-education systems through the perspective of university models and missions, noticing relevant aspects regarding the evolution of this institution over time, as well as the transformations undergone. We also consider the main challenges that current higher education systems face in the 21st century. As methodological approaches, we carry out a literature review complemented by a comparative analysis based on data from the higher education systems of ten European countries. The findings show that HEIs can contribute to development through their missions, which are related to the models of higher education. Their first mission (teaching) contributes to improving human capital and attracting highly qualified people to their regions; the second mission (research) improves scientific knowledge which can foster innovative activities; and the third mission (community service) acts as a link between research and business, including patents, business incubators, and collaboration agreements. We also conclude that the challenges of higher education in the 21st century can be categorised essentially in three main areas: (1) globalisation and massification of higher education, as well as the internationalisation of HEIs' missions and diversification of the educational supply to attract new students; (2) new technologies related to the digitalisation of teaching and distance learning; and (3) higher education entrepreneurship, showing the importance of university-company relationships. This paper provides a global setting for a reflection on the role of HEIs in the 21st century, given their connection with society and the need for a more effective contribution to socio-economic development.

Several studies have been published on disengaged test respondents, and others have analyzed disengaged survey respondents separately. For many large-scale assessments, students answer questionnaire and test items in succession. This study examines the percentage of students who continuously engage in disengaged responding behaviors across sections in a low-stakes assessment. The effects on calculated scores of filtering students, based on their responding behaviors, are also analyzed. Data of this study came from the 2015 administration of PISA. For data analysis, frequencies and percentages of engaged students in the sessions were initially calculated using students' response times. To investigate the impact of filtering disengaged respondents on parameter estimation, three groups were created, namely engaged in both measures, engaged only in the test, and engaged only in the questionnaire. Next, several validity checks were performed on each group to verify the accuracy of the classifications and the impact of filtering student groups based on their responding behavior. The results indicate that students who are disengaged in tests tend to continue this behavior when responding to the questionnaire items in PISA. Moreover, the rate of continuity of disengaged responding is non-negligible as can be seen from the effect sizes. On the other hand, removing disengaged students in both measures led to higher or nearly the same performance ratings compared to the other groups. Researchers analyzing the dataset including achievement tests and survey items are recommended to review disengaged responses and filter out students who are continuously showing disengaged responding before performing further statistical analysis.

Globalisation and policy transfer in education make it incumbent upon decision makers to prioritise among competing policy options, select policy initiatives that are appropriate for their national contexts, and understand how system-specific factors moderate the relationship between those policies and student outcomes. This study used qualitative comparative analysis and correlational analyses to explore these relationships with publicly available data on socio-economic, cultural, and education conditions, and their association with PISA 2015 results in 49 countries. Findings show that gender and income equality, human development, and individualism were outcome-enabling conditions for PISA 2015 results, and gender equality was the most consistent of these conditions. These factors significantly moderated the relationships between education policy and PISA results. Implications for the identification of meaningful peer countries for comparative educational research, policy transfer, and the future expansion of PISA are discussed.

Seamless learning has a significance that has been increasing in recent years, and an increasing number of studies on the subject in the literature draws attention. This study aimed to examine the research on seamless learning between 1996 and 2020 with the bibliometric analysis method. The Scopus database was used in the collection of the data. After various screening processes, a total of 389 publications were included in the analysis. Descriptive analysis and bibliometric analysis were used in the analysis of the data. The distribution of publications by years, types of publications, sources, and languages were analyzed in the research. Additionally, visual maps were created with analyses of co-author, cocitation, and co-word. At the end of the study, it was seen that there has been an increase in the number of publications from the past to the present, articles and papers were predominant, and that most of the studies were carried out in English. As a result of bibliometric analysis, it was concluded that the most efficient countries in seamless learning were the United Kingdom, the United States, and Singapore. Also, it has been determined that the National Institute of Education, Center for International Education and Exchange, and Kyushu University institutions are dominant. The most frequently mentioned authors cited in studies in many different fields are M. Sharples, L.-H. Wong, and H. Ogata. According to the co-word analysis, the keywords seamless learning, mobile learning, ubiquitous learning, and mobile-assisted language learning stand out in the field of seamless learning.

