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Maeir T, Makranz C, Peretz T, Odem E, Tsabari S, Nahum M, Gilboa Y. Cognitive Retraining and Functional Treatment (CRAFT) for adults with cancer related cognitive impairment: a preliminary efficacy study. Support Care Cancer 2023; 31:152. [PMID: 36746805 PMCID: PMC9902836 DOI: 10.1007/s00520-023-07611-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 01/24/2023] [Indexed: 02/08/2023]
Abstract
PURPOSE To examine the preliminary efficacy of Cognitive Retraining and Functional Treatment (CRAFT) combining remote computerized cognitive training (CCT) and occupation-based treatment in adults with cancer-related cognitive impairment (CRCI). METHODS Three-armed randomized controlled trial including 74 individuals with CRCI, randomized into 12 weeks of either CRAFT, CCT alone, or treatment-as-usual. Assessments evaluating participation in daily life, perceived cognition, cognitive performance, quality-of-life, and treatment satisfaction were administered at baseline, post-intervention, and 3-month follow-up. RESULTS Significant time × group interactions in favor of the CRAFT and CCT groups were found for participation in daily life (F2,34 = 5.31, p = .01, eta = .238), perceived cognition (F2,34 = 4.897, p = .014, eta = .224), and cognitive performance on speed of processing test (F = 5.678, p = .009, eta = .289). The CRAFT group demonstrated significantly larger clinically meaningful gains on participation in daily life (chi-square = 6.91, p = .032) and significantly higher treatment satisfaction. All treatment gains were maintained at a 3-month follow-up (n = 32). CONCLUSIONS CCT and CRAFT were found to have a positive impact on participation and cognitive outcomes among individuals with CRCI. The CRAFT showed an additional advantage in improving self-chosen occupation-based goals suggesting that a combination of cognitive training with occupation-based intervention has a positive synergistic effect resulting in "real world" health benefits. IMPLICATIONS FOR CANCER SURVIVORS A combination of cognitive training with occupation-based intervention has a positive effect resulting in clinically meaningful improvements in participation in daily life, objective cognitive performance, and subjective cognitive impairment. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov NCT04210778, December 26, 2019, retrospectively registered.
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Affiliation(s)
- Talia Maeir
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, 91240, Jerusalem, Israel
| | - Chen Makranz
- Department of Neurology and Oncology, The Gaffin Center for Neuro-Oncology, Sharett Institute for Oncology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, 91120, Jerusalem, Israel
| | - Tamar Peretz
- Hebrew University Medical School, Jerusalem, Israel.,Sharett Oncology Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ester Odem
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, 91240, Jerusalem, Israel.,Meshi Center, Bnei Brak, Israel
| | - Shani Tsabari
- Department of Neurology and Oncology, The Gaffin Center for Neuro-Oncology, Sharett Institute for Oncology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, 91120, Jerusalem, Israel
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, 91240, Jerusalem, Israel
| | - Yafit Gilboa
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, 91240, Jerusalem, Israel.
