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Dixon PR, Shapiro J, McRackan TR, Feeny D, Cushing SL, Chen JM, Tomlinson G. Derivation and Initial Validation of the Utility Function for the Hearing Utility Measure (HUM). Laryngoscope 2024. [PMID: 38899833 DOI: 10.1002/lary.31590] [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] [Received: 04/17/2024] [Revised: 05/23/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE The Hearing Utility Measure (HUM) is a replacement hearing attribute for the Health Utilities Index, Mark 3 (HUI-3) designed to improve the responsiveness of utility estimates to changes in hearing-related quality of life. The final development step is to derive the instrument's utility scoring function. METHODS Residents of Ontario, Canada, aged ≥18 years participated in standard gamble and visual analogue scale exercises. Valuations for levels (response options) within each domain, and for each domain relative to the other domains were elicited and used to generate a hearing utility function. The function outputs hearing utility ranging from 0 = 'unable to hear at all' to 1 = 'perfect hearing' for each of the 25,920 hearing states classifiable by the HUM. Performance was assessed relative to the criterion standard: directly elicited standard gamble utility. Distributions of HUM-derived hearing utility were compared with legacy HUI-3 derived estimates. RESULTS A total of 126 respondents participated (mean age 39.2, range 18-85 years, 53% female [67/126]). The utility function performed well in the estimation of directly elicited utilities (mean difference 0.03, RMSE 0.06). Using the legacy HUI-3, estimated hearing utility was 1.0 for 118/126 respondents (93.6%) compared with just 66/126 (52.4%) using the HUM. CONCLUSION The new hearing attribute is capable of measuring variations in hearing utility not captured by the legacy HUI-3, especially near the ceiling of hearing function. These findings justify its application and further work to study its measurement properties in hearing loss populations. LEVEL OF EVIDENCE 3 Laryngoscope, 2024.
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Affiliation(s)
- Peter R Dixon
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Justin Shapiro
- Department of Otolaryngology - Head & Neck Surgery, Western University, London, Ontario, Canada
| | - Theodore R McRackan
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - David Feeny
- Health Utilities Incorporated and Department of Economics and Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Sharon L Cushing
- Department of Otolaryngology - Head & Neck Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Joseph M Chen
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology - Head & Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - George Tomlinson
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto, Ontario, Canada
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Kennedy K, Pickard S, Tarride JE, Xie F. Resurrecting Multiattribute Utility Function: Developing a Value Set for Health Utility for Glaucoma. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023:S1098-3015(23)02530-5. [PMID: 37059392 DOI: 10.1016/j.jval.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 03/27/2023] [Accepted: 04/02/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVES This study aimed to develop a scoring function to calculate health utilities for health states described by the Health Utility for Glaucoma (HUG-5) based on the preferences of the general population in the United States. METHODS Preferences for HUG-5 health states were elicited using the standard gamble and visual analog scale through an online survey. Quota-based sampling was used to recruit a representative sample of the US general population in terms of age, sex, and race. A multiple attribute disutility function (MADUF) approach was adopted to derive scoring for the HUG-5. Model fit was assessed using mean absolute error associated with 5 HUG-5 marker health states that describe mild/moderate and severe glaucoma. RESULTS Of 634 respondents completing the tasks, 416 were included in the estimation of the MADUF; 260 respondents (63%) considered worst possible HUG-5 health state better than death. The preferred scoring function generates the utilities ranging from 0.05 (worst HUG-5 health state) to 1 (best HUG-5 health state). The correlation between mean elicited and estimated values for marker states was strong (R2 = 0.97) with mean absolute error = 0.11. CONCLUSIONS The MADUF for HUG-5 is used to measure health utilities on the scale of perfect health and death, which can be used to estimate quality-adjusted life-years for economic evaluations of glaucoma interventions.