This study explores the role of the welfare state in reducing young people not being in education, employment, or training (NEET)s across 15 European countries. Using data from the Survey of Adult Skills in the Program for the International Assessment of Adult Competencies (PIAAC) in combination with the Social Expenditure Database, we conducted cross-national analysis to reveal whether the increase in public social spending moderates the risk of being NEET at a young adult age, especially for socially disadvantaged young people. Our results highlighted that the rise of one percentage point of public social spending per gross domestic product, including social expenditure on education, active labor market, and unemployment, is significantly associated with decreasing the odds of being NEET. Furthermore, these social expenditures appeared to lower the NEET risk given socially disadvantaged backgrounds suggesting that young people with low educational levels, whose parents have low educational attainment levels, non-immigrant families, and females are likely to benefit given the robust social protection system. These findings suggest that public social spending may be an effective investment in promoting the social involvement of young people from socially disadvantaged background.

The use of the Internet among children and adolescents is now a norm in many parts of the world. As the Internet offers a wide range of benefits to these ones, so does it expose them to possible various risks and harm. Researchers in different countries across the world have engaged in the production of relevant research-based knowledge in order to make the virtual world a safe place for the younger ones. However, while studies have been carried out on the subject of Internet risk among children and adolescents, there is a dearth of information on the assessment of research activities across different parts of the world. The present study employed Bibliometric techniques to determine research productivity patterns across the different regions and countries of the world. All relevant publications indexed in Google Scholar were collected between November and December, 2018. The findings of the study reveal that while countries in the American and European regions of the world have been very productive in researching on the subject, the same is not the case with their African counterparts.

In this study, we investigated factors predictive of disconnection, or not being in education, employment, or training (NEET), among young adults with at least a 2-year college degree. We also explored the extent to which disconnection influences civic participation and well-being among NEETs with and without college degrees. The authors used 2012 and 2015 Organisation for Economic Co-operation and Development (OECD) data from the Survey of Adult Skills in the Program for the International Assessment of Adult Competencies (PIAAC) for 29 countries, including the United States, along with US 2012 data from the Education Longitudinal Study of 2002 (ELS:2002), collected by the National Center for Education Statistics (NCES). Results highlight that college-educated individuals whose parents have low levels of educational attainment actually have a higher likelihood of becoming NEET relative to college-educated individuals whose parents are more highly educated. Study findings also emphasize the influence of economic and geographic differences (country-level for OECD and county-level for United States) on NEET rates, in addition to the extent to which mothers have a higher likelihood and fathers have a lower likelihood of being NEET relative to their childless peers and the influence of country-level family leave policies on the odds of being NEET across the OECD. College field of study also emerges as an important influence on disconnection across the 29 OECD countries in the study, but not in the United States separately. Finally, comparing results for college-educated NEETs and NEETs without degrees, we found that higher education appears to reduce the likelihood of community disengagement and reports of poor health among NEETs across the OECD countries. However, this is not the case within the United States where NEETs are less likely to be engaged in their communities and more likely to describe themselves as in poor health regardless of their educational attainment.

The increasing availability of non-formal education in the form of Open Education Resources (OERs) and Massive Open Online Courses (MOOCs) gives rise to the questions of how such education can be formally recognized for credit. Prior Learning Assessment and Recognition (PLAR), and Qualification Frameworks are fields of practice actively engaged in and associated with the recognition of non-formal education (RNFE) and can provide guidance on RNFE for the recognition of OERs/MOOCs. A scoping exercise reviews the literatures from the three fields and associated practical exemplars. Findings suggest a growing demand for, growth in, and diversification of, the recognition of non-formal education. Synergies or creative combinations of expertise across the three fields that could be further exploited to gain maximum traction for RNFE are identified. These are multi-dimensional: top-down, bottom-up, sector to sector, country to country, qualification framework to qualification framework, system to system, field to field. There is ample evidence that the process of recognition, albeit demanding, "does" have a positive effect on the quality of the NFE, and by association, it is hoped, on the qualification status of individuals and their access to related social and economic benefits.

In this study, the variables having impact on the student motivation have been analyzed based on the articles, conference papers, master's theses and doctoral dissertations published in the years 2000-2017. A total of 165 research papers were selected for the research material and the data were collected through qualitative research techniques through document review and content analysis. According to the research results, the most important factors affecting student motivation are the fields of teacher, teachers' classroom management skills and their teaching methods. In this research, factors having less influence on the student motivation are parental communication, student characteristics and study fields. In addition, relational search type was used more than others, mostly students were selected as the study group and most researches were conducted in USA and Turkey.