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Muchadeyi MT, Hernandez-Villafuerte K, Schlander M. Quality appraisal for systematic literature reviews of health state utility values: a descriptive analysis. BMC Med Res Methodol 2022; 22:303. [PMID: 36434521 PMCID: PMC9700894 DOI: 10.1186/s12874-022-01784-6] [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] [Received: 04/24/2022] [Accepted: 11/04/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Health state utility values (HSUVs) are an essential input parameter to cost-utility analysis (CUA). Systematic literature reviews (SLRs) provide summarized information for selecting utility values from an increasing number of primary studies eliciting HSUVs. Quality appraisal (QA) of such SLRs is an important process towards the credibility of HSUVs estimates; yet, authors often overlook this crucial process. A scientifically developed and widely accepted QA tool for this purpose is lacking and warranted. OBJECTIVES To comprehensively describe the nature of QA in published SRLs of studies eliciting HSUVs and generate a list of commonly used items. METHODS A comprehensive literature search was conducted in PubMed and Embase from 01.01.2015 to 15.05.2021. SLRs of empirical studies eliciting HSUVs that were published in English were included. We extracted descriptive data, which included QA tools checklists or good practice recommendations used or cited, items used, and the methods of incorporating QA results into study findings. Descriptive statistics (frequencies of use and occurrences of items, acceptance and counterfactual acceptance rates) were computed and a comprehensive list of QA items was generated. RESULTS A total of 73 SLRs were included, comprising 93 items and 35 QA tools and good recommendation practices. The prevalence of QA was 55% (40/73). Recommendations by NICE and ISPOR guidelines appeared in 42% (16/40) of the SLRs that appraised quality. The most commonly used QA items in SLRs were response rates (27/40), statistical analysis (22/40), sample size (21/40) and loss of follow up (21/40). Yet, the most commonly featured items in QA tools and GPRs were statistical analysis (23/35), confounding or baseline equivalency (20/35), and blinding (14/35). Only 5% of the SLRS used QA to inform the data analysis, with acceptance rates of 100% (in two studies) 67%, 53% and 33%. The mean counterfactual acceptance rate was 55% (median 53% and IQR 56%). CONCLUSIONS There is a considerably low prevalence of QA in the SLRs of HSUVs. Also, there is a wide variation in the QA dimensions and items included in both SLRs and extracted tools. This underscores the need for a scientifically developed QA tool for multi-variable primary studies of HSUVs.
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Affiliation(s)
- Muchandifunga Trust Muchadeyi
- grid.7497.d0000 0004 0492 0584Division of Health Economics, German Cancer Research Center (DKFZ), Foundation Under Public Law, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Karla Hernandez-Villafuerte
- grid.7497.d0000 0004 0492 0584Division of Health Economics, German Cancer Research Center (DKFZ), Foundation Under Public Law, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany ,Health Economics, WifOR institute, Rheinstraße 22, Darmstadt, 64283 Germany
| | - Michael Schlander
- grid.7497.d0000 0004 0492 0584Division of Health Economics, German Cancer Research Center (DKFZ), Foundation Under Public Law, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany ,grid.7700.00000 0001 2190 4373Alfred Weber Institute for Economics (AWI), University of Heidelberg, Heidelberg, Germany
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Castelluccia A, Mincarone P, Tumolo MR, Sabina S, Colella R, Bodini A, Tramacere F, Portaluri M, Leo CG. Economic Evaluations of Magnetic Resonance Image-Guided Radiotherapy (MRIgRT): A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710800. [PMID: 36078513 PMCID: PMC9517760 DOI: 10.3390/ijerph191710800] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 05/06/2023]
Abstract
OBJECTIVES This review systematically summarizes the evidence on the economic impact of magnetic resonance image-guided RT (MRIgRT). METHODS We systematically searched INAHTA, MEDLINE, and Scopus up to March 2022 to retrieve health economic studies. Relevant data were extracted on study type, model inputs, modeling methods and economic results. RESULTS Five studies were included. Two studies performed a full economic assessment to compare the cost-effectiveness of MRIgRT with other forms of image-guided radiation therapy. One study performed a cost minimization analysis and two studies performed an activity-based costing, all comparing MRIgRT with X-ray computed tomography image-guided radiation therapy (CTIgRT). Prostate cancer was the target condition in four studies and hepatocellular carcinoma in one. Considering the studies with a full economic assessment, MR-guided stereotactic body radiation therapy was found to be cost effective with respect to CTIgRT or conventional or moderate hypofractionated RT, even with a low reduction in toxicity. Conversely, a greater reduction in toxicity is required to compete with extreme hypofractionated RT without MR guidance. CONCLUSIONS This review highlights the great potential of MRIgRT but also the need for further evidence, especially for late toxicity, whose reduction is expected to be the real added value of this technology.