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Affiliation(s)
- Kevin Kennedy
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Simon Pickard
- College of Pharmacy - Pharmacy Systems Outcomes and Policy, University of Illinois Chicago, Chicago, IL, USA
| | - Jean-Eric Tarride
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Feng Xie
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
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Quality of life in home-dwelling cancer patients aged 80 years and older: a systematic review. Health Qual Life Outcomes 2022; 20:154. [PMID: 36443850 PMCID: PMC9703757 DOI: 10.1186/s12955-022-02070-1] [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: 09/02/2022] [Accepted: 11/12/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Quality of Life (QoL) in elderly cancer patients is a topic that has been little explored. This systematic review aims to identify, assess, and report the literature on QoL in home-dwelling cancer patients aged 80 years and older and what QoL instruments have been used. METHODS We systematically searched the databases of Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsykINFO, Scopus, Epistemonikos and Cinahl to identify studies of any design measuring QoL among home-dwelling cancer patients aged 80 years and older. We screened the titles and abstracts according to a predefined set of inclusion criteria. Data were systematically extracted into a predesigned data charting form, and descriptively analyzed. The included studies were assessed according to the Critical Appraisal Skills Programme (CASP) checklists, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA) checklist was used to ensure rigor in conducting our investigations and reporting our findings. This systematic review was registered in PROSPERO (CRD42021240170). RESULTS We included three studies that specifically analyze QoL outcomes in the subgroup of home-dwelling cancer patients aged 80 years and older, with a total of 833 participants having various cancer diagnoses. 193 of the participants included in these three studies were aged 80 years or more. Different generic and cancer-specific QoL instruments as well as different aims and outcomes were studied. All three studies used a diagnosis-specific instrument, but none of them used an age-specific instrument. Despite heterogeneity in cancer diagnoses, instruments used, and outcomes studied, QoL in home-dwelling cancer patients aged over 80 years old seems to be correlated with age, physical function, comorbidity, living alone, needing at-home care services, being in a poor financial situation and having a small social network. CONCLUSION Our systematic review revealed only three studies exploring QoL and its determinants in the specific subgroup of home-dwelling cancer patients aged 80 years and over. A gap in the knowledge base has been identified. Future studies of this increasingly important and challenging patient group must be emphasized. Subgroup analyses by age must be performed, and valid age and diagnosis specific QoL instruments must be used to generate evidence in this segment of the population.
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Zamora V, Garin O, Pardo Y, Pont À, Gutiérrez C, Cabrera P, Gómez-Veiga F, Pijoan JI, Litwin MS, Ferrer M. Mapping the Patient-Oriented Prostate Utility Scale From the Expanded Prostate Cancer Index Composite and the Short-Form Health Surveys. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1676-1685. [PMID: 34711369 DOI: 10.1016/j.jval.2021.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 03/01/2021] [Accepted: 03/29/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study aimed to develop mapping algorithms from the Expanded Prostate Cancer Index Composite (EPIC) and the Short-Form (SF) Health Surveys to the Patient-Oriented Prostate Utility Scale (PORPUS), an econometric instrument specifically developed for patients with prostate cancer. METHODS Data were drawn from 2 cohorts concurrently administering PORPUS, EPIC-50, and SF-36v2. The development cohort included patients who had received a diagnosis of localized or locally advanced prostate cancer from 2017 to 2019. The validation cohort included men who had received a diagnosis of localized prostate cancer from 2014 to 2016. Linear regression models were constructed with ln(1 - PORPUS utility) as the dependent variable and scores from the original and brief versions of the EPIC and SF as independent variables. The predictive capacity of mapping models constructed with all possible combinations of these 2 instruments was assessed through the proportion of variance explained (R2) and the agreement between predicted and observed values. Validation was based on the comparison between estimated and observed utility values in the validation cohort. RESULTS Models constructed with EPIC-50 with and without SF yielded the highest predictive capacity (R2 = 0.884, 0.871, and 0.842) in comparison with models constructed with EPIC-26 (R2 = 0.844, 0.827, and 0.776). The intraclass correlation coefficient was excellent in the 4 models (>0.9) with EPIC and SF. In the validation cohort, predicted PORPUS utilities were slightly higher than those observed, but differences were not statistically significant. CONCLUSIONS Mapping algorithms from both the original and the abbreviated versions of the EPIC and the SF Health Surveys allow estimating PORPUS utilities for economic evaluations with cost-utility analyses in patients with prostate cancer.
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Affiliation(s)
- Víctor Zamora
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
| | - Olatz Garin
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain; Universitat Pompeu Fabra, Barcelona, Spain.