We examine recent research across countries and cultures in regard to the issues related to the formation of gifted and talented education perspectives, policies, and practices. Many modern cultures and subcultures have developed formal and informal definitions of what it means to be gifted and talented, and when we compare the perceptions, policies, and practices across nations, we discover very different constructs of intelligence and ability. These understandings of giftedness and gifted and talented education can be grouped into four binary dimensions, scholarly versus co-curricular capabilities, aptitude versus achievement, nature versus nurture, and individualistic versus collective, that have significant implications for policy and practice. These constructs can serve as a foundation for countries that are looking to formalize or expand their gifted and talented education models or can be used to challenge the norms of established systems. We put forward recommendations to address some of the challenges in advancing gifted education cross-nationally, an area that is often assumed to introduce risks of enlarging social inequity. We also provide a cross-national matrix that captures known elements of gifted education policies and programs from over 20 subnational jurisdictions, countries, and world regions.

Introduction: The prevalence rates of bullying vary significantly across countries and continents. Specifically, UNESCO estimates that the prevalence rates vary from 22.8% (CentralAmerica) to 48.2% (Sub-Saharan Africa). Recently these differences among countries andregions have been attributed to culture- and country-level variables. Thus, the first purpose ofthis study is to examine the comparability of bullying in schools across countries. Secondly, across-cultural comparison of the latent mean scores of bullying is implemented. Method: The data of 286,481 adolescent students (M=15.78, SD=0.29) from 32 countrieswere analyzed using multilevel confirmatory factor analyses (MLCFA) and multigroup factoralignment. Results: Results indicated that the meaning of bullying is equivalent within and between cultures. However, cross-cultural differences in bullying are apparent. East Asian countries havethe lowest latent means of bullying, while Southeast Asian countries have the highest means.Anglo-Saxon, Eastern European, Mediterranean, South American, and Middle East countriesdisplayed rather higher scores. Discussion and Conclusion: These findings underscore the existence of cross-cultural differential responding in bullying measures. Further, the implicit role of culture as an importantvariable that determines the rates of bullying is underscored.

This article maps the scientific production and the contents associated with the sustainable development goals and their integration with universities during the past 21 years. Although many of the topics related to sustainable development goals (SDGs) have been addressed in different studies for decades, it is since 2015 onwards that they gained greater prominence due to the inclusion of higher education as an important actor in the fulfillment of the 2030 agenda and the United Nations SDGs. For the purpose of this paper, a bibliometric analysis of 871 papers, 535 documents in Scopus, and 336 in Web of Science (WoS) from 1998 to 2019 was performed, and the Bibliometrix analysis tool was used. The objective of this mapping is to answer the following research question: Is the integration of the Sustainable Development Goals and Universities a field of study? An analysis of the network of collaborators and trend topics in Scopus and WoS allows us to identify the concurrence and relationships of some keywords, such as sustainable development, sustainability and planning, and some background words, such as humans and global health. In another analysis, the word "higher education" is related to change. This article suggests that the integration of the Sustainable Development Goals in Universities is becoming a field of study under exploration, with a peak of production in 2016 and that has remained stable in the last three years, but thanks to the leading role assigned to Universities, intellectual production should increase in the following years.

This article analyzes the UK's first "read and publish" journals agreement. The Springer Compact Agreement pilot ran from 2016 to 2018. The authors outline the methodology and data sources used to undertake a detailed analysis of the agreement. This includes the number of open access articles published, the number of author opt-outs and rejected articles. Institutional savings (or cost avoidance), and the financial implications resulting from the number of opt-outs and rejected articles are also discussed. The value of articles published and cost per download for non-OA content are also covered. The agreement, at the consortia level, has constrained the total cost of publication--during the three years, the HE sector has avoided paying additional costs of €20,000,800 ($22,761,688) for publishing OA by paying the single combined fee that capped publication costs at 2014 rates. All institutions taking part in the Springer Compact agreement published OA articles equivalent to or in excess of their total 2014 APC spend between 2016 and 2018. By 2018, 30 percent of institutions published OA articles to the value of or in excess of the combined fee paid to Springer. The article concludes with a number of recommendations for future agreements and considers compliance with Plan S guidelines.

