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Salas M, Mordin M, Castro C, Islam Z, Tu N, Hackshaw MD. Health-related quality of life in women with breast cancer: a review of measures. BMC Cancer 2022; 22:66. [PMID: 35033009 PMCID: PMC8760726 DOI: 10.1186/s12885-021-09157-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 12/24/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To identify and describe the breast cancer-specific health-related quality of life (HRQoL) instruments with evidence of validation in the breast cancer population for potential use in patients treated for breast cancer (excluding surgery). METHODS We conducted a systematic literature review using PubMed, Embase, and PsycINFO databases to identify articles that contain psychometric properties of HRQoL instruments used in patients with breast cancer. Relevant literature from January 1, 2009, to August 19, 2019, was searched. Articles published in English that reported psychometric properties (reliability, validity) of HRQoL instruments were identified. RESULTS The database search yielded 613 unique records; 131 full-text articles were reviewed; 80 articles presented psychometric data for instruments used in breast cancer (including generic measures). This article reviews the 33 full articles describing psychometric properties of breast cancer-specific HRQoL instruments: EORTC QLQ-C30, EORTC QLQ-BR23, FACT-B, FBSI, NFBSI-16, YW-BCI36, BCSS, QuEST-Br, QLICP-BR, INA-BCHRQoL, and two newly developed unnamed measures, one by Deshpande and colleagues (for use in India) and one by Vanlemmens and colleagues (for use among young women and their partners). The articles that described the EORTC QLQ-C30, QLQ-BR23, and FACT-B centered on validating translations, providing additional support for content validity, and demonstrating acceptability of electronic patient-reported outcome administration. Psychometric properties of the measures were acceptable. Several new measures have been developed in Asia with an emphasis on development on cultural relevance/sensitivity. Others focused on specific populations (i.e., young women with breast cancer). CONCLUSIONS Historically, there have been limited options for validated measures to assess HRQoL of patients with breast cancer. A number of new measures have been developed and validated, offering promising options for assessing HRQoL in this patient population. This review supports the reliability and validity of the EORTC QLQ-C30 and FACT-B; new translations and electronic versions of these measures further support their use for this population.
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Affiliation(s)
- Maribel Salas
- Epidemiology, Clinical Safety and Pharmacovigilance, Daiichi Sankyo, Inc., 211 Mount Airy Road, 1A-453, Basking Ridge, NJ, 07920, USA.
- CCEB/CPeRT, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | | | | | - Zahidul Islam
- Epidemiology, Clinical Safety and Pharmacovigilance, Daiichi Sankyo, Inc., 211 Mount Airy Road, 1A-453, Basking Ridge, NJ, 07920, USA
| | - Nora Tu
- Epidemiology, Clinical Safety and Pharmacovigilance, Daiichi Sankyo, Inc., 211 Mount Airy Road, 1A-453, Basking Ridge, NJ, 07920, USA
| | - Michelle D Hackshaw
- Epidemiology, Clinical Safety and Pharmacovigilance, Daiichi Sankyo, Inc., 211 Mount Airy Road, 1A-453, Basking Ridge, NJ, 07920, USA
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Mustacchi G. Cost/benefit evaluations in low-middle/upper-middle income countries: biases about "out of pocket money". Curr Med Res Opin 2021; 37:819-820. [PMID: 33617396 DOI: 10.1080/03007995.2021.1893674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Giorgio Mustacchi
- Professor Emeritus of Oncology, University of Trieste, Trieste, Italy
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Liu T, Li S, Wang M, Sun Q, Chen G. Mapping the Chinese Version of the EORTC QLQ-BR53 Onto the EQ-5D-5L and SF-6D Utility Scores. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2020; 13:537-555. [PMID: 32382953 DOI: 10.1007/s40271-020-00422-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to develop mapping algorithms from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-BR53, including EORTC QLQ-C30 and QLQ-BR23) onto the 5-level EQ-5D (EQ-5D-5L) and Short Form 6D (SF-6D) utility scores. METHODS The data were taken from 607 breast cancer patients in mainland China. The EQ-5D-5L and SF-6D instruments were scored using Chinese-specific tariffs. Three model specifications and seven statistical techniques were used to derive mapping algorithms, including ordinary least squares (OLS), Tobit, censored least absolute deviation (CLAD) model, generalized linear model (GLM), robust MM-estimator, finite mixtures of beta regression model for directly estimating health utility, and using ordered logit regression (OLOGIT) to predict response levels. A five-fold cross-validation approach was conducted to test the generalizability of each model. Two key goodness-of-fit statistics (mean absolute error and mean squared error) and three secondary statistics were employed to choose the optimal models. RESULTS Participants had a mean ± standard deviation (SD) age of 49.0 ± 9.8 years. The mean ± SD health state utility scores were 0.828 ± 0.184 (EQ-5D-5L) and 0.646 ± 0.125 (SF-6D). Mapping performance was better when both the QLQ-C30 and QLQ-BR23 dimensions were considered rather than when either of these dimensions were used alone. The mapping functions from the optimal direct mapping and indirect mapping approaches were reported. CONCLUSIONS The algorithms reported in this paper enable EORTC QLQ-BR53 breast cancer data to be mapped into utilities predicted from the EQ-5D-5L and SF-6D. The algorithms allow for the calculation of quality-adjusted life years for use in breast cancer cost-effectiveness analyses studies.