| | - Yolanda Pardo
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
| | - Àngels Pont
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
| | | | - Patricia Cabrera
- Department of Radiation Oncology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Francisco Gómez-Veiga
- Complejo Hospitalario Universitario de Salamanca, Grupo de Investigación Translacional de Urología, Instituto de Investigación de Salamanca, Salamanca, Spain
| | - José Ignacio Pijoan
- CIBER en Epidemiología y Salud Pública, CIBERESP, Spain; Department of Clinical Epidemiology, Hospital Universitario de Cruces, Barakaldo, Vizcaya, Spain
| | - Mark S Litwin
- Schools of Medicine, Public Health and Nursing, University of California, Los Angeles, CA, USA
| | - Montse Ferrer
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
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Swan JS, Lennes IT, Stump NN, Temel JS, Wang D, Keller L, Donelan K. A Patient-Centered Utility Index for Non-Small Cell Lung Cancer in the United States. MDM Policy Pract 2018; 3:2381468318801565. [PMID: 30349874 PMCID: PMC6194926 DOI: 10.1177/2381468318801565] [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: 01/08/2018] [Accepted: 08/17/2018] [Indexed: 11/16/2022] Open
Abstract
Background. A preference-based quality-of-life index for non–small cell lung cancer was developed with a subset of Functional Assessment of Cancer Therapy (FACT)–General (G) and FACT–Lung (L) items, based on clinician input and the literature. Design. A total of 236 non–small cell lung carcinoma patients contributed their preferences, randomly allocated among three survey groups to decrease burden. The FACT-L Utility Index (FACT-LUI) was constructed with two methods: 1) multiattribute utility theory (MAUT), where a visual analog scale (VAS)–based index was transformed to standard gamble (SG); and 2) an unweighted index, where items were summed, normalized to a 0 to 1.0 scale, and the result transformed to a scale length equivalent to the VAS or SG MAUT-based model on a Dead to Full Health scale. Agreement between patients’ direct utility and the indexes for current health was assessed. Results. The agreement of the unweighted index with direct SG was superior to the MAUT-based index (intraclass correlation for absolute agreement: 0.60 v. 0.35; mean difference: 0.03 v. 0.19; and mean absolute difference 0.09 v. 0.21, respectively). Mountain plots showed substantial differences, with the unweighted index demonstrating a median bias of 0.02 versus the MAUT model at 0.2. There was a significant difference (P = 0.0002) between early (I-II) and late stage (III-IV) patients, the mean difference for both indexes being greater than distribution-based estimates of minimal important difference. Limitations. The population was limited to non–small cell lung cancer patients. However, most quality-of-life literature consulted and the FACT instruments do not differentiate between lung cancer cell types. Minorities were also limited in this sample. Conclusions. The FACT-LUI shows early evidence of validity for informing economic analysis of lung cancer treatments.
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Affiliation(s)
- J Shannon Swan
- Massachusetts General Hospital Institute for Technology Assessment (JSS, NNS, KD), Boston, Massachusetts.,Harvard Medical School (JSS, ITL, JST, KD), Boston, Massachusetts.,Massachusetts General Hospital Cancer Center (ITL, JST), Boston, Massachusetts.,Massachusetts General Hospital Department of Radiology (DW), Boston, Massachusetts.,Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (DW).,University of Massachusetts, Amherst, Massachusetts (LK).,Massachusetts General Hospital Mongan Institute for Health Policy, Boston, Massachusetts (KD)
| | - Inga T Lennes
- Massachusetts General Hospital Institute for Technology Assessment (JSS, NNS, KD), Boston, Massachusetts.,Harvard Medical School (JSS, ITL, JST, KD), Boston, Massachusetts.,Massachusetts General Hospital Cancer Center (ITL, JST), Boston, Massachusetts.,Massachusetts General Hospital Department of Radiology (DW), Boston, Massachusetts.,Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (DW).,University of Massachusetts, Amherst, Massachusetts (LK).,Massachusetts General Hospital Mongan Institute for Health Policy, Boston, Massachusetts (KD)
| | - Natalie N Stump
- Massachusetts General Hospital Institute for Technology Assessment (JSS, NNS, KD), Boston, Massachusetts.,Harvard Medical School (JSS, ITL, JST, KD), Boston, Massachusetts.,Massachusetts General Hospital Cancer Center (ITL, JST), Boston, Massachusetts.,Massachusetts General Hospital Department of Radiology (DW), Boston, Massachusetts.,Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (DW).,University of Massachusetts, Amherst, Massachusetts (LK).,Massachusetts General Hospital Mongan Institute for Health Policy, Boston, Massachusetts (KD)
| | - Jennifer S Temel
- Massachusetts General Hospital Institute for Technology Assessment (JSS, NNS, KD), Boston, Massachusetts.,Harvard Medical School (JSS, ITL, JST, KD), Boston, Massachusetts.,Massachusetts General Hospital Cancer Center (ITL, JST), Boston, Massachusetts.,Massachusetts General Hospital Department of Radiology (DW), Boston, Massachusetts.,Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (DW).,University of Massachusetts, Amherst, Massachusetts (LK).,Massachusetts General Hospital Mongan Institute for Health Policy, Boston, Massachusetts (KD)
| | - David Wang
- Massachusetts General Hospital Institute for Technology Assessment (JSS, NNS, KD), Boston, Massachusetts.,Harvard Medical School (JSS, ITL, JST, KD), Boston, Massachusetts.,Massachusetts General Hospital Cancer Center (ITL, JST), Boston, Massachusetts.,Massachusetts General Hospital Department of Radiology (DW), Boston, Massachusetts.,Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (DW).,University of Massachusetts, Amherst, Massachusetts (LK).,Massachusetts General Hospital Mongan Institute for Health Policy, Boston, Massachusetts (KD)
