1
|
Huang D, Peng J, Chen N, Yang Q, Jiang L. Mapping study of papillary thyroid carcinoma in China: Predicting EQ-5D-5L utility values from FACT-H&N. Front Public Health 2023; 11:1076879. [PMID: 36908441 PMCID: PMC9998072 DOI: 10.3389/fpubh.2023.1076879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/02/2023] [Indexed: 02/25/2023] Open
Abstract
Objective To develop a mapping algorithm that can be used to predict EQ-5D-5L health utility scores from FACT-H&N and obtain health utility parameters for Chinese patients with papillary thyroid carcinoma (PTC), which can be used for cost-utility analysis in health economic. Methods A total of 1,050 patients with PTC from a tertiary hospital in China were included, and they completed FACT-H&N and EQ-5D-5L. Four mapping algorithms of direct mapping functions were used to derive the models: Ordinary least squares (OLS), Tobit model (Tobit), Two-part model (TPM), and Beta mixture regression model (Beta). The goodness-of-fit of models was assessed by the mean absolute error (MAE), root mean square error (RMSE), Akaike information criteria (AIC), Bayesian information criteria (BIC), and absolute error (AE). A fivefold cross-validation method was used to test the stability of the models. Results The mean utility value of the EQ-5D-5L was 0.870 ± 0.094. The mean EQ-VAS score was 76.5 ± 13.0. The Beta mixture regression model mapping FACT-H&N to EQ-5D-5L achieved the best performance [fivefold cross-validation MAE = 0.04612, RMSE = 0.06829, AIC = -2480.538, BIC = -2381.137, AE > 0.05 (%) = 32.48, AE > 0.1 (%) = 8.95]. The independent variables in this model were Physical Well-Being (PWB), Emotional Well-Being (EWB), Head & Neck Cancer Subscale (HNCS) scores and its square term and interaction term scores. Conclusions This study calculated the health utility score of Chinese patients with PTC. The reported algorithms can be used to map the FACT-H&N into the EQ-5D-5L, which can be applied in the cost-utility related study of patients with PTC.
Collapse
Affiliation(s)
- Deyu Huang
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Jialing Peng
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Na Chen
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Qing Yang
- Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Longlin Jiang
- Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
2
|
Song R, Jeet V, Sharma R, Hoyle M, Parkinson B. Cost-Effectiveness Analysis of Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography/Computed Tomography (PET/CT) for the Primary Staging of Prostate Cancer in Australia. PHARMACOECONOMICS 2022; 40:807-821. [PMID: 35761117 PMCID: PMC9300561 DOI: 10.1007/s40273-022-01156-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 05/28/2023]
Abstract
BACKGROUND AND OBJECTIVES Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) combined with computed tomography (CT) is a new imaging modality to detect the extra-prostatic spread of prostate cancer. PSMA PET/CT has a higher sensitivity and specificity than conventional imaging (CT ± whole body bone scan [WBBS]). This study conducted a cost-utility analysis of PSMA PET/CT compared with conventional imaging for patients with newly diagnosed, intermediate-risk or high-risk primary prostate cancer. PERSPECTIVE Australian healthcare perspective. SETTING Tertiary. METHODS A decision-analytic Markov model combined data from a variety of sources. The time horizon was 35 years. The sensitivity and specificity of PSMA PET/CT and CT alone were based on meta-analyses and the test accuracy of CT+WBBS was based on a single randomised controlled trial. Health outcomes included cases detected, life-years, and quality-adjusted life-years. Costs related to other diagnostic tests, initial treatment, adverse events, and post-disease progression were included. All costs were reported in 2021 Australian Dollars (A$). RESULTS The deterministic incremental cost-effectiveness ratio of PSMA PET/CT was estimated to be A $21,147/quality-adjusted life-year gained versus CT+WBBS, and A$36,231/quality-adjusted life-year gained versus CT alone. The results were most sensitive to the time horizon, and the initial treatments received by patients diagnosed with metastatic cancer. The probability of PSMA PET/CT being cost effective was estimated to be 91% versus CT+WBBS and 89% versus CT alone, using a threshold of AU$50,000/quality-adjusted life-year gained. CONCLUSIONS PSMA PET/CT is likely to be more costly than CT+WBBS or CT alone in Australia; however, it is still likely to be considered cost effective compared with conventional imaging.
Collapse
Affiliation(s)
- Rachel Song
- Macquarie University Centre for the Health Economy, Macquarie University, Level 1, 3 Innovation Road, Sydney, NSW, 2109, Australia
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Varinder Jeet
- Macquarie University Centre for the Health Economy, Macquarie University, Level 1, 3 Innovation Road, Sydney, NSW, 2109, Australia
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Rajan Sharma
- Macquarie University Centre for the Health Economy, Macquarie University, Level 1, 3 Innovation Road, Sydney, NSW, 2109, Australia
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Martin Hoyle
- Macquarie University Centre for the Health Economy, Macquarie University, Level 1, 3 Innovation Road, Sydney, NSW, 2109, Australia
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia
| | - Bonny Parkinson
- Macquarie University Centre for the Health Economy, Macquarie University, Level 1, 3 Innovation Road, Sydney, NSW, 2109, Australia.
- Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia.
| |
Collapse
|
3
|
He Z, Liang W, Xu W, Huang W, Wang X, Huang K, Yang L. Mapping the FACT-G to EQ-5D-3L utility index in cancer with the Chinese values set. Expert Rev Pharmacoecon Outcomes Res 2022; 22:1103-1116. [PMID: 35711123 DOI: 10.1080/14737167.2022.2091546] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The purpose of this research was to create a function for mapping the cancer-specific instrument (FACT-G) to a preference-based measure (EQ-5D-3L) utility index for health-related quality of life, with utility scores generated using the Chinese value set. METHOD A cross-sectional study among 243 Chinese patients with cancer was conducted through EQ-5D-3L and FACT-G questionnaires survey. The EQ-5D-3L utility index values wad predicted based on OLS, GLM, CLAD, and Tobit model regression approaches. The performance and predictive power of each model were also evaluated using r2 and adj- r2, MAE, RMSE, ICC, and MID. Linear equating was used to avoid regression of the OLS model to mean. The model was validated using a 10-fold cross-validation method. RESULTS Among all regression models for the FACT-G, the OLS 5 model predicted mean EQ-5D-3L values the best, in terms of model goodness of fit (r2= 0.6230, r2= 58.93%, MAE = 0.0448, RMSE = 0.0624). The OLS model proved to be the most accurate for the mean, and the linear equating scores were much closer to observed scores. CONCLUSION Our results suggest that the best algorithm for FACT-G mapping to EQ-5D-3L utility index is OLS model, based on the survey of Chinese patients with cancer.
