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Angyal MM, Lakatos PL, Jenei B, Brodszky V, Rencz F. Health utilities and willingness to pay in adult patients with coeliac disease in Hungary. Qual Life Res 2023:10.1007/s11136-023-03418-w. [PMID: 37067657 PMCID: PMC10393904 DOI: 10.1007/s11136-023-03418-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND Coeliac disease (CD) is a life-long food-related disorder with a global prevalence of approximately 1%. Patients with CD often experience reduced health-related quality of life that could improve with a strict adherence to a gluten-free diet (GFD). OBJECTIVES To obtain visual analogue scale (VAS), time trade-off (TTO) and willingness-to-pay (WTP) values amongst patients with CD. METHODS In 2020-2021, a cross-sectional online survey was conducted amongst 312 adult CD patients in Hungary. Patients completed the Gastrointestinal Symptom Rating Scale (GSRS) and evaluated their current health and three hypothetical health state vignettes defined based on dietary adherence using VAS, conventional 10-year TTO and WTP. Multivariate regressions were used to explore the effect of patients' demographic and clinical characteristics on utility and WTP values. RESULTS Mean VAS values for current health and 'CD with strict adherence to GFD', 'CD with loose adherence to GFD' and 'CD without GFD' hypothetical health states were 79.69 ± 18.52, 85.36 ± 16.18, 62.44 ± 19.91 and 36.69 ± 25.83, respectively. Corresponding mean TTO utilities were: 0.90 ± 0.19, 0.91 ± 0.20, 0.87 ± 0.23 and 0.76 ± 0.29. Mean annual WTP values for returning to full health were: €845 ± 1077, €648 ± 1002, €862 ± 1135 and €1251 ± 1496. Older age at diagnosis, male sex, more severe gastrointestinal symptoms (GSRS) and having comorbidities were associated with lower VAS and TTO or higher WTP values for current own health (p < 0.05). CONCLUSION This is the first study to report TTO utilities for CD health states. Strict adherence to the GFD may result in substantial health gains in symptomatic patients. Utilities and WTP results can be used to estimate benefits of GFD in cost-utility and cost-benefit analyses.
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Affiliation(s)
- M Mercédesz Angyal
- Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, 26 Üllői út, Budapest, 1085, Hungary
- Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary
| | - Peter L Lakatos
- McGill University Health Centre, Montreal General Hospital, 1650 Ave. Cedar, D16.173.1, Montreal, QC, H3G 1A4, Canada
- Department of Internal Medicine and Oncology, Semmelweis University, Korányi Sándor u. 2/a, Budapest, 1083, Hungary
| | - Balázs Jenei
- Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary
| | - Valentin Brodszky
- Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary
| | - Fanni Rencz
- Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary.
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Miret C, Orive M, Sala M, García-Gutiérrez S, Sarasqueta C, Legarreta MJ, Redondo M, Rivero A, Castells X, Quintana JM, Garin O, Ferrer M. Reference values of EORTC QLQ-C30, EORTC QLQ-BR23, and EQ-5D-5L for women with non-metastatic breast cancer at diagnosis and 2 years after. Qual Life Res 2023; 32:989-1003. [PMID: 36630024 PMCID: PMC10063520 DOI: 10.1007/s11136-022-03327-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE To obtain reference norms of EORTC QLQ-C30, EORTC QLQ-BR23, and EQ-5D-5L, based on a population of Spanish non-metastatic breast cancer patients at diagnosis and 2 years after, according to relevant demographic and clinical characteristics. METHODS Multicentric prospective cohort study including consecutive women aged ≥ 18 years with a diagnosis of incident non-metastatic breast cancer from April 2013 to May 2015. Health-related quality of life (HRQoL) questionnaires were administered between diagnosis and beginning the therapy, and 2 years after. HRQoL differences according to age, comorbidity and stage were tested with ANOVA or Chi Square test and multivariate linear regression models. RESULTS 1276 patients were included, with a mean age of 58 years. Multivariate models of EORTC QLQ-C30 summary score and EQ-5D-5L index at diagnosis and at 2-year follow-up show the independent association of comorbidity and tumor stage with HRQoL. The standardized multivariate regression coefficient of EORTC QLQ-C30 summary score was lower (poorer HRQoL) for women with stage II and III than for those with stage 0 at diagnosis (- 0.11 and - 0.07, p < 0.05) and follow-up (- 0.15 and - 0.10, p < 0.01). The EQ-5D-5L index indicated poorer HRQoL for women with Charlson comorbidity index ≥ 2 than comorbidity 0 both at diagnosis (- 0.13, p < 0.001) and follow-up (- 0.18, p < 0.001). Therefore, we provided the reference norms at diagnosis and at the 2-year follow-up, stratified by age, comorbidity index, and tumor stage. CONCLUSION These HRQoL reference norms can be useful to interpret the scores of women with non-metastatic breast cancer, comparing them with country-specific reference values for this population.