| | - Lisa Keller
- Massachusetts General Hospital Institute for Technology Assessment (JSS, NNS, KD), Boston, Massachusetts.,Harvard Medical School (JSS, ITL, JST, KD), Boston, Massachusetts.,Massachusetts General Hospital Cancer Center (ITL, JST), Boston, Massachusetts.,Massachusetts General Hospital Department of Radiology (DW), Boston, Massachusetts.,Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (DW).,University of Massachusetts, Amherst, Massachusetts (LK).,Massachusetts General Hospital Mongan Institute for Health Policy, Boston, Massachusetts (KD)
| | - Karen Donelan
- Massachusetts General Hospital Institute for Technology Assessment (JSS, NNS, KD), Boston, Massachusetts.,Harvard Medical School (JSS, ITL, JST, KD), Boston, Massachusetts.,Massachusetts General Hospital Cancer Center (ITL, JST), Boston, Massachusetts.,Massachusetts General Hospital Department of Radiology (DW), Boston, Massachusetts.,Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (DW).,University of Massachusetts, Amherst, Massachusetts (LK).,Massachusetts General Hospital Mongan Institute for Health Policy, Boston, Massachusetts (KD)
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Rowen D, Brazier J, Ara R, Azzabi Zouraq I. The Role of Condition-Specific Preference-Based Measures in Health Technology Assessment. PHARMACOECONOMICS 2017; 35:33-41. [PMID: 29052164 DOI: 10.1007/s40273-017-0546-9] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A condition-specific preference-based measure (CSPBM) is a measure of health-related quality of life (HRQOL) that is specific to a certain condition or disease and that can be used to obtain the quality adjustment weight of the quality-adjusted life-year (QALY) for use in economic models. This article provides an overview of the role and the development of CSPBMs, and presents a description of existing CSPBMs in the literature. The article also provides an overview of the psychometric properties of CSPBMs in comparison with generic preference-based measures (generic PBMs), and considers the advantages and disadvantages of CSPBMs in comparison with generic PBMs. CSPBMs typically include dimensions that are important for that condition but may not be important across all patient groups. There are a large number of CSPBMs across a wide range of conditions, and these vary from covering a wide range of dimensions to more symptomatic or uni-dimensional measures. Psychometric evidence is limited but suggests that CSPBMs offer an advantage in more accurate measurement of milder health states. The mean change and standard deviation can differ for CSPBMs and generic PBMs, and this may impact on incremental cost-effectiveness ratios. CSPBMs have a useful role in HTA where a generic PBM is not appropriate, sensitive or responsive. However, due to issues of comparability across different patient groups and interventions, their usage in health technology assessment is often limited to conditions where it is inappropriate to use a generic PBM or sensitivity analyses.
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Affiliation(s)
- Donna Rowen
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - John Brazier
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Roberta Ara
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Ismail Azzabi Zouraq
- Takeda Pharmaceuticals International AG, Thurgauerstrasse 130, 8152, Glattpark-Opfikon (Zurich), Switzerland
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7
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Longford NT. Inflated assessments of disability. J Appl Stat 2017. [DOI: 10.1080/02664763.2016.1221914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Gries KS, Regier DA, Ramsey SD, Patrick DL. Utility Estimates of Disease-Specific Health States in Prostate Cancer from Three Different Perspectives. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2017; 15:375-384. [PMID: 27704390 DOI: 10.1007/s40258-016-0282-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To develop a statistical model generating utility estimates for prostate cancer specific health states, using preference weights derived from the perspectives of prostate cancer patients, men at risk for prostate cancer, and society. METHODS Utility estimate values were calculated using standard gamble (SG) methodology. Study participants valued 18 prostate-specific health states with the five attributes: sexual function, urinary function, bowel function, pain, and emotional well-being. Appropriateness of model (linear regression, mixed effects, or generalized estimating equation) to generate prostate cancer utility estimates was determined by paired t-tests to compare observed and predicted values. Mixed-corrected standard SG utility estimates to account for loss aversion were calculated based on prospect theory. RESULTS 132 study participants assigned values to the health states (n = 40 men at risk for prostate cancer; n = 43 men with prostate cancer; n = 49 general population). In total, 792 valuations were elicited (six health states for each 132 participants). The most appropriate model for the classification system was a mixed effects model; correlations between the mean observed and predicted utility estimates were greater than 0.80 for each perspective. CONCLUSIONS Developing a health-state classification system with preference weights for three different perspectives demonstrates the relative importance of main effects between populations. The predicted values for men with prostate cancer support the hypothesis that patients experiencing the disease state assign higher utility estimates to health states and there is a difference in valuations made by patients and the general population.