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Affiliation(s)
- Tong Liu
- School of Health Care Management, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Shunping Li
- School of Health Care Management, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
| | - Min Wang
- Qingdao Municipal Hospital, Qingdao, 266011, China
| | - Qiang Sun
- School of Health Care Management, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Gang Chen
- Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA, 5042, Australia
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Zhou K, Li M, Wang W, An J, Huo L, He X, Li J, Zhuang G, Li X. Reliability, validity, and sensitivity of the Chinese Short-Form 36 Health Survey version 2 (SF-36v2) in women with breast cancer. J Eval Clin Pract 2019; 25:864-872. [PMID: 30548365 DOI: 10.1111/jep.13088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/22/2018] [Accepted: 11/23/2018] [Indexed: 11/26/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES The psychometrics of the Short-Form 36 Health Survey version 2 (SF-36v2) in female breast cancer patients remains unknown. This study aimed to test the reliability, validity, and sensitivity of the Chinese SF-36v2 in women with breast cancer. METHODS The sample included 326 eligible participants. The reliability and the item convergent and discriminant validity were estimated using Cronbach α (≥0.70) and the multi-trait multi-item matrix analysis, respectively. The structural validity was tested using confirmatory factor analysis. Sensitivity was determined via an analysis of variance and the relative efficiency for initially diagnosed cases (yes vs no) as well as the time since diagnosis (years) before and after stratifying by initially diagnosed cases. RESULTS The overall Cronbach α was 0.91 (eight scales range: 0.72-0.92). All hypothesized item-scale correlations were greater than the alternatives (r ≥ 0.40). With acceptable model fit indices, the physical functioning, role-physical, bodily pain, and general health subscales had stronger contributions to the physical component summary (goodness-of-fit index [GFI]: 0.92, parsimony goodness-of-fit index [PGFI]: 0.60, comparative fit index [CFI]: 0.91, Tucker-Lewis index [TLI]: 0.93, adjusted goodness-of-fit index [AGFI]: 0.91, root mean square error of approximation [RMSEA]: 0.06, normed chi-squared [NC]: 2.65), while the vitality, social functioning, role-emotional, and mental health subscales contributed more to the mental component summary (GFI: 0.91, PGFI: 0.62, CFI: 0.91, TLI: 0.92, AGFI: 0.91, RMSEA: 0.07, NC: 2.76). The relative efficiencies with significant F-statistics were found for mental health (relative efficiency: 34.28; initially diagnosed cases), physical functioning (12.88; time since diagnosis), and physical functioning (5.80), role-physical (5.15), bodily pain (7.70), social functioning (4.62), role-emotional (4.72), mental health (4.75), and physical component summary (6.96; initially diagnosed cases with time since diagnosis; P < 0.05 for all variables). CONCLUSIONS Chinese SF-36v2 has acceptable psychometric properties and is suitable for women with breast cancer.