International businesses face a difficult task when trying to decide where to place or expand a business that could be located anywhere in the world. Each country is a complex system of human capabilities, technical systems, [infrastructure bases, laws, cultures and economic systems. How can a company know which country is best for it today, and even more importantly, which country will grow into an appropriate location for future business opportunities? Several studies offer insights into how to make site selection decisions (O'Farrell & Wood, 1994; Papadopoulos et al., 2002; Rothaermel et al., 2006) but the complexity of the data required makes initial analysis across many countries problematic. Most businesses, trying to predict an ideal country or sequence of countries to enter, are left to simple rules of thumb or decision models using limited criteria (Górecka & Szalucka, 2013; Alexander et al., 2011). A wide variety of country data of varying reliability and efficacy are frequently used (Rahman, 2003). Many of the largest companies have developed specialized teams with sophisticated models for site selection. However, for smaller companies finding reliable, consistently measured data they can interpret and analyze in ways that provide useful insights is a challenge. This article introduces the Social Progress Index, launched in April 2013 at the 10th annual Skoll World Forum held at the University of Oxford (The Origins, 2015). The Social Progress Index is unique because it is the most comprehensive framework developed for measuring social progress and the first to measure social progress independently of GDP or other economic variables (Porter, 2015; Keohane, 2015). Three cases have been chosen to demonstrate the usefulness of the Social Progress Index for site selection in three very different circumstances.

In this paper, I examine whether generalized trust and education, as well as social security policies of welfare state institutions matter for cross-national differences in subjective well-being (SWB), because knowledge on this issue is still lacking. For this purpose I integrated the insights of two sociological theories: Social Function Production theory and Actor-Centred Institutionalism. Based on these theoretical notions we derived several hypotheses, which I tested using multilevel analysis of the data from the European Social Survey (2006), in a sample of 37,237 respondents from 22 European countries. My findings indicate that various extensiveness of social security policies matter for the level of SWB, and for the impact of education on SWB. I found negative impact of low education on SWB in all countries, except in Northern and Western European countries. This might suggest that social security policies of the latter countries have diminished the negative impact of low education on SWB. Moreover, my findings indicate positive relationship between individual education and generalized trust; as well as between generalized trust and SWB in countries with all five types of social security policies.

What is the significance of regulations of job contracts and wages when it comes to young people's access to labour market? This is an issue that has attracted and continues to attract a great deal of interest in both research and politics. Proposals for deregulated employment protection and reduced entry-level pay recur regularly in public debate. In our view it is incomprehensible how sectors of the labour market that are dominated by jobs with low productivity and unstable employment conditions could be expected to offer a permanent solution for the large group of young people who are currently finding it difficult to enter the labour market and reach an acceptable standard of living. Instead, the responses to the challenges facing young people in the labour market could involve training in the form of apprenticeships rather than more insecure jobs and/or lower pay. Essentially, our starting point is that apprenticeship training could provide a more accurate response to the challenges facing young people in working life. This response would not involve the costs in terms of increased social polarisation and increased social risks that may follow in the wake of an increasingly deregulated labour market.

The academic profession has been long recognized as a pivotal source of belief and identity alongside the discipline and the institution of belonging. However, the ways in which academics as a professional group organize themselves towards common objectives that possibly transcend systems, institutions and disciplines, has not been explored so far. Therefore, the goal of this article is investigate how academics organize themselves in the pursuit of their professional, scientific and scholarly interests outside the university setting and across national higher education systems. We address this question by studying European academic associations. Drawing from World Polity Theory, studies on Professions and Professionalism, as well as on Interest Groups, we derive expectations as to the growth in number of academic associations and their aims. Based on the analysis of 324 associations, our findings show that assuming that the founding of academic associations is related primarily to the emergence or presence of international organizations needs to be revisited, as foundations appear to be affected by other contingent events as well. As to their aims, there is more variety than usually posited and five types of academic associations can be identified. We discuss the implications of on-going European integration in higher education and research from theory and policy perspectives.