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Affiliation(s)
| | - Dean A Regier
- Canadian Centre for Applied Research in Cancer Control, BC Cancer Agency Research Centre, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Scott D Ramsey
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Donald L Patrick
- Department of Health Services, University of Washington, Seattle, WA, USA
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Swan JS, Pandharipande PV, Salazar GM. Developing a Patient-Centered Radiology Process Model. J Am Coll Radiol 2016; 13:510-6. [DOI: 10.1016/j.jacr.2015.11.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 11/20/2015] [Accepted: 11/20/2015] [Indexed: 11/25/2022]
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10
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Goodwin E, Green C. A Systematic Review of the Literature on the Development of Condition-Specific Preference-Based Measures of Health. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2016; 14:161-83. [PMID: 26818198 DOI: 10.1007/s40258-015-0219-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND Health state utility values (HSUVs) are required to calculate quality-adjusted life-years (QALYs). They are frequently derived from generic preference-based measures of health. However, such generic measures may not capture health attributes of relevance to specific conditions. In such cases, a condition-specific preference-based measure (CSPBM) may be more appropriate. OBJECTIVE This systematic review aimed to identify all published accounts of developing CSPBMs to describe and appraise the methods used. METHOD We undertook a systematic search (of Embase, MEDLINE, PsycINFO, Web of Science, the Cochrane Library, CINAHL, EconLit, ASSIA and the Health Management Information Consortium database) to identify published accounts of CSPBM development up to July 2015. Studies were reviewed to investigate the methods used to design classification systems, estimate HSUVs, and validate the measures. RESULTS A total of 86 publications were identified, describing 51 CSPBMs. Around two-thirds of these were QALY measures; the remainder were designed for clinical decision making only. Classification systems for 33 CSPBMs were derived from existing instruments; 18 were developed de novo. HSUVs for 34 instruments were estimated using a 'composite' approach, involving statistical modelling; the remainder used a 'decomposed' approach based on multi-attribute utility theory. Half of the papers that described the estimation of HSUVs did not report validating their measures. CONCLUSION Various methods have been used at all stages of CSPBM development. The choice between developing a classification system de novo or from an existing instrument may depend on the availability of a suitable existing measure, while the choice between a decomposed or composite approach appears to be determined primarily by the purpose for which the instrument is designed. The validation of CSPBMs remains an area for further development.
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Affiliation(s)
- Elizabeth Goodwin
- Health Economics Group, University of Exeter Medical School, University of Exeter, Room 1.06, South Cloisters, St Luke's Campus, Exeter, EX1 2LU, UK.