Collapse
Affiliation(s)
- ZhiKui He
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
| | - WenJie Liang
- Department of Social Medicine, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
| | - WenJia Xu
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
| | - WenXiu Huang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
| | - XiaoMin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
| | - KaiYong Huang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
| | - Li Yang
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, Guangxi Province, P.R. China
| |
Collapse
|
4
|
Kretschmer A, van den Bergh RCN, Martini A, Marra G, Valerio M, Tsaur I, Heidegger I, Kasivisvanathan V, Kesch C, Preisser F, Fankhauser CD, Zattoni F, Ceci F, Olivier J, Chiu P, Puche-Sanz I, Thibault C, Gandaglia G, Tilki D. Assessment of Health-Related Quality of Life in Patients with Advanced Prostate Cancer-Current State and Future Perspectives. Cancers (Basel) 2021; 14:cancers14010147. [PMID: 35008310 PMCID: PMC8749907 DOI: 10.3390/cancers14010147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/22/2021] [Accepted: 12/25/2021] [Indexed: 11/25/2022] Open
Abstract
Simple Summary In recent years, evidence regarding survival outcomes of novel therapies has increased significantly. However, less is known regarding the impact of novel therapy combinations on quality of life aspects of the treated patients. In the current comprehensive review, we discuss the importance of quality of life for patients with advanced prostate cancer, and present the most frequently used tools to evaluate quality of life in recent randomized trials. Further, we discuss the ease of use of these validated questionnaires for clinicians and try to focus on the suggested appropriate use as well as potential strategies for improvement of quality of life evaluation in these clinical scenarios of advanced prostate cancer. Abstract With the therapeutic landscape of advanced prostate cancer rapidly evolving and oncological benefits being shown for a plethora of new agents and indications, health-related quality of life (HRQOL)-associated evidence is still subpar. In the current comprehensive review, we discuss the importance of HRQOL for patients with advanced PC (metastatic hormone-sensitive prostate cancer (mHSPC), metastatic castration-resistant prostate cancer (mCRPC) and non-metastatic castration-resistant prostate cancer (nmCRPC)), and present the most frequently used tools to evaluate HRQOL in recent randomized trials. Furthermore, we discuss the ease of use of these validated questionnaires for clinicians and try to focus on the suggested appropriate use in clinical practice, as well as potential strategies for improvement of HRQOL evaluation in these clinical scenarios of advanced prostate cancer.
Collapse
Affiliation(s)
- Alexander Kretschmer
- Department of Urology, Ludwig-Maximilians University, 81377 Munich, Germany
- Correspondence: ; Tel.: +49-89440076531
| | | | - Alberto Martini
- Unit of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (A.M.); (G.G.)
| | - Giancarlo Marra
- Department of Urology, San Giovanni Battista Hospital, University of Torino, 10126 Torino, Italy;
| | - Massimo Valerio
- Department of Urology, CHUV Lausanne, 1011 Lausanne, Switzerland;
| | - Igor Tsaur
- Department of Urology and Pediatric Urology, Mainz University Medicine, 55131 Mainz, Germany;
| | - Isabel Heidegger
- Department of Urology, Medical University Innsbruck, 6020 Innsbruck, Austria;
| | - Veeru Kasivisvanathan
- Division of Surgery and Interventional Science, University College London, London W1W 7TY, UK;
| | - Claudia Kesch
- Department of Urology, University Hospital Essen, 45147 Essen, Germany;
| | - Felix Preisser
- Department of Urology, University Hospital Frankfurt, 60590 Frankfurt, Germany;
| | | | - Fabio Zattoni
- Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padua, Italy;
- Urology Unit, Academical Medical Centre Hospital, 33100 Udine, Italy
| | - Francesco Ceci
- Division of Nuclear Medicine, IEO European Institute of Oncology, 20141 Milan, Italy;
| | - Jonathan Olivier
- Department of Urology, Lille University Hospital, 59000 Lille, France;
| | - Peter Chiu
- SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China;
| | - Ignacio Puche-Sanz
- Department of Urology, Bio-Health Research Institute, Hospital Universitario Virgen de las Nieves, University of Granada, 18014 Granada, Spain;
| | - Constance Thibault
- Department of Medical Oncology, European Georges Pompidou Hospital, Assistance Publique des Hôpitaux de Paris, Paris Descartes University, 75004 Paris, France;
| | - Giorgio Gandaglia
- Unit of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (A.M.); (G.G.)
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
- Department of Urology, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany
- Department of Urology, Koc University Hospital, 34010 Istanbul, Turkey
| | | |
Collapse
|
5
|
Degeling K, Corcoran NM, Pereira-Salgado A, Hamid AA, Siva S, IJzerman MJ. Lifetime Health and Economic Outcomes of Active Surveillance, Radical Prostatectomy, and Radiotherapy for Favorable-Risk Localized Prostate Cancer. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1737-1745. [PMID: 34838271 DOI: 10.1016/j.jval.2021.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/18/2021] [Accepted: 06/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To estimate the lifetime health and economic outcomes of selecting active surveillance (AS), radical prostatectomy (RP), or radiation therapy (RT) as initial management for low- or favorable-risk localized prostate cancer. METHODS A discrete-event simulation model was developed using evidence from published randomized trials. Health outcomes were measured in life-years and quality-adjusted life-years (QALYs). Costs were included from a public payer perspective in Australian dollars. Outcomes were discounted at 5% over a lifetime horizon. Probabilistic and scenario analyses quantified parameter and structural uncertainty. RESULTS A total of 60% of patients in the AS arm eventually received radical treatment (surgery or radiotherapy) compared with 90% for RP and 91% for RT. Although AS resulted in fewer treatment-related complications, it led to increased clinical progression (AS 40.7%, RP 17.6%, RT 19.9%) and metastatic disease (AS 13.4%, RP 6.1%, RT 7.0%). QALYs were 10.88 for AS, 11.10 for RP, and 11.13 for RT. Total costs were A$17 912 for AS, A$15 609 for RP, and A$15 118 for RT. At a willingness to pay of A$20 000/QALY, RT had a 61.4% chance of being cost-effective compared to 38.5% for RP and 0.1% for AS. CONCLUSIONS Although AS resulted in fewer and delayed treatment-related complications, it was not found to be a cost-effective strategy for favorable-risk localized prostate cancer over a lifetime horizon because of an increase in the number of patients developing metastatic disease. RT was the dominant strategy yielding higher QALYs at lower cost although differences compared with RP were small.