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Affiliation(s)
- Carme Miret
- Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autònoma de Barcelona (UAB), 08193, Bellaterra, Barcelona, Spain
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, i Universitat Pompeu Fabra, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Miren Orive
- Departamento Psicología Social, Facultad Farmacia, UPV/EHU, Vitoria-Gasteiz, Araba, Spain
- KRONIKGUNE-Institute for Health Service Research, Barakaldo, Bizkaia, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Maria Sala
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, i Universitat Pompeu Fabra, Barcelona, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
| | - Susana García-Gutiérrez
- Osakidetza Basque Health Service, Research Unit, Galdakao-Usansolo University Hospital, Galdakao, Bizkai, Spain
- KRONIKGUNE-Institute for Health Service Research, Barakaldo, Bizkaia, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Cristina Sarasqueta
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
- Biodonostia Health Research Institute, Donostia University Hospital, Donostia, Gipuzkoa, Spain
| | - Maria Jose Legarreta
- Osakidetza Basque Health Service, Research Unit, Galdakao-Usansolo University Hospital, Galdakao, Bizkai, Spain
- KRONIKGUNE-Institute for Health Service Research, Barakaldo, Bizkaia, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Maximino Redondo
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
- Research and Innovation Unit, Hospital Costa del Sol, Marbella, Spain
| | - Amado Rivero
- Servicio de Evaluación y Planificación del Servicio Canario de la Salud (SESCS), Tenerife, Spain
| | - Xavier Castells
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB, Parc de Salut Mar, Agència de Salut Pública de Barcelona, i Universitat Pompeu Fabra, Barcelona, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
| | - José M Quintana
- Osakidetza Basque Health Service, Research Unit, Galdakao-Usansolo University Hospital, Galdakao, Bizkai, Spain
- KRONIKGUNE-Institute for Health Service Research, Barakaldo, Bizkaia, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Galdakao, Bizkaia, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Olatz Garin
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003, Barcelona, Spain
| | - Montse Ferrer
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003, Barcelona, Spain.
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
- Departament de Medicina i Ciències de la Vida, Universitat Pompeu Fabra (UPF), Barcelona, Spain.
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Pleyer L, Heibl S, Tinchon C, Vallet S, Schreder M, Melchardt T, Stute N, Föhrenbach Quiroz KT, Leisch M, Egle A, Scagnetti L, Wolf D, Beswick R, Drost M, Larcher-Senn J, Grochtdreis T, Vaisband M, Hasenauer J, Zaborsky N, Greil R, Stauder R. Health-Related Quality of Life as Assessed by the EQ-5D-5L Predicts Outcomes of Patients Treated with Azacitidine-A Prospective Cohort Study by the AGMT. Cancers (Basel) 2023; 15:cancers15051388. [PMID: 36900181 PMCID: PMC10000211 DOI: 10.3390/cancers15051388] [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: 01/24/2023] [Revised: 02/10/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
In this prospective study (NCT01595295), 272 patients treated with azacitidine completed 1456 EuroQol 5-Dimension (EQ-5D) questionnaires. Linear mixed-effect modelling was used to incorporate longitudinal data. When compared with a matched reference population, myeloid patients reported more pronounced restrictions in usual activities (+28%, p < 0.0001), anxiety/depression (+21%, p < 0.0001), selfcare (+18%, p < 0.0001) and mobility (+15%, p < 0.0001), as well as lower mean EQ-5D-5L indices (0.81 vs. 0.88, p < 0.0001), and lower self-rated health on the EuroQol Visual Analogue Scale (EQ-VAS) (64 vs. 72%, p < 0.0001). After multivariate-adjustment, (i) the EQ-5D-5L index assessed at azacitidine start the predicted time with clinical benefit (TCB) (9.6 vs. 6.6 months; p = 0.0258; HR = 1.43), time to next treatment (TTNT) (12.8 vs. 9.8 months; p = 0.0332; HR = 1.42) and overall survival (OS) (17.9 vs. 12.9 months; p = 0.0143; HR = 1.52); (ii) Level Sum Score (LSS) predicted azacitidine response (p = 0.0160; OR = 0.451) and the EQ-5D-5L index showed a trend (p = 0.0627; OR = 0.522); (iii) up to 1432 longitudinally assessed EQ-5D-5L response/clinical parameter pairs revealed significant associations of EQ-5D-5L response parameters with haemoglobin level, transfusion dependence and hematologic improvement. Significant increases of the likelihood ratios were observed after addition of LSS, EQ-VAS or EQ-5D-5L-index to the International Prognostic Scoring System (IPSS) or the revised IPSS (R-IPSS), indicating that they provide added value to these scores.
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Affiliation(s)
- Lisa Pleyer
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- Salzburg Cancer Research Institute (SCRI), Center for Clinical Cancer and Immunology Trials (CCCIT), Austria and Cancer Cluster Salzburg (CCS), 5020 Salzburg, Austria
- 3rd Medical Department with Hematology, Medical Oncology, Hemostaseology, Rheumatology and Infectiology, Oncologic Center, Paracelsus Medical University, 5020 Salzburg, Austria
- Correspondence: or ; Tel.: +43-(0)676-8997-58271
| | - Sonja Heibl
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- 4th Medical Department of Internal Medicine, Hematology, Internistic Oncology and Palliative Medicine, Klinikum Wels-Grieskirchen GmbH, 4600 Wels, Austria
| | - Christoph Tinchon
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- Department for Hemato-Oncology, LKH Hochsteiermark, 8700 Leoben, Austria
| | - Sonia Vallet
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- Department of Internal Medicine 2, University Hospital Krems, Karl Landsteiner Private University of Health Sciences, 3500 Krems, Austria
| | - Martin Schreder
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- 1st Department of Internal Medicine, Center for Oncology and Hematology, Klinik Ottakring, Wiener Gesundheitsverbund, 1030 Vienna, Austria