Background: Data from the Programme for the International Assessment of Adult Competencies (PIAAC) revealed that countries systematically differ in their respondents' literacy, numeracy, and problem solving in technology-rich environments skills; skill levels also vary by gender, age, level of education or migration background. Similarly, systematic differences have been documented with respect to adults' participation in education, which can be considered as a means to develop and maintain skills. From a psychological perspective, motivation to learn is considered a key factor associated with both skill development and participation in (further) education. In order to account for motivation when analyzing PIAAC data, four items from the PIAAC background questionnaire were recently compiled into a motivation-to-learn scale. This scale has been found to be invariant (i.e., showing full weak and partial strong measurement invariance) across 21 countries. Methods: This paper presents further analyses using multiple-group graded response models to scrutinize the validity of the motivation-to-learn scale for group comparisons. Results: Results indicate at least partial strong measurement invariance across gender, age groups, level of education, and migration background in most countries under study (all CFI > 0.95, all RMSEA < 0.08). Thus, the scale is suitable for comparing both means and associations across these groups. Conclusions:Results are discussed in light of country characteristics, challenges of measurement invariance testing, and potential future research using PIAAC data.

This article reports an analysis of the relationship between women's increased participation in higher education and other recent social changes over the last four decades. To date, women's increased involvement in higher education has been studied as either a force for or a consequence of other sociocultural changes. Drawing on data from key international data sets and with a focus on a range of Organisation for Economic Co-Operation and Development (OECD) countries, this article details an exploratory factor analysis of women's higher education participation and a range of other variables identified as indicators of or mediators for social change. This analysis reveals the existence of four underlying factors showing the structural interrelationship between the variables.

The old myth about the ability and variability of potential in children is a comforting myth, for those who are uneasy with the degree of inequality they see and would rather seek to justify it than confront it. The myth of inherent potential helps some explain to themselves why they are privileged. Extend the myth to believe in inherited ability and some can come to believe that their children will inherit part of a greater potential. These beliefs create and sustain inequality in society and allow for the creation of levels of ignorance in populations. This article uses insights from social geography and the sociology of education to examine how the myths are sustained past and present. It notes that countries with the highest degree of income inequality and the most unequal education systems have the worst outcomes for young adults, and these are the countries in which eugenic notions of inherited ability are resurfacing.

This article focuses on analysing the effect of educational differentiation policies of OECD educational systems on socioeconomically disadvantaged students, based on data from PISA 2009. The analysis is conducted on the basis of a definition of two subgroups of disadvantaged students: those that achieve high scores, and those obtaining scores that are significantly below the average for their country. Educational systems are classified in four models following the classification proposed by N. Mons. Results show that the more integrated the educational system, the greater the number of disadvantaged high achievers, and the lower the number of disadvantaged low achievers.

Background To stop the spread of the new coronavirus disease in 2019 (COVID-19), many countries had completely locked down. This lockdown restricted the everyday life of the affected residents and changed their mobility pattern, but its effects on sleep pattern were largely unknown. Methods Here, utilizing one of the largest crowdsourced database (Sleep as Android), we analyzed the sleep pattern of 25 217 users with 1 352 513 sleep records between 1 January and 29 April 2020 in the US and 16 European countries (Germany, UK, Spain, France, Italy, The Netherlands, Belgium, Hungary, Denmark, Finland, Norway, Czech, Sweden, Austria, Poland and Switzerland) with more than 100 records in all days of 2020. Results During the COVID-19 pandemic, the sleeping pattern before and after the country-level lockdown largely differed. The subjects increased their sleep duration by an average of 11.3 to 18.6 min on weekday nights, except Denmark (4.9 min) and Finland (7.1 min). In addition, subjects form all 16 European countries delayed their sleep onset from 10.7 min (Sweden) to 29.6 min (Austria). Conclusion During the COVID-19 pandemic, residents in the US and 16 European countries delayed their bedtime and slept longer than usual. [ABSTRACT FROM AUTHOR]