Collapse
Affiliation(s)
- Koen Degeling
- Cancer Health Services Research, Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia; Cancer Health Services Research, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
| | - Niall M Corcoran
- Department of Surgery, The University of Melbourne, Melbourne, Australia; Department of Urology, Frankston Hospital, Frankston, Australia; Division of Urology, Royal Melbourne Hospital, Melbourne, Australia
| | - Amanda Pereira-Salgado
- Cancer Health Services Research, Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia; Cancer Health Services Research, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Anis A Hamid
- Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Shankar Siva
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia; Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Maarten J IJzerman
- Cancer Health Services Research, Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia; Cancer Health Services Research, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia; Department of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| |
Collapse
|
6
|
Zamora V, Garin O, Pardo Y, Pont À, Gutiérrez C, Cabrera P, Gómez-Veiga F, Pijoan JI, Litwin MS, Ferrer M. Mapping the Patient-Oriented Prostate Utility Scale From the Expanded Prostate Cancer Index Composite and the Short-Form Health Surveys. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1676-1685. [PMID: 34711369 DOI: 10.1016/j.jval.2021.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 03/01/2021] [Accepted: 03/29/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study aimed to develop mapping algorithms from the Expanded Prostate Cancer Index Composite (EPIC) and the Short-Form (SF) Health Surveys to the Patient-Oriented Prostate Utility Scale (PORPUS), an econometric instrument specifically developed for patients with prostate cancer. METHODS Data were drawn from 2 cohorts concurrently administering PORPUS, EPIC-50, and SF-36v2. The development cohort included patients who had received a diagnosis of localized or locally advanced prostate cancer from 2017 to 2019. The validation cohort included men who had received a diagnosis of localized prostate cancer from 2014 to 2016. Linear regression models were constructed with ln(1 - PORPUS utility) as the dependent variable and scores from the original and brief versions of the EPIC and SF as independent variables. The predictive capacity of mapping models constructed with all possible combinations of these 2 instruments was assessed through the proportion of variance explained (R2) and the agreement between predicted and observed values. Validation was based on the comparison between estimated and observed utility values in the validation cohort. RESULTS Models constructed with EPIC-50 with and without SF yielded the highest predictive capacity (R2 = 0.884, 0.871, and 0.842) in comparison with models constructed with EPIC-26 (R2 = 0.844, 0.827, and 0.776). The intraclass correlation coefficient was excellent in the 4 models (>0.9) with EPIC and SF. In the validation cohort, predicted PORPUS utilities were slightly higher than those observed, but differences were not statistically significant. CONCLUSIONS Mapping algorithms from both the original and the abbreviated versions of the EPIC and the SF Health Surveys allow estimating PORPUS utilities for economic evaluations with cost-utility analyses in patients with prostate cancer.
Collapse
Affiliation(s)
- Víctor Zamora
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
| | - Olatz Garin
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain; Universitat Pompeu Fabra, Barcelona, Spain.
| | - Yolanda Pardo
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
| | - Àngels Pont
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
| | | | - Patricia Cabrera
- Department of Radiation Oncology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Francisco Gómez-Veiga
- Complejo Hospitalario Universitario de Salamanca, Grupo de Investigación Translacional de Urología, Instituto de Investigación de Salamanca, Salamanca, Spain
| | - José Ignacio Pijoan
- CIBER en Epidemiología y Salud Pública, CIBERESP, Spain; Department of Clinical Epidemiology, Hospital Universitario de Cruces, Barakaldo, Vizcaya, Spain
| | - Mark S Litwin
- Schools of Medicine, Public Health and Nursing, University of California, Los Angeles, CA, USA
| | - Montse Ferrer
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
| |
Collapse
|
7
|
Ghijben P, Petrie D, Zavarsek S, Chen G, Lancsar E. Healthcare Funding Decisions and Real-World Benefits: Reducing Bias by Matching Untreated Patients. PHARMACOECONOMICS 2021; 39:741-756. [PMID: 33834425 DOI: 10.1007/s40273-021-01020-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
Governments and health insurers often make funding decisions based on health gains from randomised controlled trials. These decisions are inherently uncertain because health gains in trials may not translate to practice owing to differences in the population, treatment use and setting. Post-market analysis of real-world data can provide additional evidence but estimates from standard matching methods may be biased when unobserved characteristics explain whether a patient is treated and their outcomes. We propose a new untreated matching approach that can reduce this bias. Our approach utilises the outcomes of contemporaneous untreated patients to improve the matching of treated and historical control patients. We assess the performance of this new approach compared to standard matching using a simulation study and demonstrate the steps required using a funding decision for prostate cancer treatments in Australia. Our simulation study shows that our new matching approach eliminates nearly all bias when unobserved treatment selection is related to outcomes, and outperforms standard matching in most scenarios. In our empirical example, standard matching overestimated survival by 15% (95% confidence interval 2-34) compared to our untreated matching approach. The health gains estimated using our approach were slightly lower than expected based on the trial evidence, but we also found evidence that in practice prescribers ceased prior therapies earlier, treated a more vulnerable population and continued treatment for longer. Our untreated matching approach offers researchers a new tool for reducing uncertainty in healthcare funding decisions using real-world data.
Collapse
Affiliation(s)
- Peter Ghijben
- Centre for Health Economics, Monash Business School, Monash University, Caulfield East, VIC, Australia.