| | - Colin Green
- Health Economics Group, University of Exeter Medical School, University of Exeter, Room 1.06, South Cloisters, St Luke's Campus, Exeter, EX1 2LU, UK
- Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, University of Exeter, Exeter, UK
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11
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Comparing Morbidities of Testing With a New Index: Screening Colonoscopy Versus Core-Needle Breast Biopsy. J Am Coll Radiol 2015; 12:295-301. [DOI: 10.1016/j.jacr.2014.08.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 08/21/2014] [Indexed: 11/17/2022]
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12
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Tramontano AC, Schrag DL, Malin JK, Miller MC, Weeks JC, Swan JS, McMahon PM. Catalog and comparison of societal preferences (utilities) for lung cancer health states: results from the Cancer Care Outcomes Research and Surveillance (CanCORS) study. Med Decis Making 2015; 35:371-87. [PMID: 25670839 DOI: 10.1177/0272989x15570364] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The EQ-5D and SF-6D are 2 health-related quality-of-life indexes that provide preference-weighted measures for use in cost-effectiveness analyses. METHODS The National Cancer Institute's Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium included the EQ-5D and SF-12v2 in their survey of newly diagnosed lung cancer patients. Utilities were calculated from patient-provided scores for each domain of the EQ-5D or the SF-6D. Utilities were calculated for categories of cancer type, stage, and treatment. RESULTS There were 5015 enrolled lung cancer patients with a baseline survey in CanCORS; 2396 (47.8%) completed the EQ-5D, and 2344 (46.7%) also completed the SF-12v2. The mean (standard deviation) utility from the EQ-5D was 0.78 (0.18), and from the SF-6D (derived from SF-12v2) was 0.68 (0.14). The EQ-5D demonstrated a ceiling effect, with 20% of patients reporting perfect scores, translating to a utility of 1.0. No substantial SF-6D floor effects were noted. Utilities increased with age and decreased with stage and comorbidities. Patient-reported (EQ-5D) visual analog scale scores for health status had a moderate (r = 0.48, p < 0.0001) positive correlation with utilities. A subset (n = 1474) completed follow-up EQ-5D questionnaires 11-13 months after diagnosis. Among these patients, there was a nonsignificant decrease in mean utility for stage IV and an increase in mean utility for stages I, II, and III. CONCLUSION This study generated a catalog of community-weighted utilities applicable to societal-perspective cost-effectiveness analyses of lung cancer interventions and compared utilities based on the EQ-5D and SF-6D. Potential users of these scores should be aware of the limitations and think carefully about their use in specific studies.
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Affiliation(s)
- Angela C Tramontano
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA (ACT, MCM, JSS, PMM)
| | - Deborah L Schrag
- Dna-Farber Cancer Institute, Boston, MA (DLS, JCW),Department of Radiology, Harvard Medical School, Boston, MA (DLS, JSS, PMM)
| | | | - Melecia C Miller
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA (ACT, MCM, JSS, PMM)
| | - Jane C Weeks
- Dna-Farber Cancer Institute, Boston, MA (DLS, JCW)
| | - J Shannon Swan
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA (ACT, MCM, JSS, PMM),Department of Radiology, Harvard Medical School, Boston, MA (DLS, JSS, PMM)
| | - Pamela M McMahon
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA (ACT, MCM, JSS, PMM),Department of Radiology, Harvard Medical School, Boston, MA (DLS, JSS, PMM)
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Avila M, Pardo Y, Castells M, Ferrer F, Boladeras A, Pera J, Prada PJ, Guix B, de Paula B, Hernandez H, Pont A, Alonso J, Garin O, Bremner K, Krahn M, Ferrer M. Adaptation and validation of the Spanish version of the Patient-Oriented Prostate Utility Scale (PORPUS). Qual Life Res 2014; 23:2481-7. [PMID: 24789667 DOI: 10.1007/s11136-014-0701-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The Patient-Oriented Prostate Utility Scale (PORPUS) is a combined profile and utility-based quality of life measure for prostate cancer patients. Our objectives were to adapt the PORPUS into Spanish and to assess its acceptability, reliability, and validity. METHODS The PORPUS was adapted into Spanish using forward and back translations and cognitive debriefing. PORPUS was administered jointly with the SF-36 and the Expanded Prostate Index Composite (EPIC) to 480 Spanish prostate cancer patients treated with radical prostatectomy or radiotherapy. The Spanish PORPUS scores' distribution and reliability were examined and compared with the original instrument. To evaluate construct validity, relationships were assessed between PORPUS and other instruments (testing hypotheses of the original PORPUS study), and among known groups defined by side effect severity. RESULTS Reliability coefficient was 0.76 (similar to the original PORPUS' 0.81). Spanish PORPUS items presented correlations ranging 0.57-0.88 with the corresponding EPIC domains, as in the original PORPUS study (0.60-0.83). Both PORPUS-P and PORPUS-U showed significant differences and large effect sizes (0.94-1.90) when comparing severe versus no problem groups on urinary, bowel, sexual and hormonal side effects defined by EPIC. CONCLUSIONS A conceptually equivalent Spanish version was obtained, with high reliability and good construct validity, similar to the original Canadian PORPUS version. It can therefore be used to measure health-related quality of life and utilities in Spanish prostate cancer patients.