| | - Thomas Melchardt
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- Salzburg Cancer Research Institute (SCRI), Center for Clinical Cancer and Immunology Trials (CCCIT), Austria and Cancer Cluster Salzburg (CCS), 5020 Salzburg, Austria
- 3rd Medical Department with Hematology, Medical Oncology, Hemostaseology, Rheumatology and Infectiology, Oncologic Center, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Norbert Stute
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- Salzburg Cancer Research Institute (SCRI), Center for Clinical Cancer and Immunology Trials (CCCIT), Austria and Cancer Cluster Salzburg (CCS), 5020 Salzburg, Austria
- 3rd Medical Department with Hematology, Medical Oncology, Hemostaseology, Rheumatology and Infectiology, Oncologic Center, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Kim Tamara Föhrenbach Quiroz
- Salzburg Cancer Research Institute (SCRI), Center for Clinical Cancer and Immunology Trials (CCCIT), Austria and Cancer Cluster Salzburg (CCS), 5020 Salzburg, Austria
| | - Michael Leisch
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- Salzburg Cancer Research Institute (SCRI), Center for Clinical Cancer and Immunology Trials (CCCIT), Austria and Cancer Cluster Salzburg (CCS), 5020 Salzburg, Austria
- 3rd Medical Department with Hematology, Medical Oncology, Hemostaseology, Rheumatology and Infectiology, Oncologic Center, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Alexander Egle
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- Salzburg Cancer Research Institute (SCRI), Center for Clinical Cancer and Immunology Trials (CCCIT), Austria and Cancer Cluster Salzburg (CCS), 5020 Salzburg, Austria
- 3rd Medical Department with Hematology, Medical Oncology, Hemostaseology, Rheumatology and Infectiology, Oncologic Center, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Lukas Scagnetti
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- 4th Medical Department of Internal Medicine, Hematology, Internistic Oncology and Palliative Medicine, Klinikum Wels-Grieskirchen GmbH, 4600 Wels, Austria
| | - Dominik Wolf
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- Department of Internal Medicine V, Innsbruck Medical University, 6020 Innsbruck, Austria
| | - Richard Beswick
- International Marketing, Swiss Business School, 8302 Zurich, Switzerland
| | - Manuel Drost
- Assign Data Management and Biostatistics GmbH, 6020 Innsbruck, Austria
| | | | - Thomas Grochtdreis
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Marc Vaisband
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- Salzburg Cancer Research Institute (SCRI), Center for Clinical Cancer and Immunology Trials (CCCIT), Austria and Cancer Cluster Salzburg (CCS), 5020 Salzburg, Austria
- Life and Medical Sciences Institute, University of Bonn, 53115 Bonn, Germany
| | - Jan Hasenauer
- Life and Medical Sciences Institute, University of Bonn, 53115 Bonn, Germany
| | - Nadja Zaborsky
- Salzburg Cancer Research Institute (SCRI), Center for Clinical Cancer and Immunology Trials (CCCIT), Austria and Cancer Cluster Salzburg (CCS), 5020 Salzburg, Austria
- 3rd Medical Department with Hematology, Medical Oncology, Hemostaseology, Rheumatology and Infectiology, Oncologic Center, Paracelsus Medical University, 5020 Salzburg, Austria
- Laboratory of Immunological and Molecular Cancer Research (LIMCR), 5020 Salzburg, Austria
| | - Richard Greil
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- Salzburg Cancer Research Institute (SCRI), Center for Clinical Cancer and Immunology Trials (CCCIT), Austria and Cancer Cluster Salzburg (CCS), 5020 Salzburg, Austria
- 3rd Medical Department with Hematology, Medical Oncology, Hemostaseology, Rheumatology and Infectiology, Oncologic Center, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Reinhard Stauder
- Austrian Group for Medical Tumor Therapy (AGMT) Study Group, 1180 Vienna, Austria
- Department of Internal Medicine V, Innsbruck Medical University, 6020 Innsbruck, Austria
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Engel L, Whitehurst DGT, Haagsma J, Janssen MF, Mulhern B. What is measured by the composite, single-item pain/discomfort dimension of the EQ-5D-5L? An exploratory analysis. Qual Life Res 2022; 32:1175-1186. [PMID: 36469212 DOI: 10.1007/s11136-022-03312-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE This study examines the EQ-5D-5L pain/discomfort dimension by drawing comparisons with five other pain and discomfort items (pain severity, discomfort severity, pain frequency, discomfort frequency and pain interference) collected in the Australian psychometric study for the EQ Health and Wellbeing instrument. METHODS Participants, recruited via a market research company, completed an online survey. Methods of analyses included the assessment of descriptive statistics, variation in reporting patterns using chi-square tests and cross-tabulations, correlation analyses, ordered univariate logistic regression, and discriminatory power analyses (Shannon index (H') and Shannon Evenness index (J')). RESULTS Survey data from 514 participants were used. Compared with EQ-5D-5L pain/discomfort, there was a higher proportion of respondents reporting some level of impairment on at least one of the pain severity and discomfort severity items (74% versus 81%). Correlation with EQ-5D-5L pain/discomfort was strongest for pain severity (r = 0.83) and weakest for discomfort frequency (r = 0.41); the same inferences were drawn for predictive ability. Adding any additional pain or discomfort items to the EQ-5D-5L increased the absolute informativity (H') but not the relative informativity (J'). When replacing EQ-5D-5L pain/discomfort with separate pain and/or discomfort items - i.e., adding items to a modified 'EQ-4D-5L'-absolute informativity increased, while relative informativity increased only when pain interference and frequency-related items (independently or in combination) were added. CONCLUSION The EQ-5D-5L pain/discomfort dimension captures aspects of pain more than aspects of discomfort. Potential reasons include the absence of descriptors or because pain is mentioned first in the composite item.