| | - Dennis Petrie
- Centre for Health Economics, Monash Business School, Monash University, Caulfield East, VIC, Australia
| | - Silva Zavarsek
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, VIC, Australia
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Caulfield East, VIC, Australia
| | - Emily Lancsar
- Department of Health Services Research and Policy, College of Health and Medicine, The Australian National University, Acton, ACT, Australia
| |
Collapse
|
8
|
Procopio G, Chiuri VE, Giordano M, Mantini G, Maisano R, Bordonaro R, Calvani N, Facchini G, De Placido S, Airoldi M, Sbrana A, Gasparro D, Ludovico GM, Guglielmini P, Naglieri E, Fagnani D, Aglietta M, Schips L, Beccaglia P, Sciarra A, Livi L, Santini D. Effectiveness of abiraterone acetate plus prednisone in chemotherapy-naïve patients with metastatic castration-resistant prostate cancer in a large prospective real-world cohort: the ABItude study. Ther Adv Med Oncol 2020; 12:1758835920968725. [PMID: 33193831 PMCID: PMC7604981 DOI: 10.1177/1758835920968725] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 10/02/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Real-world data on chemotherapy-naïve patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone plus prednisone are limited, largely deriving from small retrospective studies. Methods: ABitude is an Italian, observational, prospective, multicenter study of mCRPC patients receiving abiraterone plus prednisone in clinical practice. Chemotherapy-naïve mCRPC patients were consecutively enrolled at abiraterone start (February 2016 to June 2017) and are being followed for 3 years, with evaluation approximately every 6 months. Several clinical and patients reported outcomes were examined. Results: In this second interim analysis, among 481 enrolled patients, 453 were evaluable for analyses. At baseline, the median age was 77 years and ~69% of patients had comorbidities (mainly cardiovascular diseases). Metastases were located mainly at bones and lymph nodes; 8.4% of patients had visceral metastases. During a median follow-up of 18 months, 1- and 2-year probability of radiographic progression-free survival were 73.9% and 56.2%, respectively; the corresponding rates for overall survival were 87.3% and 70.4%. In multivariable analyses, the number of bone metastases significantly affected radiographic progression-free survival and overall survival. During abiraterone plus prednisone treatment, 65% of patients had a ⩾50% prostate-specific antigen decline, and quality of life remained appreciably high. Among symptomatic patients according to the Brief Pain Inventory) (32%), scores significantly declined after 6 months of treatment. Overall, eight patients (1.7%) had serious adverse reactions to abiraterone. Conclusions: Abiraterone plus prednisone is effective and safe for chemotherapy-naïve mCRPC patients in clinical practice.
Collapse
Affiliation(s)
- Giuseppe Procopio
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, Milan, 20133, Italy
| | | | - Monica Giordano
- Medical Oncology Division, ASST-Lariana, Como, Lombardia, Italy
| | - Giovanna Mantini
- Radiochemotherapy Unit, Department of Diagnostics for Imaging, Oncological Radiotherapy and Hematology, Fondazione Policlinico A. Gemelli IRCCS, Rome - University Department of Radiological and Hematological Sciences, Università Cattolica Sacro Cuore, Italy
| | - Roberto Maisano
- Department of Oncology, A.O. Bianchi-Melacrino-Morelli, Reggio Calabria, Calabria, Italy
| | | | - Nicola Calvani
- Medical Oncology Unit, Antonio Perrino Hospital, Brindisi, Puglia, Italy
| | - Gaetano Facchini
- Departmental Unit of Experimental Uro-Andrological Clinical Oncology, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Sabino De Placido
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Campania, Italy
| | - Mario Airoldi
- Oncology Unit 2 - Città della Salute e della Scienza di Torino, Turin, Piemonte, Italy
| | - Andrea Sbrana
- Medical Oncology Unit 2, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Donatello Gasparro
- Medical Oncology Unit, Department of General and Specialistic Medicine, University Hospital of Parma, Parma, Italy
| | | | - Pamela Guglielmini
- Oncology Unit, SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | | | | | - Massimo Aglietta
- Department of Oncology, University of Turin; Candiolo Cancer Institute - FPO- IRCCS, Candiolo, Italy
| | - Luigi Schips
- Department of Medical, Oral and Biotechnological Sciences, G. d'Annunzio University of Chieti, Urology unit, "SS. Annunziata Hospital", Chieti, Italy
| | | | - Alessandro Sciarra
- Department of Urology, Sapienza Rome University Policlinico Umberto I, Rome, Italy
| | - Lorenzo Livi
- Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, University of Florence, Florence, Italy
| | - Daniele Santini
- Department of Medical Oncology, University Campus Biomedico, Rome, Italy
| |
Collapse
|
9
|
Tsiachristas A, Potter CM, Rocks S, Peters M, Cundell M, McShane R, Batchelder L, Fox D, Forder JE, Jones K, Waite F, Freeman D, Fitzpatrick R. Estimating EQ-5D utilities based on the Short-Form Long Term Conditions Questionnaire (LTCQ-8). Health Qual Life Outcomes 2020; 18:279. [PMID: 32795317 PMCID: PMC7427949 DOI: 10.1186/s12955-020-01506-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 07/22/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose The aim of this work was to develop a mapping algorithm for estimating EuroQoL 5 Dimension (EQ-5D) utilities from responses to the Long-Term Conditions Questionnaire (LTCQ), thus increasing LTCQ’s potential as a comprehensive outcome measure for evaluating integrated care initiatives. Methods We combined data from three studies to give a total sample of 1334 responses. In each of the three datasets, we randomly selected 75% of the sample and combined the selected random samples to generate the estimation dataset, which consisted of 1001 patients. The unselected 25% observations from each dataset were combined to generate an internal validation dataset of 333 patients. We used direct mapping models by regressing responses to the LTCQ-8 directly onto EQ-5D-5L and EQ-5D-3L utilities as well as response (or indirect) mapping to predict the response level that patients selected for each of the five EQ-5D-5L domains. Several models were proposed and compared on mean squared error and mean absolute error. Results A two-part model with OLS was the best performing based on the mean squared error (0.038) and mean absolute error (0.147) when estimating the EQ-5D-5L utilities. A multinomial response mapping model using LTCQ-8 responses was used to predict EQ-5D-5L responses levels. Conclusions This study provides a mapping algorithm for estimating EQ-5D utilities from LTCQ responses. The results from this study can help broaden the applicability of the LTCQ by producing utility values for use in economic analyses.