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Affiliation(s)
- Alessandra Castelluccia
- Radiation Oncology, Department of Radiotherapy, Hospital “A. Perrino”, ASL Brindisi, 72100 Brindisi, Italy
| | - Pierpaolo Mincarone
- Institute for Research on Population and Social Policies, National Research Council, 72100 Brindisi, Italy
- MOVE-Mentis s.r.l., 47522 Cesena, Italy
- Correspondence: ; Tel.: +39-3289168745
| | - Maria Rosaria Tumolo
- Department of Biological and Environmental Sciences and Technology, University of Salento, 73100 Lecce, Italy
| | - Saverio Sabina
- MOVE-Mentis s.r.l., 47522 Cesena, Italy
- Institute of Clinical Physiology, National Research Council, 73100 Lecce, Italy
| | - Riccardo Colella
- Department of Engineering for Innovation, University of Salento, 73100 Lecce, Italy
| | - Antonella Bodini
- Institute for Applied Mathematics and Information Technologies “E. Magenes”, National Research Council, 20133 Milan, Italy
| | - Francesco Tramacere
- Radiation Oncology, Department of Radiotherapy, Hospital “A. Perrino”, ASL Brindisi, 72100 Brindisi, Italy
| | - Maurizio Portaluri
- Radiation Oncology, Department of Radiotherapy, Hospital “A. Perrino”, ASL Brindisi, 72100 Brindisi, Italy
| | - Carlo Giacomo Leo
- MOVE-Mentis s.r.l., 47522 Cesena, Italy
- Institute of Clinical Physiology, National Research Council, 73100 Lecce, Italy
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Yates P, Carter R, Cockerell R, Cowan D, Dixon C, Magnus A, Newton RU, Hart NH, Galvão DA, Baguley B, Denniston N, Skinner T, Couper J, Emery J, Frydenberg M, Liu WH. An integrated multicomponent care model for men affected by prostate cancer: A feasibility study of TrueNTH Australia. Psychooncology 2021; 30:1544-1554. [PMID: 33984175 PMCID: PMC8518483 DOI: 10.1002/pon.5729] [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: 04/23/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the feasibility of implementing an integrated multicomponent survivorship care model for men affected by prostate cancer. METHODS Using a single arm prospective cohort study design, men with prostate cancer were recruited from two regional public hospitals in Australia for a 6-months program that provided information and decision support, exercise and nutrition management, specialised clinical support, and practical support through localised and central care coordination. Carers of the men were also invited to the program. Data were collected from multiple sources to evaluate: (1) recruitment capability and participant characteristics; (2) appropriateness and feasibility of delivering the specific intervention components using an electronic care management tool; and (3) suitability of data collection procedures and proposed outcome measures. RESULTS Of the 105 eligible men, 51 (consent rate 49%) participated in the program. Of the 31 carers nominated by the men, 13 consented (consent rate 42%). All carers and 50 (98%) men completed the program. Most (92%) men were newly diagnosed with localised prostate cancer. All men attended initial screening and assessment for supportive care needs; a total of 838 episodes of contact/consultation were made by the intervention team either in person (9%) or remotely (91%). The intervention was implemented as proposed with no adverse events. The proposed outcome measures and evaluation procedures were found to be appropriate. CONCLUSIONS Our results support the feasibility of implementing this integrated multicomponent care model for men affected by prostate cancer.
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Affiliation(s)
- Patsy Yates
- Faculty of Health, Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Rob Carter
- Faculty of Health, Deakin Health Economics, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia
| | - Robyn Cockerell
- Faculty of Health, Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Cyril Dixon
- Movember, Melbourne, Victoria, Australia.,Dixon Healthcare Consulting, Melbourne, Victoria, Australia
| | - Anne Magnus
- Faculty of Health, Deakin Health Economics, Institute for Health Transformation, Deakin University, Melbourne, Victoria, Australia
| | - Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Nicolas H Hart
- Faculty of Health, Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Queensland, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia
| | - Brenton Baguley
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.,School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
| | | | - Tina Skinner
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jeremy Couper
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Jon Emery
- Department of General Practice, Centre for Cancer Research, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mark Frydenberg
- Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Cabrini Institute, Cabrini Health, Monash University, Melbourne, Victoria, Australia
| | - Wei-Hong Liu
- Faculty of Health, Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, Queensland, Australia
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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.