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Affiliation(s)
- Mónica Avila
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003, Barcelona, Spain
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Assessing quality of life in patients with prostate cancer: a systematic and standardized comparison of available instruments. Qual Life Res 2014; 23:2169-81. [PMID: 24748557 PMCID: PMC4155169 DOI: 10.1007/s11136-014-0678-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2014] [Indexed: 11/07/2022]
Abstract
Purpose The objective was to obtain a standardized evaluation of available prostate cancer-specific quality of life instruments used in patients with early-stage disease. Methods We carried out systematic literature reviews in the PubMed database to identify manuscripts which contained information regarding either the development process or metric properties of prostate cancer-specific quality of life instruments. Each instrument was evaluated by two experts, independently, using the Evaluating Measures of Patient-Reported Outcomes (EMPRO) tool. An overall and seven attribute-specific EMPRO scores were calculated (range 0–100, worst to best): measurement model, reliability, validity, responsiveness, interpretability, burden and alternative forms. Results Eight instruments and 57 manuscripts (2–15 per instrument) were identified. The Expanded Prostate Cancer Index Composite (EPIC) was the best rated (overall EMPRO score 83.1 points). Good results were also obtained by University of California Los Angeles-Prostate Cancer Index (UCLA-PCI), Patient-Oriented Prostate Utility Scale (PORPUS) and Prostate Cancer Quality of Life Instrument (PC-QoL) with 77.3, 70.5 and 64.8 points, respectively. These four instruments passed with distinction the validity and responsiveness evaluation. Insufficient reliability results were observed for UCLA-PCI and PORPUS. Conclusions Current evidence supports the choice of EPIC, PORPUS or PC-QoL. Attribute-specific EMPRO results facilitate selecting the adequate instrument for every purpose. For longitudinal studies or clinical trials, where responsiveness is the priority, EPIC or PC-QoL should be considered. We recommend the PORPUS for economic evaluations because it allows cost-utility analysis, and EPIC short versions to minimize administration burden. Electronic supplementary material The online version of this article (doi:10.1007/s11136-014-0678-8) contains supplementary material, which is available to authorized users.
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Perlis N, Krahn M, Alibhai S, Finelli A, Ritvo P, Bremner KE, Kulkarni G. Conceptualizing global health-related quality of life in bladder cancer. Qual Life Res 2014; 23:2153-67. [PMID: 24729055 DOI: 10.1007/s11136-014-0685-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2014] [Indexed: 12/20/2022]
Abstract
PURPOSE Patients' values for health outcomes are central to treatment decisions in bladder cancer (BCa). An instrument incorporating the expressed preferences of BCa patients, as measured by utility, can inform clinical guidelines, resource allocation and policy decisions. Developing this instrument requires a formal conceptual framework summarizing the important domains comprising global health-related quality of life (HRQOL) in BCa. METHODS We performed a systematic literature search on the HRQOL effects of BCa and its treatments to generate initial items in Medline, Embase, CINAHL and PsychInfo up to January 2013. Thematic synthesis was used to group related items into overarching themes (domains) and create a provisional conceptual framework. In focus groups, 12 BCa experts and 47 BCa patients with diverse clinical histories generated further items to inform the final conceptual framework. RESULTS We retrieved 1,275 citations and reviewed 170 full-text publications. One hundred and sixty-nine items were extracted into 12 domains. Study investigators used the findings from the focus groups to confirm the domains and condense the list to 83 clinically important items. Functional limitations in work, travel, social interaction and sleep lowered HRQOL in many domains. The final conceptual framework included BCa-specific (urinary, sexual, bowel, body image) and generic domains (pain, vigor, social, psychological, sleep, functional, family relationship, medical care relationship). CONCLUSIONS A conceptual framework including 12 domains can serve as the foundation for the development of an instruments measuring global HRQOL in BCa and in particular, one that can measure patient preferences and generate utilities.