Collapse
Affiliation(s)
- Apostolos Tsiachristas
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Caroline M Potter
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Stephen Rocks
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Michele Peters
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | | | - Laurie Batchelder
- Personal Social Services Research Unit, School of Social Policy Sociology and Social Research, University of Kent, Canterbury, UK
| | - Diane Fox
- Personal Social Services Research Unit, School of Social Policy Sociology and Social Research, University of Kent, Canterbury, UK
| | - Julien E Forder
- Personal Social Services Research Unit, School of Social Policy Sociology and Social Research, University of Kent, Canterbury, UK
| | - Karen Jones
- Personal Social Services Research Unit, School of Social Policy Sociology and Social Research, University of Kent, Canterbury, UK
| | - Felicity Waite
- Oxford Health NHS Foundation Trust, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Daniel Freeman
- Oxford Health NHS Foundation Trust, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ray Fitzpatrick
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| |
Collapse
|
10
|
Nahvijou A, Safari H, Yousefi M, Rajabi M, Arab-Zozani M, Ameri H. Mapping the cancer-specific FACT-B onto the generic SF-6Dv2. Breast Cancer 2020; 28:130-136. [DOI: 10.1007/s12282-020-01141-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 07/16/2020] [Indexed: 02/07/2023]
|
11
|
Wang Y, Shi J, Du L, Huang H, Wang L, Zhu J, Li H, Bai Y, Liao X, Mao A, Liu G, Ren J, Sun X, Gong J, Zhou Q, Mai L, Zhu L, Xing X, Liu Y, Ren Y, Song B, Lan L, Zhou J, Lou P, Sun X, Qi X, Wu S, Wei W, Zhang K, Dai M, Chen W, He J. Health-related quality of life in patients with esophageal cancer or precancerous lesions assessed by EQ-5D: A multicenter cross-sectional study. Thorac Cancer 2020; 11:1076-1089. [PMID: 32130756 PMCID: PMC7113059 DOI: 10.1111/1759-7714.13368] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/09/2020] [Accepted: 02/10/2020] [Indexed: 12/24/2022] Open
Abstract
Background We aimed to obtain a set of health state utility scores of patients with esophageal cancer (EC) and precancerous lesions in China, and to explore the influencing factors of health‐related quality of life (HRQoL). Methods A hospital‐based multicenter cross‐sectional study was conducted. From 2013 to 2014, patients with EC or precancerous lesions were enrolled. HRQoL was assessed using a European quality of life‐5 dimension (EQ‐5D‐3L) instrument. Multivariable linear regression analysis was performed to explore the influencing factors of the EQ‐5D utility scores. Results A total of 2090 EC patients and 156 precancer patients were included in the study. The dimension of pain/discomfort had the highest rate of self‐reported problems, 60.5% in EC and 51.3% in precancer patients. The mean visual analog scale (VAS) score for EC and precancer patients were 68.4 ± 0.7 and 64.5 ± 3.1, respectively. The EQ‐5D utility scores for EC and precancer patients were estimated as 0.748 ± 0.009 and 0.852 ± 0.022, and the scores of EC at stage I, stage II, stage III, and stage IV were 0.693 ± 0.031, 0.747 ± 0.014, 0.762 ± 0.015, and 0.750 ± 0.023, respectively. According to the multivariable analyses, the factors of region, occupation, household income in 2012, health care insurance type, pathological type, type of therapy, and time points of the survey were statistically associated with the EQ‐5D utility scores of EC patients. Conclusions There were remarkable decrements of utility scores among esophageal cancer patients, compared with precancer patients. The specific utility scores of EC would support further cost‐utility analysis in populations in China.
Collapse
Affiliation(s)
- Youqing Wang
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences/Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences/Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou, China
| | - Jufang Shi
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lingbin Du
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences/Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences/Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou, China
| | - Huiyao Huang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Le Wang
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences/Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences/Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou, China
| | - Juan Zhu
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huizhang Li
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences/Department of Cancer Prevention, Cancer Hospital of the University of Chinese Academy of Sciences/Department of Cancer Prevention, Zhejiang Cancer Hospital, Hangzhou, China
| | - Yana Bai
- Institute of Epidemiology and Health Statistics, Lanzhou University, Lanzhou, China
| | - Xianzhen Liao
- Hunan Office for Cancer Control and Research, Hunan Provincial Cancer Hospital, Changsha, China
| | - Ayan Mao
- Public Health Information Research Office, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, China
| | - Guoxiang Liu
- Department of Health Economics, School of Health Management, Harbin Medical University, Harbin, China
| | - Jiansong Ren
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaojie Sun
- Center for Health Management and Policy, Key Lab of Health Economics and Policy, Shandong University, Jinan, China
| | - Jiyong Gong
- Science and Education Department of Public Health Division, Shandong Tumor Hospital, Jinan, China
| | - Qi Zhou
- Chongqing Office for Cancer Control and Research, Chongqing Cancer Hospital, Chongqing, China
| | - Ling Mai
- Department of Institute of Tumor Research, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Lin Zhu
- Teaching and Research Department, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiaojing Xing
- Liaoning Office for Cancer Control and Research, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Yuqin Liu
- Cancer Epidemiology Research Center, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Ying Ren
- Urban Office of Cancer Early Detection and Treatment, Tieling Central Hospital, Tieling, China
| | - Bingbing Song
- Heilongjiang Office for Cancer Control and Research, Affiliated Cancer Hospital of Harbin Medical University, Harbin, China
| | - Li Lan
- Institute of Chronic Disease Prevention and Control, Harbin Center for Disease Control and Prevention, Harbin, China
| | - Jinyi Zhou
- Institute of Chronic Non-communicable Diseases Prevention and Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Peian Lou
- Department of Control and Prevention of Chronic Non-Communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China
| | - Xiaohua Sun
- Ningbo Clinical Cancer Prevention Guidance Center, Ningbo No.2 Hospital, Ningbo, China
| | - Xiao Qi
- Department of Occupational Medicine, Tangshan People's Hospital, Tangshan, China
| | - Shouling Wu
- Health Department of Kailuan Group, Kailuan General Hospital, Tangshan, China
| | - Wenqiang Wei
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kai Zhang
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Dai
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wanqing Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie He
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
12
|
Moskovitz M, Jao K, Su J, Brown MC, Naik H, Eng L, Wang T, Kuo J, Leung Y, Xu W, Mittmann N, Moody L, Barbera L, Devins G, Li M, Howell D, Liu G. Combined cancer patient-reported symptom and health utility tool for routine clinical implementation: a real-world comparison of the ESAS and EQ-5D in multiple cancer sites. ACTA ACUST UNITED AC 2020; 26:e733-e741. [PMID: 31896943 DOI: 10.3747/co.26.5297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background We assessed whether the presence and severity of common cancer symptoms are associated with the health utility score (hus) generated from the EQ-5D (EuroQol Research Foundation, Rotterdam, Netherlands) in patients with cancer and evaluated whether it is possible pragmatically to integrate routine hus and symptom evaluation in our cancer population. Methods Adult outpatients at Princess Margaret Cancer Centre with any cancer were surveyed cross-sectionally using the Edmonton Symptom Assessment System (esas) and the EQ-5D-3L, and results were compared using Spearman correlation coefficients and regression analyses. Results Of 764 patients analyzed, 27% had incurable disease. We observed mild-to-moderate correlations between each esas symptom score and the hus (Spearman coefficients: -0.204 to -0.416; p < 0.0001 for each comparison), with the strongest associations being those for pain (R = -0.416), tiredness (R = -0.387), and depression (R =-0.354). Multivariable analyses identified pain and depression as highly associated (both p < 0.0001) and tiredness as associated (p = 0.03) with the hus. The ability of the esas to predict the hus was low, at 0.25. However, by mapping esas pain, anxiety, and depression scores to the corresponding EQ-5D questions, we could derive the hus using partial esas data, with Spearman correlations of 0.83-0.91 in comparisons with direct EQ-5D measurement of the hus. Conclusions The hus derived from the EQ-5D-3L is associated with all major cancer symptoms as captured by the esas. The esas scores alone could not predict EQ-5D scores with high accuracy. However, esas-derived questions assessing the same domains as the EQ-5D-3L questions could be mapped to their corresponding EQ-5D questions to generate the hus, with high correlation to the directly measured hus. That finding suggests a potential approach to integrating routine symptom and hus evaluations after confirmatory studies.