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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
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6
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Murasawa H, Sugiyama T, Matsuoka Y, Okabe T, Hino A, Tanaka N, Sugimoto M, Oyama M, Fujimoto K, Horie S, Noto S, Shimozuma K. Health utility and health-related quality of life of Japanese prostate cancer patients according to progression status measured using EQ-5D-5L and FACT-P. Qual Life Res 2019; 28:2383-2391. [PMID: 31025290 DOI: 10.1007/s11136-019-02184-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2019] [Indexed: 01/22/2023]
Abstract
PURPOSE To obtain health utility data to allow for cost-effectiveness analysis in groups stratified by disease progression along with health-related quality of life (HRQoL) information in Japanese prostate cancer (PC) patients. METHODS In this cross-sectional observational study, EuroQol-5 Dimension- 5 Level (EQ-5D-5L), EuroQol Visual Analog Scale (EQ-VAS), and Functional Assessment of Cancer Therapy-Prostate (FACT-P) measures were used to examine utility, VAS scores, and disease-specific HRQoL, respectively. Scores obtained were statistically examined for the correlation among measures and domains. Parameter estimates of statistically significant factors were assessed using generalized linear models (GLM). RESULTS A total of 380 patients stratified by their disease progression status were analyzed. The numbers (%) of patients in groups stratified as having localized (L), localized progression (LP), distant metastatic (DM), and DM-castration-resistant PC (CRPC) were 275 (72.4), 40 (10.5), 27 (7.1), and 38 (10.0), respectively. EQ-5D-5L mean (standard deviation, SD) scores of L, LP, DM, and DM-CRPC in study participants were 0.87 (0.15), 0.86 (0.15), 0.85 (0.18), and 0.84 (0.17), respectively. The mean (SD) scores assessed by EQ-5D-5L, EQ-VAS, and FACT-P instruments were 0.86 (0.16), 74.6 (16.8), and 110.8 (19.6), respectively. Utility scores correlated well with FACT-P scores. Eastern Cooperative Oncology Group performance status had significant influences on all instruments' scores. CONCLUSIONS We obtained health utility and HRQoL scores of Japanese PC patients stratified by disease progression in detail. Our results will be useful for establishing cost-effectiveness analyses in Japanese PC settings.
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Affiliation(s)
- Hideki Murasawa
- Department of Life Sciences, Ritsumeikan University, Kusatsu, Japan.
| | - Takayuki Sugiyama
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuki Matsuoka
- Department of Urology, Faculty of medicine, Kagawa University, Kagawa, Japan
| | - Takashi Okabe
- Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Amiko Hino
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | | | - Mikio Sugimoto
- Department of Urology, Faculty of medicine, Kagawa University, Kagawa, Japan
| | - Masafumi Oyama
- Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | | | - Shigeo Horie
- Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | - Shinichi Noto
- Department of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Kojiro Shimozuma
- Department of Life Sciences, Ritsumeikan University, Kusatsu, Japan
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7
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Preiß M, Friedrich M, Stolzenburg JU, Zenger M, Hinz A. Response shift effects in the assessment of urologic cancer patients' quality of life. Eur J Cancer Care (Engl) 2019; 28:e13027. [PMID: 30815952 DOI: 10.1111/ecc.13027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 01/14/2019] [Accepted: 02/01/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Urologic cancer patients often assess their quality of life (QoL) as being relatively good. Response shift (change in internal standards) may be one reason for that effect. The aim of this study was to test such response shift effects. METHODS A sample of 197 male urologic cancer patients was tested while hospitalised (t1) and three months later (t2). The participants had to assess their current health state and the health state of two anchoring vignettes. They also completed the EORTC QLQ-C30 and PHQ-4 questionnaires, including a retrospective thentest. The control sample was comprised of members of the general population. RESULTS The patients rated their general health as being worse than people from the general population did (effect size: d = 0.73, p < 0.001). Moreover, the patients assessed the vignette presenting physical problems as being significantly healthier than people from the general population did (d = 0.42, p < 0.001). Under the retrospective thentest condition, the patients rated their QoL and their mental burden as being significantly worse than in the pre-test condition. Both methods showed response shift effects. CONCLUSION Urologic cancer patients' assessments of their QoL should be handled with caution because of possible shifts in their internal standards of judgement.