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Affiliation(s)
- Lidia Engel
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St. Kilda Road, Melbourne, VIC, 3004, Australia.
| | - David G T Whitehurst
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
| | - Juanita Haagsma
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
| | - M F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
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Rencz F, Janssen MF. Analyzing the Pain/Discomfort and Anxiety/Depression Composite Domains and the Meaning of Discomfort in the EQ-5D: A Mixed-Methods Study. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:2003-2016. [PMID: 35973925 DOI: 10.1016/j.jval.2022.06.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/20/2022] [Accepted: 06/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The EQ-5D has 2 composite domains: pain/discomfort (PD) and anxiety/depression (AD). This study aims to explore how respondents use the composites to self-report health and what the meaning of discomfort is in the EQ-5D for the general public. METHODS Both qualitative and quantitative data were collected in an online cross-sectional survey involving a nationally representative general population sample in Hungary (n = 1700). Respondents completed the 5-level version of EQ-5D, followed by the composites split into individual subdomains. Open-ended questions were asked to explore respondents' interpretations and experiences of discomfort. RESULTS Six different response behaviors were identified in the composites: "uniform" (21%-32%), "most severe" (30%-34%), "least severe" (16%-23%), "average" (2%-4%), "synergistic" (4%-5%), and "inconsistent" (13%-15%). Compared with the individual subdomains, many respondents under-reported their problems on both composites (PD 16%-22% and AD 6%-13%, P < .05). In respondents who scored differently in the 2 separate domains, mainly problems with the first subdomain determined responses in the composites (PD 66% and AD 61%). The discomfort subdomain in the EQ-5D captured more than 100 different problems, including pain, nonpain physical discomfort (eg, tiredness, dizziness, and nausea), and psychological discomfort (eg, anxiety, nervousness, and sadness). Women, older adults, and those in worse general health status more often considered discomfort as pain (P < .05). CONCLUSIONS We found empirical evidence of measurement error in the composite responses on the EQ-5D, including under- and inconsistent reporting, ordering effects, potential differential item functioning, and interdomain dependency. Our findings contribute new knowledge to the development of new and refinement of existing self-reported health status instruments, also beyond the EQ-5D.
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Affiliation(s)
- Fanni Rencz
- Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary.
| | - Mathieu F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
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Efficacy and safety of olaparib according to age in BRCA1/2-mutated patients with recurrent platinum-sensitive ovarian cancer: Analysis of the phase III SOLO2/ENGOT-Ov21 study. Gynecol Oncol 2022; 165:40-48. [PMID: 35115180 DOI: 10.1016/j.ygyno.2022.01.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND Olaparib has significantly improved outcome and patient-centered endpoints in BRCA1/2-mutated patients with recurrent platinum-sensitive ovarian cancer (PSOC). Specific information on efficacy and safety of olaparib for older patients appears of special interest. METHODS 295 patients from the SOLO2 trial randomly assigned to olaparib or placebo were categorized according to age-cutoff at 65 years. Efficacy, tolerability, and quality of life (QoL) of olaparib relative to placebo within in each age group was analyzed. RESULTS Baseline characteristics were similar in patients ≥65 years (N = 62;21.0%) compared to patients <65 years (N = 233;78.9%). No significant difference in the magnitude of progression-free survival (PFS) benefit from olaparib for older patients (N = 40, hazard ratio [HR]≥65 0.43, 95%-confidence interval [CI] 0.24-0.81) as compared with younger patients (N = 155, HR<65 0.31 (95%-CI 0.22-0.43) was seen (interaction P = 0.33). The overall survival (OS)benefit seen in younger patients in the olaparib arm was not observed in older patients. Older and younger patients had comparable safety profiles and QoL scores although higher discontinuation rates for toxicity, and higher frequency of AML/MDS were noted in the older subset. TWiST analysis revealed clinically meaningful duration of good QoL on olaparib for both age groups (≥65: 13.5 vs <65: 18.4 months, P = 0.05). CONCLUSIONS Results of this large phase III cohort of BRCA1/2-mutated PSOC patients treated with olaparib underline impressive efficacy of olaparib maintenance irrespective of age. Although toxicity and tolerability did not raise significant concerns, some caution, close monitoring, and follow-up needs to be exercised for older patients given higher discontinuation rates, frequency of AML/MDS, and no clear effects on OS.
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Cheng LJ, Tan RLY, Luo N. Measurement Properties of the EQ VAS Around the Globe: A Systematic Review and Meta-Regression Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1223-1233. [PMID: 34372988 DOI: 10.1016/j.jval.2021.02.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/21/2021] [Accepted: 02/19/2021] [Indexed: 05/26/2023]
Abstract
OBJECTIVES This study aimed to synthesize and evaluate published evidence on the measurement properties of the EQ VAS, a component of all EQ-5D questionnaires. METHODS This systematic review followed the Consensus-Based Standards for the Selection of Health Measurement Instruments guidelines. Five electronic databases were searched for EQ-5D-3L and EQ-5D-5L validation articles published from January 1, 2009, to November 5, 2019. Evidence for construct validity, test-retest reliability, and responsiveness was extracted from individual studies before being aggregated for evaluation of the populations represented by the studied samples. Multivariable logistic meta-regression was conducted to explore the effects of potential covariates on construct validity. RESULTS A total of 50 articles containing 488 studies, using samples drawn from 12 different populations, were identified. Generally, the quality of evidence was high for construct validity studies (n = 397) but only moderate for both test-retest reliability studies (n = 21) and responsiveness studies (n = 70). "Sufficient" construct validity of EQ VAS was found in 8 of 12 populations, "sufficient" test-retest reliability was found in 3 of 11 populations, and "sufficient" responsiveness was found in 5 of 12 populations. Meta-regression analyses suggested that construct validity studies from the Asian-Pacific region were more likely to show a negative rating compared with studies from Europe and North America. CONCLUSION The EQ VAS exhibits "sufficient" construct validity, "inconsistent" test-retest reliability, and "inconsistent" responsiveness across a broad range of populations. Additional studies are needed to explore the suboptimal validity of the EQ VAS in the Asian-Pacific region, whereas more high-quality validation studies are needed to assess its reliability and responsiveness.