Collapse
Affiliation(s)
- M Moskovitz
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, and Department of Medicine, University of Toronto, Toronto, ON
| | - K Jao
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, and Department of Medicine, University of Toronto, Toronto, ON.,Hôpital du Sacré-Coeur, McGill University, Montreal, QC
| | - J Su
- Department of Biostatistics, Ontario Cancer Institute, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON
| | - M C Brown
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, and Department of Medicine, University of Toronto, Toronto, ON
| | - H Naik
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, and Department of Medicine, University of Toronto, Toronto, ON.,Department of Medicine, University of British Columbia, Vancouver, BC
| | - L Eng
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, and Department of Medicine, University of Toronto, Toronto, ON
| | - T Wang
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, and Department of Medicine, University of Toronto, Toronto, ON.,Faculty of Pharmacy, University of Toronto, Toronto, ON
| | - J Kuo
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, and Department of Medicine, University of Toronto, Toronto, ON
| | - Y Leung
- Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON
| | - W Xu
- Department of Biostatistics, Ontario Cancer Institute, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON
| | - N Mittmann
- Cancer Care Ontario, Toronto, ON.,Odette Cancer Centre, University of Toronto, Toronto, ON
| | - L Moody
- Cancer Care Ontario, Toronto, ON
| | - L Barbera
- Cancer Care Ontario, Toronto, ON.,Odette Cancer Centre, University of Toronto, Toronto, ON
| | - G Devins
- Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON.,Department of Psychiatry, University of Toronto, Toronto, ON
| | - M Li
- Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON
| | - D Howell
- Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON.,Lawrence Bloomberg School of Nursing, University of Toronto, Toronto, ON
| | - G Liu
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, and Department of Medicine, University of Toronto, Toronto, ON.,Department of Epidemiology, Dalla Lana School of Public Health, Department of Medical Biophysics, and Institute of Medical Science, University of Toronto, Toronto, ON
| |
Collapse
|
13
|
Factors contributing to the ceiling effect of the EQ-5D-5L: an analysis of patients with prostate cancer judged "no-problems". Qual Life Res 2019; 29:755-763. [PMID: 31583618 PMCID: PMC7028791 DOI: 10.1007/s11136-019-02316-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2019] [Indexed: 11/22/2022]
Abstract
Purpose The goal of the present study was to determine factors related to a ceiling effect (CE) on the EQ-5D-5L among Japanese patients with prostate cancer (PC). Methods An existent cross-sectional observational study dataset was used. Patients were ≥ 20 years of age and diagnosed with PC. For CE determinants on the EQ-5D-5L, we excluded possible “full-health” patients flagged by the EQ-VAS (score = 100) and/or FACT-P (score = 156) instruments. We then divided them into binary variables: A CE group (EQ-5D-5L score = 1) and others (< 1). The associations between CE, sociodemographic and medical characteristics, and FACT-P subscale scores were examined using a multivariate LASSO selection followed by a binomial logistic regression analysis performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results A total of 362 patients were analyzed. The LASSO selection variables, including all obtained variables, were as follows: age, palliative treatment, FACT-P physical well-being, and PC subscale score. Statistically significant variables predicting CE were palliative treatment (OR 0.23; 95% CI 0.09–0.60), physical well-being (OR 1.54; 95% CI 1.34–1.76), and PC subscale (OR 1.08; 95% CI 1.03–1.14). Conclusions This study revealed that palliative treatment and two FACT-P physical well-being and PC subscale scores were positively related to CE on the EQ-5D-5L. To our knowledge, this is the first study to examine predictors of CE on the EQ-5D-5L. The present results may be helpful for facilitating the consideration of “bolt-on” studies from the standpoint of PC patients.
Collapse
|
14
|
Magnus A, Isaranuwatchai W, Mihalopoulos C, Brown V, Carter R. A Systematic Review and Meta-Analysis of Prostate Cancer Utility Values of Patients and Partners Between 2007 and 2016. MDM Policy Pract 2019; 4:2381468319852332. [PMID: 31192309 PMCID: PMC6540514 DOI: 10.1177/2381468319852332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 03/03/2019] [Indexed: 11/24/2022] Open
Abstract
Background. There is widespread agreement that both the length and
quality of life matter when assessing new technologies and/or models of care in
the treatment for cancer patients. Quality of life for partners/carers also
matters, particularly for prostate cancer. Purpose. This systematic
review aims to provide up-to-date utility values along the prostate cancer care
continuum (i.e., from prescreening through to palliative care) for use where
future trial-based or modelled economic evaluations cannot collect primary data
from men and/or partners. Data Sources. A protocol was developed
and registered on the international register of systematic reviews—PROSPERO.
Databases searched included EBSCO Information Services (CINAHL, EconLit, Global
Health, HEED, MEDLINE Complete, PsycINFO), Cochrane Database of Systematic
Reviews, Web of Science, and Embase. Study Selection. Study
selection terms included health-related quality of life, prostate cancer, and
partners or carers. Data Extraction. The authors identified
articles published between 2007 and 2016 that provided health state utility
values, with statistical uncertainty, for men with or at risk of prostate cancer
and/or their partner/carers. Data Synthesis and Results. Study
quality and generalizability of utilities was evaluated and meta-analysis
conducted against prespecified criteria. From 906 original articles, 29 recent
primary studies met the inclusion/exclusion criteria. We tabulate all the
utility values with uncertainty, along with considerable methodological detail
and patient population characteristics. Limitations. Utility values
pertaining to carers/partners were limited to one study.
Conclusions. Studies varied in design, measurement instruments
utilized, quality, and generalizability. There is sufficient qualitative and
quantitative detail for the reported utility values to be readily incorporated
into economic evaluations. More research is needed with carers/partners and with
newly developing prostate cancer-specific quality of life tools.