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Affiliation(s)
- Martin Preiß
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | | | - Markus Zenger
- Faculty of Applied Human Studies, University of Applied Sciences Magdeburg and Stendal, Stendal, Germany.,Integrated Research and Treatment Center Adiposity Diseases, Leipzig University Medical Center, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
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Liu Y, Uemura H, Ye D, Lee JY, Chiong E, Pu YS, Razack AHA, Pripatnanont C, Rawal S, Low GKM, Qiu H, Chow WH, Van Kooten Losio M. Prostate cancer in Asia: design of a patient registry to inform real-world treatments, outcomes, and quality of life. Prostate Int 2018; 7:108-113. [PMID: 31485435 PMCID: PMC6713796 DOI: 10.1016/j.prnil.2018.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/14/2018] [Accepted: 12/08/2018] [Indexed: 11/26/2022] Open
Abstract
Background The incidence of prostate cancer (PC) in Asian countries is increasing for reasons that are not clear. Data describing how PC is diagnosed and treated are fragmented across Asia, with marked intercountry and intracountry differences in outcome and knowledge gaps in clinical diagnostic and treatment practices. To address these knowledge gaps, we have established a PC disease registry with the aim of providing a comprehensive picture of PC diagnosis, prognosis, treatment and outcome, population characteristics, and comorbidities in real-world clinical practice in Asia. Methods This is a multinational, multicenter, longitudinal, and observational registry of PC patients presenting to participating tertiary-care hospitals in eight Asian countries (www.clinicaltrials.gov NCT02546908. Registry Identifier: NOPRODPCR4001). Approximately 3500-4000 eligible patients with existing or newly diagnosed high-risk localized PC (cohort 1), nonmetastatic biochemically recurrent PC (cohort 2), or metastatic PC (cohort 3) will be consecutively enrolled and followed-up for 5 years. An enrollment cap of 600 patients each will be applied to cohorts 1 and 2. Disease status is collected at enrollment, and outcome variables captured at 3-monthly intervals include diagnostic/staging, treatments including reason for change, laboratory results, comorbidities, and concomitant medications. Treatments and survival outcomes will be captured real time until study end. Patient-reported quality-of-life will be measured every 6 months, and medical resource utilization summarized at study end. Data analysis will include exploratory analyses of potential associations between multiple risk factors and socioeconomic variables with disease progression and evaluation of various treatments for PC including novel therapies on clinical outcome and health-related quality-of-life outcomes. Results 3636 men with PC were enrolled until July 2018; 416 in cohort 1, 399 in cohort 2 and 2821 in cohort 3. Discussion A total of 3636 patients were enrolled until July 2018. The prospective disease registry will provide comprehensive and wide-ranging real-world information on how PC is diagnosed and treated in Asia. Such information can be used to inform policy development for best practice and direct clinical study design evaluating new treatments.