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Affiliation(s)
- Ling Jie Cheng
- Nursing Research Unit, Department of Nursing, Khoo Teck Puat Hospital, Yishun Health Campus, National Healthcare Group, Singapore; Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Rachel Lee-Yin Tan
- Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Nan Luo
- Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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Noel CW, Keshavarzi S, Forner D, Stephens RF, Watson E, Monteiro E, Hosni A, Hansen A, Goldstein DP, de Almeida JR. Construct Validity of the EuroQoL-5 Dimension and the Health Utilities Index in Head and Neck Cancer. Otolaryngol Head Neck Surg 2021; 166:877-885. [PMID: 34311628 PMCID: PMC9066667 DOI: 10.1177/01945998211030173] [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] [Indexed: 12/21/2022]
Abstract
Objective The objective of this study was to evaluate the construct validity of 2 health utility instruments—the EuroQoL–5 Dimension (EQ-5D) and the Health Utilities Index–Mark 3 (HUI-3)—and to compare them with disease-specific measures in patients with head and neck cancer. Study Design Prospective cross-sectional analysis. Setting Princess Margaret Cancer Centre. Methods Patients were administered the EQ-5D, HUI-3, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its head and neck cancer module (EORTC QLQ-H&N35), and the University of Washington Quality of Life Questionnaire (UWQoL). Several a priori expected relations were examined. The correlative and discriminative properties of the various instruments were examined. Results A total of 209 patients completed the 4 questionnaires. A significant ceiling effect was observed among EQ-5D responses (23% reported a maximum score of 1). The EQ-5D (rho = 0.79) and HUI-3 (rho = 0.60) had a strong correlation with the social-emotional domain of the UWQoL. The EQ-5D had a moderate correlation with the physical domain of the UWQoL (rho = 0.42), whereas the HUI-3 had a weak correlation (rho = 0.29). The EQ-5D and HUI-3 were able to distinguish among levels of health severity measured on the EORTC QLQ-C30 though not the QLQ-H&N35. Comparatively, the UWQoL was able to distinguish levels of disease severity on the EORTC QLQ-C30 and QLQ-H&N35. Conclusion The results of this study demonstrate that disease-specific domains from head and neck quality-of-life instruments are not strongly correlated with the EQ-5D and HUI-3. Consideration should be put toward development of a disease-specific preference-based measure for health economic evaluation. Level of evidence 4.
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Affiliation(s)
- Christopher W Noel
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sareh Keshavarzi
- Department of Biostatistics, University Health Network, Toronto, Canada
| | - David Forner
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Department of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Canada
| | - Robert F Stephens
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada
| | - Erin Watson
- Department of Dentistry, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada
| | - Eric Monteiro
- Department of Otolaryngology-Head and Neck Surgery, Sinai Health System, University of Toronto, Toronto, Canada
| | - Ali Hosni
- Department of Radiation Oncology, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada
| | - Aaron Hansen
- Department of Medical Oncology, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada
| | - David P Goldstein
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada
| | - John R de Almeida
- Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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9
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Zhou T, Guan H, Wang L, Zhang Y, Rui M, Ma A. Health-Related Quality of Life in Patients With Different Diseases Measured With the EQ-5D-5L: A Systematic Review. Front Public Health 2021; 9:675523. [PMID: 34268287 PMCID: PMC8275935 DOI: 10.3389/fpubh.2021.675523] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/24/2021] [Indexed: 01/04/2023] Open
Abstract
Background: The EQ-5D-5L is a generic preference-based questionnaire developed by the EuroQol Group to measure health-related quality of life (HRQoL) in 2005. Since its development, it has been increasingly applied in populations with various diseases and has been found to have good reliability and sensitivity. This study aimed to summarize the health utility elicited from EQ-5D-5L for patients with different diseases in cross-sectional studies worldwide. Methods: Web of Science, MEDLINE, EMBASE, and the Cochrane Library were searched from January 1, 2012, to October 31, 2019. Cross-sectional studies reporting utility values measured with the EQ-5D-5L in patients with any specific disease were eligible. The language was limited to English. Reference lists of the retrieved studies were manually searched to identify more studies that met the inclusion criteria. Methodological quality was assessed with the Agency for Health Research and Quality (AHRQ) checklist. In addition, meta-analyses were performed for utility values of any specific disease reported in three or more studies. Results: In total, 9,400 records were identified, and 98 studies met the inclusion criteria. In the included studies, 50 different diseases and 98,085 patients were analyzed. Thirty-five studies involving seven different diseases were included in meta-analyses. The health utility ranged from 0.31 to 0.99 for diabetes mellitus [meta-analysis random-effect model (REM): 0.83, (95% CI = 0.77–0.90); fixed-effect model (FEM): 0.93 (95% CI = 0.93–0.93)]; from 0.62 to 0.90 for neoplasms [REM: 0.75 (95% CI = 0.68–0.82); FEM: 0.80 (95% CI = 0.78–0.81)]; from 0.56 to 0.85 for cardiovascular disease [REM: 0.77 (95% CI = 0.75–0.79); FEM: 0.76 (95% CI = 0.75–0.76)]; from 0.31 to 0.78 for multiple sclerosis [REM: 0.56 (95% CI = 0.47–0.66); FEM: 0.67 (95% CI = 0.66–0.68)]; from 0.68 to 0.79 for chronic obstructive pulmonary disease [REM: 0.75 (95% CI = 0.71–0.80); FEM: 0.76 (95% CI = 0.75–0.77)] from 0.65 to 0.90 for HIV infection [REM: 0.84 (95% CI = 0.80–0.88); FEM: 0.81 (95% CI = 0.80–0.82)]; from 0.37 to 0.89 for chronic kidney disease [REM: 0.70 (95% CI = 0.48–0.92; FEM: 0.76 (95% CI = 0.74–0.78)]. Conclusions: EQ-5D-5L is one of the most widely used preference-based measures of HRQoL in patients with different diseases worldwide. The variation of utility values for the same disease was influenced by the characteristics of patients, the living environment, and the EQ-5D-5L value set. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42020158694.
