Background: In recent years, due to various risk factors, the incidence, prevalence, and mortality rates of female lung cancer have been increasing in both China and globally. This has become a significant public health challenge worldwide. Lung cancer not only poses a severe threat to women's health but also places a heavy burden on families and society. Objective: To conduct an in-depth analysis of the trends in disease burden for female lung cancer in China and globally from 1990 to 2021 and to forecast the next 15 years (2022-2037). The aim is to provide a reliable theoretical basis and reference value for clinical research and practice in female lung cancer and offer guidance for resource allocation and policy-making in society. Methods: Based on the Global Burden of Disease (GBD) 2021 database, we analyzed the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of lung cancer in China and globally from 1990 to 2021. These metrics were stratified by gender (BOTH, MALE, FEMALE), and the average annual percentage change (AAPC) was calculated for each metric over this period. The JOINPOINT regression model was used to analyze the trends in female lung cancer in China and globally from 1990 to 2021. The ARIMA model was applied to forecast the changes in age-standardized incidence rates (ASIR) and age-standardized mortality rates (ASDR) for the next fifteen years (2022-2037) for female lung cancer in China and globally. Results: The results indicate an upward trend in incidence, prevalence, mortality, and DALYs for lung cancer in China. Globally, the prevalence of lung cancer showed an increasing trend, while the incidence, mortality, and DALYs demonstrated a declining trend. Both in China and globally, the incidence, prevalence, mortality, and DALY trends for female lung cancer were higher than those for males. From 1990 to 2021, the incidence, prevalence, mortality, and DALYs of female lung cancer in China exhibited an upward trend, with AAPC growth rates of 1.151%, 2.086%, 0.508%, and 0.210%, respectively. Similarly, globally, the incidence, prevalence, and mortality of female lung cancer also showed an upward trend, with growth rates of 0.576%, 1.123%, and 0.276%, respectively, while DALYs showed a slight decline with an AAPC of -0.029%. Conclusion: Although the overall disease burden of female lung cancer is not as high as that of males, the growth rate for female lung cancer is significantly higher than that for males both in China and globally. The overall disease burden and the growth rates of incidence and prevalence of female lung cancer in China are higher than the global average.

Objectives: Health-related quality-of-life (HRQoL) instruments for cardiovascular diseases (CVD) have been commonly used to measure important patient-reported outcomes (PROs) in clinical trials and practices. This study aimed at systematically identifying and assessing the content validity of CVD-specific HRQoL instruments in clinical studies. Methods: The research team searched Cumulative Index to Nursing and Allied Health Literature, Embase, and PubMed from inception to January 20, 2022. The research team included studies that reported the development and content validity for CVD-specific instruments. Two reviewers independently assessed the methodological quality using the Consensus-based Standards for the Selection of Health Measurement Instruments methods on evaluating content validity of PROs. Content analysis was used to categorize the items included in the instruments. Results: The research team found 69 studies reporting the content validity of 40 instruments specifically developed for CVD. Fourteen (35.0%) were rated "sufficient" with very low to moderate quality of evidence. For PRO development, all instruments were rated "doubtful" or "inadequate." Twenty-eight (70.0%) instruments cover the core concepts of HRQoL. Conclusions: The quality of development and content validity vary among existing CVD-specific instruments. The evidence on the content validity should be considered when choosing HRQoL instrument in CVD clinical studies and health economic evaluations.

Objectives: China Health -Related Outcomes Measures (CHROME) was an initiative aimed at developing a system of preference -based health -related quality of life instruments for China. CHROME -cardiovascular disease (CVD) is a CVD-specific instrument with 14 items developed under this initiative. This study aimed to test the psychometric properties of CHROME-CVD. Methods: This validation study was conducted using cross-sectional questionnaire survey in China. Eligible patients with CVD were recruited and asked to complete the CHROME-CVD, the EQ-5D-5L, and a CVD-specific nonpreference-based healthrelated quality of life instrument selected according to the confirmed diagnosis of the patients. Item evaluation, internal consistency, measurement invariance, test -retest reliability, structural validity, and construct validity were tested using classic test theory. Item response theory was used to evaluate item -level performance. Results: A total of 444 patients with CVD (coronary artery disease, n = 276, heart failure, n = 104, angina, n = 33, and atrial fibrillation, n =16) from 6 provinces in China were enrolled for the validation. Exploratory factor analysis identified 4 factors: chest pain, other symptoms, physical health, and mental and social health. Cronbach 's alpha and intraclass correlation coefficient were .0.8. A total of 20 of 26 (76.9%), and 90 of 95 (94.7%) predefined hypotheses were met for convergent and discriminant validities, respectively. No important difference was identified between subgroups of gender and residency. Response options of 10 items were found overlapped based on categorical response curves, which led to modification to 4 -level response options. Wording of 3 items were modified by referring wordings of reference instruments. Conclusion: The validation of the CHROME-CVD demonstrated generally good psychometric properties. Further validation on the modified CHROME-CVD is needed.