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Affiliation(s)
- Yanfang Liu
- Janssen Research and Development, Titusville, NJ 08560, United States
| | - Hirotsugu Uemura
- Department of Urology, Kindai University Hospital, Osaka 589-8511, Japan
| | - Dingwei Ye
- Fudan University Shang Hai Cancer Center, Xuhui District, 200032, China
| | - Ji Y Lee
- The Catholic University of Korea, Seoul St.Mary's Hospital, 06591 Seoul, Korea
| | - Edmund Chiong
- Department of Urology, National University Health System, Singapore
| | - Yeong-S Pu
- Department of Urology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Azad H A Razack
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, 50603 Malaysia
| | - Choosak Pripatnanont
- Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110 Thailand
| | - Sudhir Rawal
- Rajeev Gandhi Cancer Institutes, 110085, New Delhi, India
| | - Grace K M Low
- Janssen Research and Development, Epidemiology, Ascent, 118222, Singapore
| | - Hong Qiu
- Janssen Research and Development, Titusville, NJ 08560, United States
| | - Weng H Chow
- Janssen Research and Development, Epidemiology, Ascent, 118222, Singapore
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9
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Ramaekers BLT, Riemsma R, Tomini F, van Asselt T, Deshpande S, Duffy S, Armstrong N, Severens JL, Kleijnen J, Joore MA. Abiraterone Acetate for the Treatment of Chemotherapy-Naïve Metastatic Castration-Resistant Prostate Cancer: An Evidence Review Group Perspective of an NICE Single Technology Appraisal. PHARMACOECONOMICS 2017; 35:191-202. [PMID: 27566699 PMCID: PMC5253156 DOI: 10.1007/s40273-016-0445-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The National Institute for Health and Care Excellence (NICE) invited Janssen, the company manufacturing abiraterone acetate (AA; tradename Zytiga®), to submit evidence for the clinical and cost effectiveness of AA in combination with prednisone/prednisolone (AAP) compared with watchful waiting (i.e. best supportive care [BSC]) for chemotherapy-naïve patients with metastatic castration-resistant prostate cancer (mCRPC). Kleijnen Systematic Reviews Ltd (KSR), in collaboration with Maastricht University Medical Center, was commissioned as the Evidence Review Group (ERG). This paper presents a summary of the company submission (CS), the ERG report, subsequent addenda, and the development of the NICE guidance for the use of this drug in England and Wales by the Appraisal Committee (AC). The ERG produced a critical review of the clinical and cost effectiveness of AAP based on the CS. An important question in this appraisal was, according to the ERG, whether AAP followed by docetaxel is more effective than BSC followed by docetaxel. In the COU-AA-302 trial, 239 of 546 (43.8 %) AAP patients and 304 of 542 (56.1 %) BSC patients received docetaxel as subsequent therapy, following AA or placebo. The results for this specific group of patients were not presented in the CS; therefore, the ERG asked the company to provide these data in the clarification letter; however, these data were presented as commercial-in-confidence and cannot therefore be reported here. The ERG's critical assessment of the company's economic evaluation highlighted a number of concerns, including (a) not using the intention-to-treat (ITT) population; (b) inconsistencies in estimating prediction equations; (c) not fully incorporating the impact of adverse events; (d) incorrectly incorporating the new patient access scheme (PAS); and (e) the assumption that AA non-compliance leads to recoverable drug costs. Although some of these issues were adjusted in the ERG base case, the ERG could not estimate the impact of all of these issues, and thus acknowledges that there are still uncertainties concerning the cost-effectiveness evidence. With the exception of the ERG's preference for using the ITT population, the AC agreed with the approach taken in the ERG base case. The original company and ERG base-case incremental cost-effectiveness ratios (ICERs) were £46,722 and £57,688 per QALY gained, respectively; these changed to £28,563 and £38,061 per QALY gained, respectively, in the revised base cases applying a new PAS. Regarding the end-of-life criteria, after 24 months approximately 63 % of patients in the control group of the COU-AA-302 trial were still alive, and the median survival was 30.1 months (95 % CI 27.3-34.1). Therefore, it is unlikely that life expectancy would be less than 24 months. The AC stated that the most plausible ICER is likely between £28,600 and £32,800 per QALY gained, and concluded that AAP at this stage in the treatment pathway did not meet the end-of-life criterion for short life expectancy. Moreover, in March 2016, the AC produced the final guidance, stating that AAP is recommended, within its marketing authorisation, as an option for treating mCRPC.
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Affiliation(s)
- Bram L T Ramaekers
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands.
| | | | - Florian Tomini
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
| | - Thea van Asselt
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Pharmacy, University of Groningen, Groningen, The Netherlands
| | | | | | | | - Johan L Severens
- Institute of Health Policy and Management, iMTA-Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jos Kleijnen
- Kleijnen Systematic Reviews Ltd, York, UK
- School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Manuela A Joore
- Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA), Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands
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