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Affiliation(s)
- Ting Zhou
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Haijing Guan
- China Center for Health Economic Research, Peking University, Beijing, China
| | - Luying Wang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Yao Zhang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Mingjun Rui
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Aixia Ma
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
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10
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Gamper EM, Cottone F, Sommer K, Norman R, King M, Breccia M, Caocci G, Patriarca A, Palumbo GA, Stauder R, Niscola P, Platzbecker U, Caers J, Vignetti M, Efficace F. The EORTC QLU-C10D was more efficient in detecting clinical known group differences in myelodysplastic syndromes than the EQ-5D-3L. J Clin Epidemiol 2021; 137:31-44. [PMID: 33753228 DOI: 10.1016/j.jclinepi.2021.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim was to investigate the relative validity of the preference-based measure EORTC QLU-C10D in comparison with the EQ-5D-3L in myelodysplastic syndromes (MDS) patients. METHODS We used data from an international multicentre, observational cohort study of MDS patients. Baseline EORTC QLU-C10D and EQ-5D-3L scores were used and index scores calculated for Italy, Australia, and the UK. Criterion validity was established by Spearman and intraclass correlations (ICC) and Bland-Altman plots. Construct validity was established by the instruments' ability to discriminate known groups, i.e. groups whose health status is expected to differ. RESULTS We analyzed data from 619 MDS patients (61.1% male; median age 73.8 years). Correlations between theoretically corresponding domains were largely higher than between unrelated domains. ICCs and Bland-Altman plots indicated moderate to good criterion validity. Ceiling effects were lower for the QLU-C10D (4.7%) than for the EQ-5D-3L (22.6%). The EQ-5D-3L failed to discriminate known-groups in two and the QLU-C10D in one of the comparisons; the QLU-C10D's efficiency in doing so was higher in clinical known-groups. Results were comparable between the countries. CONCLUSIONS The QLU-C10D may be suitable to generate health utilities for economic research in MDS. Responsiveness and minimal important differences need yet to be established.
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Affiliation(s)
- Eva M Gamper
- Innsbruck Institute of Patient-centered Outcome Research (IIPCOR), Innsbruck, Austria.
| | - Francesco Cottone
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center & Health Outcomes Research Unit, Rome, Italy
| | - Kathrin Sommer
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center & Health Outcomes Research Unit, Rome, Italy
| | - Richard Norman
- School of Public Health, Curtin University, Perth, Australia
| | - Madeleine King
- University of Sydney, School of Psychology, Sydney, NSW, Australia
| | - Massimo Breccia
- Division of Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Giovanni Caocci
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Andrea Patriarca
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Giuseppe A Palumbo
- Dipartimento di Scienze Mediche, Chirurgiche e Tecnologie Avanzate "G.F. Ingrassia", University of Catania, Catania, Italy
| | - Reinhard Stauder
- Department of Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, Innsbruck, Austria
| | | | - Uwe Platzbecker
- Clinic and Policlinic of Hematology and Cellular Therapy, Hemostaseology, University Hospital Leipzig, Leipzig, Germany
| | - Jo Caers
- Department of Hematology, CHU de Liège, University of Liege, Liege, Belgium
| | - Marco Vignetti
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center & Health Outcomes Research Unit, Rome, Italy
| | - Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center & Health Outcomes Research Unit, Rome, Italy
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11
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Zeng X, Sui M, Liu R, Qian X, Li W, Zheng E, Yang J, Li J, Huang W, Yang H, Yu H, Luo N. Assessment of the health utility of patients with leukemia in China. Health Qual Life Outcomes 2021; 19:65. [PMID: 33639980 PMCID: PMC7913428 DOI: 10.1186/s12955-021-01711-1] [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: 04/22/2020] [Accepted: 02/18/2021] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVES This study aimed to assess the health utility of leukemia patients in China using the EQ-5D-5L, compare it with the population norms, and identify the potential factors associated with health utility. METHODS A hospital based cross-sectional survey was conducted in three tertiary hospitals from July 2015 to February 2016. A total of 186 patients with leukemia completed the EQ-5D-5L and their health utility scores were calculated using the Chinese value set. EQ-5D-5L utility and dimensions scores of leukemia patients were compared with China's population norms using Kruskal-Wallis test and chi square test. Potential factors associated with health utility were identified using Tobit regression. RESULTS The mean EQ-5D-5L utility scores of patients with leukemia, grouped by either gender or age, were significantly lower than those of the general population (p < 0.001). The same results were found for individual dimensions of EQ-5D-5L, where leukemia patients reported more health problems than the general population (p < 0.001). The utility score of leukemia patients was found to be significantly related to medical insurance, religious belief, comorbidities, social support and ECOG performance status. CONCLUSION This study indicated that leukemia patients have worse health status compared to the general population of China and that multiple factors affect the health utility of the patients. The utility scores reported in this study could be useful in future cost-utility analysis.