Eating out has been linked to the current obesity epidemic, but the evaluation of the extent to which out of home (OH) dietary intakes are different from those at home (AH) is limited. Data collected among 8849 men and 14 277 women aged 35-64 years from the general population of eleven European countries through 24-h dietary recalls or food diaries were analysed to: (1) compare food consumption OH to those AH; (2) describe the characteristics of substantial OH eaters, defined as those who consumed 25% or more of their total daily energy intake at OH locations. Logistic regression models were fit to identify personal characteristics associated with eating out. In both sexes, beverages, sugar, desserts, sweet and savoury bakery products were consumed more OH than AH. In some countries, men reported higher intakes of fish OH than AH. Overall, substantial OH eating was more common among men, the younger and the more educated participants, but was weakly associated with total energy intake. The substantial OH eaters reported similar dietary intakes OH and AH. Individuals who were not identified as substantial OH eaters reported consuming proportionally higher quantities of sweet and savoury bakery products, soft drinks, juices and other non-alcoholic beverages OH than AH. The OH intakes were different from the AH ones, only among individuals who reported a relatively small contribution of OH eating to their daily intakes and this may partly explain the inconsistent findings relating eating out to the current obesity epidemic. [ABSTRACT FROM AUTHOR]

Background: Venous thromboembolism (VTE, including deep vein thrombosis [DVT] and pulmonary embolism [PE]) has an annual incidence rate of 104–183 per 100,000 person-years. After a VTE episode, the two-year recurrence rate is about 17%. Consequently, effective and safe anticoagulation is paramount. Edoxaban is a direct oral anticoagulant (DOAC) approved VTE treatment. Current safety and efficacy data are derived from clinical trials, and information about treatment durations beyond 12 months are not available. Methods: ETNA-VTE-Europe is an 18-month prospective, single-arm, non-interventional, multinational post-authorisation safety study. Approximately 310 sites across eight European countries (Austria, Belgium, Germany, Ireland, Italy, the Netherlands, Switzerland and the United Kingdom) will participate in the study, with the intention to represent the regional distributions of centres, healthcare settings and specialties. An estimated cohort of 2700 patients will be recruited, the only enrolment criteria being acute symptomatic VTE, no participation in an interventional study, and treating physician decision to prescribe edoxaban independently from the registry. Data from patient medical records and/or telephone interviews will be collected at baseline, 1, 3, 6, 12 and 18 months. The primary objective is to evaluate the 18-month rate of symptomatic VTE recurrence in patients with VTE treated with edoxaban outside a clinical trial. The co-primary objective is to evaluate the real-world rates of bleeding and adverse drug reactions. Secondary outcomes include rates of other patient-relevant safety events, adherence to and discontinuation of edoxaban. Furthermore, 12-month ETNA-VTE-Europe data will be considered in the context of those for patients receiving different anticoagulants in the PREFER in VTE registry and Hokusai-VTE clinical trial. Conclusions: ETNA-VTE-Europe will allow the safety and effectiveness of edoxaban to be evaluated over an extended period in acute symptomatic VTE patients encountered in routine clinical practice. Findings will be informative for European practitioners prescribing edoxaban as part of real-world VTE treatment/prevention. Trial registration: ClinicalTrials.gov Identifier: NCT02943993. [ABSTRACT FROM AUTHOR]

Background: The EORTC QLQ-C30 is one of the most widely used quality of life questionnaires in cancer research. Availability of thresholds for clinical importance for the individual questionnaire domains could help to increase its interpretability. The aim of our study was to identify thresholds for clinical importance for four EORTC QLQ-C30 scales: Physical Functioning (PF), Emotional Functioning (EF), Pain (PA) and Fatigue (FA)., Methods: We recruited adult cancer patients from Austria, the Netherlands, Poland and the UK. No restrictions were placed on diagnosis or type or stage of treatment. Patients completed the QLQ-C30 and three anchor items reflecting potential attributes of clinically important levels of PF, EF, PA and FA. We merged the anchor items assessing perceived burden, limitations in daily activities and need for help into a dichotomous external criterion to estimate thresholds for clinical importance using Receiver Operator Characteristic (ROC) analysis., Results: In our sample of 548 cancer patients (mean age 60.6 years; 54 % female), the QLQ-C30 scales showed high diagnostic accuracy in identifying patients reporting burden, limitations and/or need for help related to PF, EF, PA and FA. All areas under the curve were above 0.86., Conclusions: We were able to estimate thresholds for clinical importance for four QLQ-C30 scales. When used in daily clinical practice, these thresholds can help to identify patients with clinically important problems requiring further exploration and possibly intervention by health care professionals.