Collapse
Affiliation(s)
- Anne Magnus
- Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Wanrudee Isaranuwatchai
- Centre for Excellence in Economic Analysis Research, St. Michael's Hospital; Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Cathrine Mihalopoulos
- Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Victoria Brown
- Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Rob Carter
- Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
15
|
Mukuria C, Rowen D, Harnan S, Rawdin A, Wong R, Ara R, Brazier J. An Updated Systematic Review of Studies Mapping (or Cross-Walking) Measures of Health-Related Quality of Life to Generic Preference-Based Measures to Generate Utility Values. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2019; 17:295-313. [PMID: 30945127 DOI: 10.1007/s40258-019-00467-6] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Mapping is an increasingly common method used to predict instrument-specific preference-based health-state utility values (HSUVs) from data obtained from another health-related quality of life (HRQoL) measure. There have been several methodological developments in this area since a previous review up to 2007. OBJECTIVE To provide an updated review of all mapping studies that map from HRQoL measures to target generic preference-based measures (EQ-5D measures, SF-6D, HUI measures, QWB, AQoL measures, 15D/16D/17D, CHU-9D) published from January 2007 to October 2018. DATA SOURCES A systematic review of English language articles using a variety of approaches: searching electronic and utilities databases, citation searching, targeted journal and website searches. STUDY SELECTION Full papers of studies that mapped from one health measure to a target preference-based measure using formal statistical regression techniques. DATA EXTRACTION Undertaken by four authors using predefined data fields including measures, data used, econometric models and assessment of predictive ability. RESULTS There were 180 papers with 233 mapping functions in total. Mapping functions were generated to obtain EQ-5D-3L/EQ-5D-5L-EQ-5D-Y (n = 147), SF-6D (n = 45), AQoL-4D/AQoL-8D (n = 12), HUI2/HUI3 (n = 13), 15D (n = 8) CHU-9D (n = 4) and QWB-SA (n = 4) HSUVs. A large number of different regression methods were used with ordinary least squares (OLS) still being the most common approach (used ≥ 75% times within each preference-based measure). The majority of studies assessed the predictive ability of the mapping functions using mean absolute or root mean squared errors (n = 192, 82%), but this was lower when considering errors across different categories of severity (n = 92, 39%) and plots of predictions (n = 120, 52%). CONCLUSIONS The last 10 years has seen a substantial increase in the number of mapping studies and some evidence of advancement in methods with consideration of models beyond OLS and greater reporting of predictive ability of mapping functions.
Collapse
Affiliation(s)
- Clara Mukuria
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Donna Rowen
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Sue Harnan
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Andrew Rawdin
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Ruth Wong
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Roberta Ara
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - John Brazier
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| |
Collapse
|
16
|
Cella D, Traina S, Li T, Johnson K, Ho KF, Molina A, Shore ND. Relationship between patient-reported outcomes and clinical outcomes in metastatic castration-resistant prostate cancer: post hoc analysis of COU-AA-301 and COU-AA-302. Ann Oncol 2019; 29:392-397. [PMID: 29237083 DOI: 10.1093/annonc/mdx759] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Patient-reported outcomes (PROs) are used to assess benefit-risk in drug development. The relationship between PROs and clinical outcomes is not well understood. We aim to elucidate the relationships between changes in PRO measures and clinical outcomes in metastatic castration-resistant prostate cancer (mCRPC). Patients and methods We investigated relationships between changes in self-reported fatigue, pain, functional well-being (FWB), physical well-being (PWB) and prostate cancer-specific symptoms with overall survival (OS) and radiographic progression-free survival (rPFS) after 6 and 12 months of treatment in COU-AA-301 (N = 1195) or COU-AA-302 (N = 1088). Eligible COU-AA-301 patients had progressed after docetaxel and had Eastern Cooperative Oncology Group performance status (ECOG PS) ≤ 2. Eligible COU-AA-302 patients had no prior chemotherapy and ECOG PS 0 or 1. Patients were treated with abiraterone acetate (1000 mg/day) plus prednisone (10 mg/day) or prednisone alone daily. Association between self-reported fatigue, pain and functional status, and OS and/or rPFS, using pooled data regardless of treatment, was assessed. Cox proportional hazard regression modeled time to death or radiographic progression. Results In COU-AA-301 patients, PRO improvements were associated with longer OS and longer time to radiographic progression versus worsening or stable PROs (P < 0.0001). In multivariate models, all except pain intensity remained associated with OS. Pain intensity, PWB and FWB improvements remained associated with rPFS. In COU-AA-302 patients, worsening PROs were associated with higher likelihood of radiographic progression (P ≤ 0.025) compared with improved or stable PROs. In multivariate models, worsening PWB remained associated with worse rPFS. The 12-month analysis confirmed the 6-month results. Conclusions PROs are significantly associated with clinically relevant time-to-event efficacy outcomes in clinical trials and may complement and help predict traditional clinical practice methods for monitoring patients for disease progression.
Collapse
Affiliation(s)
- D Cella
- Department of Medical Social Sciences, Northwestern University, Chicago, USA.
| | - S Traina
- Janssen Global Services, Raritan, USA
| | - T Li
- Janssen Global Services, Raritan, USA
| | - K Johnson
- Janssen Global Services, Raritan, USA
| | - K F Ho
- STAT-TU Inc., Toronto, Canada
| | - A Molina
- Janssen Research & Development, Menlo Park, USA
| | - N D Shore
- Carolina Urologic Research Center, Atlantic Urology Clinics, Myrtle Beach, USA
| |
Collapse
|
17
|
Meregaglia M, Borsoi L, Cairns J, Tarricone R. Mapping health-related quality of life scores from FACT-G, FAACT, and FACIT-F onto preference-based EQ-5D-5L utilities in non-small cell lung cancer cachexia. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2019; 20:181-193. [PMID: 28948436 PMCID: PMC6438942 DOI: 10.1007/s10198-017-0930-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 08/25/2017] [Indexed: 05/08/2023]
Abstract
BACKGROUND Health-related quality of life (HRQoL) measurements from disease-specific tools cannot be directly used in economic evaluations. This study aimed to develop and validate mapping algorithms that predicted EuroQol 5-Dimensions 5-Levels (EQ-5D-5L) utilities from Functional Assessment of Anorexia-Cachexia Therapy (FAACT) and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and their common component (Functional Assessment of Cancer Therapy-General-FACT-G) in patients with non-small cell lung cancer cachexia. METHODS Data were collected on five occasions over a 12-week period in two multicenter placebo-controlled trials. EQ-5D-5L utilities were calculated using both English and Dutch value sets. The study sample was divided into development and validation datasets according to patients' geographical residence. Generalized estimating equations were applied to five different sets of independent variables including overall, Trial Outcome Index (TOI), and individual subscales results. The best performing models were selected based on mean absolute error (MAE) and root-mean square error (RMSE). RESULTS EQ-5D-5L and FAACT/FACIT-F results were available for 96 patients. The developed algorithms showed a good predictive performance, with acceptable MAE/RMSE and small differences between mean observed and predicted EQ-5D-5L utilities. In FACT-G models, Physical Well-Being had the highest explanatory value, while Emotional Well-Being did not significantly affect the EQ-5D-5L score; Anorexia-Cachexia and Fatigue subscales were highly statistically significant in FAACT and FACIT-F models, respectively, as well as the TOI scores. The Eastern Cooperative Oncology Group status was included as covariate in all models. CONCLUSION The developed algorithms enable the estimation of EQ-5D-5L utilities from three cancer-specific instruments when preference-based HRQoL data are missing.