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Affiliation(s)
- Xueyun Zeng
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Mingjie Sui
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Rui Liu
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Xinyu Qian
- National University Singapore Saw Swee Hock School of Public Health, Singapore, 117549, Singapore
| | - Wenfeng Li
- Department of Hematology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Erwei Zheng
- First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Jinjin Yang
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Jinmei Li
- Public Health Education and Information Center of Heilongjiang Province, Harbin, 150063, China
| | - Weidong Huang
- School of Health Management, Harbin Medical University, Harbin, 150086, China.
| | - Hongbin Yang
- Department of Medical Oncology, Third Affiliated Hospital of Harbin Medical University, Harbin, 150081, China.
| | - Hongjuan Yu
- Department of Hematology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China. .,Southern University of Science and Technology Hospital, Shenzhen, 518055, China.
| | - Nan Luo
- National University Singapore Saw Swee Hock School of Public Health, Singapore, 117549, Singapore
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12
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Measurement Properties of the EQ-5D-5L and EQ-5D-3L in Six Commonly Diagnosed Cancers. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2020; 14:209-222. [PMID: 33123985 DOI: 10.1007/s40271-020-00466-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND This study aimed to compare the measurement properties of the EQ-5D-3L (3L) and EQ-5D-5L (5L) in cancer patients. METHODS A consecutive sample of inpatients with lung, breast, colorectal, liver, gastric, or thyroid cancer were interviewed using the 3L, 5L, and Functional Assessment of Cancer Therapy-General (FACT-G) questionnaires, and a subgroup was invited to complete the 3L and 5L again. Kappa and intraclass correlation coefficient were used to assess test-retest reliability, and Spearman's correlation between the EQ-5D and FACT-G was evaluated to assess convergent validity. Comparison of subgroups defined using Eastern Cooperative Oncology Group status and cancer stage were performed to assess known-group validity and discriminatory power using the F-statistic and area under the receiver-operating characteristics curve. All analyses were also performed for each subgroup of cancer patients. RESULTS A total of 416 cancer patients completed the baseline questionnaire and 90 patients also completed the follow-up survey after 2 days. Ceiling effects were smaller in 5L (10.1%) than in 3L (17.8%). The test-retest reliability and convergent validity of the 5L were slightly better than those of the 3L. Both the 3L and 5L showed known-group validity; however, the 5L index showed better discriminatory power. Similar trends were found in the six types of cancers. CONCLUSION In general, 5L appears to have better measurement properties than 3L for measuring the health-related quality of life of cancer patients. While both the 3L and 5L are suitable, 5L should be preferable to 3L for use in cancer outcomes research.
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13
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Yu H, Zeng X, Sui M, Liu R, Tan RLY, Yang J, Huang W, Luo N. A head-to-head comparison of measurement properties of the EQ-5D-3L and EQ-5D-5L in acute myeloid leukemia patients. Qual Life Res 2020; 30:855-866. [PMID: 32965633 DOI: 10.1007/s11136-020-02644-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study aimed to compare the measurement properties of EQ-5D-3L(3L) and EQ-5D-5L(5L) in patients with acute myeloid leukemia (AML) in China. METHODS We consecutively recruited 168 patients with AML from three tertiary hospitals to complete two rounds of interviews using the two versions of the EQ-5D. We compared (i) the ceiling effect using the McNemar's test, (ii) test-retest reliability using intraclass correlation coefficient (ICC) and Cohen's weighted Kappa, (iii) convergent validity using Spearman's rank correlation coefficient (r) and iv) discriminatory ability using F statistic and area under the receiver operating characteristics curve (AUROC) of the 5L and the 3L. RESULTS The 5L descriptive system showed significantly lower ceiling effects in comparison to the 3L descriptive system (p < 0.001). While 5L showed superior reproducibility (Cohen's weighted Kappa = 0.56-0.67 and ICC = 0.89), both instruments exhibited good test-retest reliability. Even though both 3L and 5L showed good convergent and known-groups validity, 5L showed better convergent validity and discriminatory ability. CONCLUSION The current study found both 3L and 5L to be suitable for use in AML patients. However, 5L showed superior measurement properties compared to 3L. Thus, 5L could be the preferred instrument over 3L for use in AML patients.
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Affiliation(s)
- Hongjuan Yu
- Department of Hematology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.,Southern University of Science and Technology Hospital, Shenzhen, 518000, China
| | - Xueyun Zeng
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Mingjie Sui
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Rui Liu
- School of Health Management, Harbin Medical University, Harbin, 150086, China
| | - Rachel Lee-Yin Tan
- National University Singapore Saw Swee Hock School of Public Health, Singapore, Singapore
| | - Jinjin Yang
- Bejing Tsinghua Changgung Hospital, Beijing, 102218, China
| | - Weidong Huang
- School of Health Management, Harbin Medical University, Harbin, 150086, China.