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Affiliation(s)
- Kaina Zhou
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Minjie Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Wen Wang
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Jinghua An
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Lanting Huo
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Xiaole He
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Jin Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Guihua Zhuang
- School of Public Health, Xi'an Jiaotong University Health Science Centre, Xi'an, China
| | - Xiaomei Li
- School of Nursing, Xi'an Jiaotong University Health Science Centre, Xi'an, China
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Sanchez L, Fernandez N, Calle AP, Ladera V, Casado I, Sahagun AM. Long-term treatment for emotional distress in women with breast cancer. Eur J Oncol Nurs 2019; 42:126-133. [PMID: 31522057 DOI: 10.1016/j.ejon.2019.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE Breast cancer patients have many needs, including strategies to cope with the associated distress, during and after cancer treatment. Establishing and implementing adequate social and emotional support for these women, to reduce the detrimental effects of stress resulting from their treatment and disease, is the need of the hour. This study aims to assess how women, diagnosed and treated for breast cancer, combat emotional stress using mechanisms of coping and control and emotional defense, as well as to identify potential groups among them, with different long-term patterns and needs. METHODS 98 patients belonging to a local breast cancer support association (ALMOM), were enrolled in this study. A questionnaire specifically designed for them was administered, and its internal consistency and reliability assessed. A hierarchical clustering was employed to classify the women. The questionnaire focused on four sections, including personal feelings, coping strategies, environmental influences and maladaptive coping. RESULTS An adequate internal reliability was obtained with Cronbach's α near or greater than 0.60. Personal feelings were significant and clearly correlated with coping strategies and maladaptive coping. Three groups of women with different patterns of emotional characteristics and needs were identified: positivist, unsafe, and hopeless women, with different long-term emotional needs to be satisfied. CONCLUSIONS Psychological therapeutic interventions should be maintained in many breast cancer patients over time, even after treatment completion, in order to consolidate adaptive and sustainable responses.
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Affiliation(s)
- Leticia Sanchez
- Department of Nursing and Physical Therapy, University of Leon, 24071, Leon, Spain.
| | - Nelida Fernandez
- Department of Biomedical Sciences, IBIOMED, University of Leon, 24071, Leon, Spain.
| | - Angela P Calle
- Department of Nursing and Physical Therapy, University of Leon, 24071, Leon, Spain.
| | - Valentina Ladera
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, 37005, Salamanca, Spain.
| | - Ines Casado
- Department of Nursing and Physical Therapy, University of Leon, 24071, Leon, Spain.
| | - Ana M Sahagun
- Department of Biomedical Sciences, IBIOMED, University of Leon, 24071, Leon, Spain.
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Health-Related Quality of Life among Women Breast Cancer Patients in Eastern China. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1452635. [PMID: 30065931 PMCID: PMC6051298 DOI: 10.1155/2018/1452635] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 05/29/2018] [Accepted: 06/05/2018] [Indexed: 11/18/2022]
Abstract
Objectives Breast cancer is one of the major cancers in Chinese women. European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ-C30 and QLQ-BR23) are now the most common and well developed instruments assessing the health-related quality of life (HRQOL) of breast cancer patients internationally, whereas there are relatively few Chinese studies. This study has two aims: to investigate the HRQOL and explore which dimensions of HRQOL play more important roles in breast cancer patients' overall quality of life in China and to explore the latent factor structure and the potential complementary relationship between these two EORTC questionnaires. Methods This cross-sectional and descriptive study was performed from October 2014 to February 2015 in Qingdao Municipal Hospital, China. A total of 621 women breast cancer patients were enrolled. EOTRC QLQ-C30 and QLQ-BR23 were used to evaluate the HRQOL of the participants. The nonparametric test, multiple linear regression, and exploratory factor analysis (EFA) were the main statistical methods we used. Results 608 participants completed the questionnaires with a response rate of 97.9%. The mean age of the participants was 48.0 years (SD=9.6). About 33% were illiterate or only finished primary school education. Almost half participants (47.4%) only adopted chemotherapy. HRQOL was significantly different with regard to patients' social-demographic and clinical characteristics. Age, residence, educational level, employment status, and TNM stage were five significant predictors for global health status. Pain, dyspnea, sexual enjoyment, and systemic therapy side-effect were main subscales which had a significant impact on the global health status for patients in different TNM stage. The EFA result suggested that QLQ-C30 and QLQ-BR23 were complementary questionnaires. Conclusions The EORTC QLQ-C30 and QLQ-BR23 questionnaires provide complementary information regarding breast cancer patients' HRQOL, and depending on the different cancer staging functional/symptom scales which significantly contributed to the overall HRQOL differed.
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