Collapse
Affiliation(s)
- Michela Meregaglia
- CeRGAS (Research Centre on Health and Social Care Management), Bocconi University, Via Roentgen 1, 20136, Milan, Italy.
- Department of Health Services Research, London School of Hygiene and Tropical Medicine (LSHTM), London, UK.
| | - Ludovica Borsoi
- CeRGAS (Research Centre on Health and Social Care Management), Bocconi University, Via Roentgen 1, 20136, Milan, Italy
| | - John Cairns
- Department of Health Services Research, London School of Hygiene and Tropical Medicine (LSHTM), London, UK
- CCBIO (Centre for Cancer Biomarkers), University of Bergen, Bergen, Norway
| | - Rosanna Tarricone
- CeRGAS (Research Centre on Health and Social Care Management), Bocconi University, Via Roentgen 1, 20136, Milan, Italy
- Department of Policy Analysis and Public Management, Bocconi University, Milan, Italy
| |
Collapse
|
18
|
Dearden L, Shalet N, Artenie C, Mills A, Jackson C, Grant L, Gater A. Fatigue, treatment satisfaction and health-related quality of life among patients receiving novel drugs suppressing androgen signalling for the treatment of metastatic castrate-resistant prostate cancer. Eur J Cancer Care (Engl) 2018; 28:e12949. [DOI: 10.1111/ecc.12949] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 03/23/2017] [Accepted: 08/24/2018] [Indexed: 12/13/2022]
|
19
|
Zhang Y, Zhou Z, Gao J, Wang D, Zhang Q, Zhou Z, Su M, Li D. Health-related quality of life and its influencing factors for patients with hypertension: evidence from the urban and rural areas of Shaanxi Province, China. BMC Health Serv Res 2016; 16:277. [PMID: 27430314 PMCID: PMC4950775 DOI: 10.1186/s12913-016-1536-x] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 07/07/2016] [Indexed: 01/19/2023] Open
Abstract
Background Hypertension is an important public health issue in China, but there are few studies on health-related quality of life (HRQoL) for patients with hypertension in China. This study aims to examine the HRQoL as measured by EQ-5D and investigate the factors that influence HRQoL for patients with hypertension in Shaanxi Province, China. Methods Data were collected from the Shaanxi’s fifth National Health Service Survey conducted in 2013. EQ-5D was employed to measure the HRQoL for patients with hypertension. The Chinese population-based preference trade-off time (TTO) model was used to convert the EQ-5D values. All descriptive analyses, including demographic characteristics, socio-economic status and clinical characteristics, were stratified by urban and rural residence. Tobit regression model was used to investigate the influencing factors of HRQoL. Results A statistically significant difference was observed between the EQ-5D utility scores of urban (0.891) and rural hypertension patients (0.870). The urban hypertension patients showed significantly higher utility scores than the rural patients in three of the five dimensions, namely usual activities, pain / discomfort and anxiety / depression. The influencing factors of HRQoL for hypertension patients in China included age, marital status, education level, employment status, physical activity and medical examination. For patients aged 55 years and above, EQ-5D utility score decreased significantly with increasing age. The EQ-5D score increased with higher education level. Married patients showed a higher EQ-5D score than divorced and widowed patients, and employed patients showed a higher score than unemployed and retired patients. Regular physical activity and medical examination had a positive effect on the HRQoL of hypertension patients. Conclusions Our study indicated that urban hypertension patients might have higher HRQoL than rural patients in Shaanxi, China. To enhance HRQoL, it is necessary to strengthen the health education for hypertension patients to improve hypertension prevention and to adopt healthy habits such as regular physical activity. It is also important to strengthen the management and monitoring of hypertension in the elderly, and further implement the free medical examination program for the elderly under the public health programs. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1536-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Yulian Zhang
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
| | - Jianmin Gao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
| | - Dan Wang
- Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Qian Zhang
- Nursing Department, Shaanxi Provincial People's Hospital, Xi'an, China
| | - Zhiying Zhou
- School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Min Su
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Dan Li
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| |
Collapse
|
20
|
USE OF PATIENT ASSESSED HEALTH-RELATED QUALITY OF LIFE INSTRUMENTS IN PROSTATE CANCER RESEARCH: A SYSTEMATIC REVIEW OF THE LITERATURE 2002-15. Int J Technol Assess Health Care 2016; 32:97-106. [PMID: 27001542 DOI: 10.1017/s0266462316000118] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The objectives of this study were to identify and qualitatively describe, in a systematic literature review, published studies that collected prostate cancer patients' health-related quality of life (HRQoL) estimates by using validated, generic instruments. METHODS Systematic searches of the literature were made using the Medline, Cochrane Library, PsycINFO, and CINAHL electronic databases from 2002 to 2015. RESULTS The search identified 2,171 references, of which 237 were obtained for full-text assessment; thirty-three of these articles were deemed relevant and included in the systematic review. An indirect valuation method was used in 73 percent (n = 24) of the studies. The most commonly used HRQoL instrument with an indirect valuation method was the EuroQol (EQ-5D; n = 21), and the second most common was the 15D (n = 5). A direct valuation method was used in 48 percent (n = 16) of the studies. Of these, the Visual Analogue Scale (VAS) was the most often used (n = 10), followed by the Time-Trade-Off (n = 6). HRQoL scores varied in localized and early stage disease between 0.63 and 0.91, and in advanced or metastatic disease stage between 0.50 and 0.87. There was also variance in the HRQoL instruments and study methods used, which explains the large variance in HRQoL scores between the various disease stages. CONCLUSIONS Although utility and quality-adjusted life-years gained are considered important measures of effectiveness in health care, the number of studies in which utilities of prostate cancer patients have been estimated using generic HRQoL instruments, based on either direct or indirect measurement of HRQoL, is fairly small.
Collapse
|
21
|
Gee A, Challapalli A, Bahl A. Health-related quality of life in men with metastatic castration–resistant prostate cancer. Expert Rev Pharmacoecon Outcomes Res 2015; 15:941-9. [DOI: 10.1586/14737167.2015.1107479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|