| | - Nan Luo
- National University Singapore Saw Swee Hock School of Public Health, Singapore, Singapore
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14
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Herdman M, Kerr C, Pavesi M, Garside J, Lloyd A, Cubi-Molla P, Devlin N. Testing the validity and responsiveness of a new cancer-specific health utility measure (FACT-8D) in relapsed/refractory mantle cell lymphoma, and comparison to EQ-5D-5L. J Patient Rep Outcomes 2020; 4:22. [PMID: 32219576 PMCID: PMC7099111 DOI: 10.1186/s41687-020-0185-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 02/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The FACT-8D is a new cancer-specific, preference-based measure (PBM) of health, derived from the Functional Assessment of Cancer Therapy - General (FACT-G) questionnaire. The FACT-8D's measurement properties have not been tested to date. We assessed it's validity and responsiveness in relapsed/refractory mantle cell lymphoma (RR MCL) and compared the results to the EQ-5D-5L. METHODS Blinded analysis of pooled data from a phase 3 clinical trial. FACT-8D baseline and follow-up data (weeks 4, 7, 16, 31) were scored using Australian preference weights, the first available value-set. Convergent validity was assessed by estimating baseline correlations with the FACT-Lym total score, Trial Outcome Index (TOI), FACT-Lym lymphoma-specific sub-scale (LymS), EQ-5D Visual Analog Scale (VAS), and haemoglobin (HgB). Relevant clinical variables were used to categorise patients to test known groups' validity and responsiveness was investigated using data from baseline (n = 250) and week 31 (n = 130). Results were compared with EQ-5D-5L, scored using the UK 3L crosswalk and the 5L England value-sets. RESULTS The FACT-8D showed good convergent validity and responsiveness; baseline Pearson correlation coefficients between FACT-8D Index scores and other PRO measures were moderate to very strong (range: 0.49 for the EQ-VAS to 0.79 for FACT TOI) and the size of the change in FACT-8D Index scores at week 31 differed significantly (p < 0.005) between patients categorised as improved, worsened or stable using the FACT-Lym total score, LymS, and HgB. However, when assessing known groups' validity, FACT-8D failed to discriminate between patients categorised by health status on four of the seven variables analysed. Overall, FACT-8D and EQ-5D-5L performed similarly, although EQ-5D-5L showed better known groups' validity. CONCLUSIONS This is the first investigation into the psychometric properties of the FACT-8D. In this RR MCL trial dataset, it showed good convergent validity and responsiveness, but poorer known groups' validity, and EQ-5D performed as well or better on the tests conducted. The FACT-8D may offer an alternative method to generate utilities for the cost-effectiveness analysis of cancer treatments but needs further testing in other types of cancer patients. Evaluation of utility gains may have been limited by high baseline performance status in this RR MCL trial sample.
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Affiliation(s)
- Michael Herdman
- Office of Health Economics, Southside, 7th Floor, 105 Victoria Street, London, SW1E 6QT, UK.
| | | | - Marco Pavesi
- Data Management Centre, European Foundation for the Study of Chronic Liver Failure (EF-CLIF), Barcelona, Spain
| | | | | | - Patricia Cubi-Molla
- Office of Health Economics, Southside, 7th Floor, 105 Victoria Street, London, SW1E 6QT, UK
| | - Nancy Devlin
- Office of Health Economics, Southside, 7th Floor, 105 Victoria Street, London, SW1E 6QT, UK
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15
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Mamolo CM, Cappelleri JC, Hoang CJ, Kim R, Hadfield A, Middleton C, Rider A, Walter RB. A real-world, cross-sectional, community survey of symptoms and health-related quality of life of adults with acute myeloid leukemia. Future Oncol 2019; 15:1895-1909. [PMID: 30912462 DOI: 10.2217/fon-2018-0842] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: We used Adelphi Real World Disease-Specific Programme data to characterize adults with newly diagnosed or relapsed/refractory de novo acute myeloid leukemia (AML). Materials & methods: Community-practice hematologists/oncologists completed patient record forms for their regular AML patients. Patients were invited to complete patient self-completion forms including 3-Level EuroQol 5-Dimensions (EQ-5D-3L) and Functional Assessment of Cancer Therapy-Leukemia (FACT-Leu) questionnaires. Results: Physicians provided patient record forms for 389 patients (339 newly diagnosed, 50 relapsed/refractory); 68 patients completed patient self-completion forms. Mean EQ-5D visual-analog scale and index and FACT-General scores were significantly lower than US population norms (p < 0.0001); health-related quality of life (HRQoL) scores were generally lower than 11 other cancers. Conclusion: HRQoL impairment is grave in AML. Efforts are needed to improve HRQoL in affected patients.
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Affiliation(s)
| | | | | | - Ruth Kim
- Pfizer Inc, New York, NY 10017, USA
| | | | | | - Alex Rider
- Adelphi Real World, Cheshire, SK10 5JB, UK
| | - Roland B Walter
- Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA
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16
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Kosilov K, Kuzina I, Kosilova L, Gainullina Y, Kuznetsov V, Ivanovskaya M, Prokofyeva A. Health-related quality of life and socioeconomic status of imprisoned middle-age and elderly persons. SOCIAL THEORY & HEALTH 2018. [DOI: 10.1057/s41285-018-0069-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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17
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Kosilov K, Loparev S, Kuzina I, Kosilova L, Ivanovskaya M, Prokofyeva A. Health-related quality of life's dependence on socio-economic status and demographic characteristics among men with benign prostatic hyperplasia. Andrologia 2017; 50. [DOI: 10.1111/and.12892] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 12/30/2022] Open
Affiliation(s)
- K. Kosilov
- Department of Social and Psychological Sciences; School of Humanities; Far Eastern Federal University; Vladivostok Russian Federation
- Department of Public Health; Pacific State Medical University; Vladivostok Russian Federation
| | - S. Loparev
- Department of Urology; City Polyclinic no 3; Vladivostok Russian Federation
| | - I. Kuzina
- Department of Social and Psychological Sciences; School of Humanities; Far Eastern Federal University; Vladivostok Russian Federation
| | - L. Kosilova
- Department of Functional Methods of Diagnostic; Medical Association no 2 of Vladivostok-city; Vladivostok Russian Federation
| | - M. Ivanovskaya
- Department of Law; Far Eastern Fisheries University; Vladivostok Russian Federation
| | - A. Prokofyeva
- Department of Social and Psychological Sciences; School of Humanities; Far Eastern Federal University; Vladivostok Russian Federation
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