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Affiliation(s)
- Nathan Perlis
- Division of Urology, Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, University of Toronto, 610 University Avenue, 3-130, Toronto, ON, M5G 2M9, Canada,
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Bremner KE, Mitsakakis N, Wilson L, Krahn MD. Predicting utility scores for prostate cancer: mapping the Prostate Cancer Index to the Patient-Oriented Prostate Utility Scale (PORPUS). Prostate Cancer Prostatic Dis 2013; 17:47-56. [PMID: 24126796 DOI: 10.1038/pcan.2013.44] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 08/20/2013] [Accepted: 08/22/2013] [Indexed: 01/27/2023]
Abstract
BACKGROUND The Prostate Cancer Index (PCI) is a health profile instrument that measures health-related quality of life with six subscales: urinary, sexual, and bowel function and bother. The Patient-Oriented Prostate Utility Scale (PORPUS-U) measures utility (0=dead and 1=full health). Utility is a preference-based approach to measure health-related quality of life, required for decision analyses and cost-effectiveness analyses. We developed a function to estimate PORPUS-U utilities from PCI scores. METHODS The development data set included 676 community-dwelling prostate cancer (PC) survivors who completed the PCI and PORPUS-U by mail. We fit three linear regression models: one used original PORPUS-U scores and two used log-transformed PORPUS-U scores, one with a hierarchy constraint and one without. The model selection was performed using stepwise selection and fivefold cross validation. The validation data included 248 PC outpatients with three assessments on the PCI and PORPUS-U. Scores were retransformed for validation, with Duan's smearing estimator applied to correct potential bias. The predictive ability of the models was assessed with R(2), root mean square error (RMSE) and by comparing predicted and observed utilities. RESULTS The best-fitting model used the log-transformed PORPUS-U with no hierarchy constraint. The R(2) was 0.72. The RMSE ranged from 0.040 to 0.061 for the three validation data sets. Differences between predicted and observed utilities ranged from 0.000 to 0.006 but predicted utilities overestimated the lowest 5% of observed PORPUS-U scores and underestimated the highest observed scores. CONCLUSIONS Our algorithm can calculate PORPUS-U utility scores from PCI scores, thus supplementing descriptive quality of life measures with utility scores in PC patients. Utilities derived from mapping algorithms are useful for assigning utility to groups of patients but are less accurate at predicting utility of individual patients. We are exploring statistical methods to improve the mapping of utilities from descriptive instruments.
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Affiliation(s)
- K E Bremner
- 1] Toronto General Hospital, Clinical Decision Making and Health Care, University Health Network, Toronto, Ontario, Canada [2] Toronto Health Economics and Technology Assessment Collaborative (THETA), Toronto, Ontario, Canada
| | - N Mitsakakis
- Toronto Health Economics and Technology Assessment Collaborative (THETA), Toronto, Ontario, Canada
| | - L Wilson
- Faculty of Pharmacy, University of California San Francisco, San Francisco, CA, USA
| | - M D Krahn
- 1] Toronto General Hospital, Clinical Decision Making and Health Care, University Health Network, Toronto, Ontario, Canada [2] Toronto Health Economics and Technology Assessment Collaborative (THETA), Toronto, Ontario, Canada [3] Department of Medicine, Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada [4] Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Swan JS, Hur C, Lee P, Motazedi T, Donelan K. Responsiveness of the testing morbidities index in colonoscopy. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2013; 16:1046-1053. [PMID: 24041354 DOI: 10.1016/j.jval.2013.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 06/20/2013] [Accepted: 07/30/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES The Testing Morbidities Index (TMI) was developed to measure the effects of any diagnostic or screening procedure on health-related quality of life (HRQOL); it includes seven domains incorporating mental and physical aspects before, during, and after testing. To add to prior work on the validity of the TMI classification, responsiveness of a summated scale version was evaluated in 71 colonoscopy patients. Further data on construct validity were also obtained. METHODS Patients enrolled in the study when scheduling colonoscopy days to weeks beforehand. The baseline survey included the EuroQol five-dimensional (EQ-5D) questionnaire with five levels in each attribute (EQ-5D-5L questionnaire) and its visual analogue scale (VAS) assessment (EQ-VAS), the Short Form 12 version 2 (SF-12v2) component summary scores and six-dimensional health state short-form (derived from the short-form 12v2 health survey [SF-6D] utilities), and an original construct-specific VAS (CS-VAS) for usual HRQOL using utility scale anchors. The TMI's highest possible summated score (all best levels) served as its baseline. Survey data were generally obtained by telephone interview. A postprocedure survey was given to patients after colonoscopy and interviews conducted as soon as possible after the day of the procedure. The postprocedure survey included the SF-12v2/SF-6D, EQ-5D questionnaire instruments, TMI items, and a CS-VAS incorporating the overall HRQOL effects of colonoscopy. RESULTS Standardized response means showed greatest responsiveness by the TMI (-1.52) followed by the CS-VAS instruments (-0.42). The EQ-5D-5L questionnaire, the EQ-VAS, and the SF-12 component summaries were unresponsive, and the SF-6D was minimally responsive (-0.05). Correlation of the post-CS-VAS with the TMI was substantial (r = -0.52), suggesting TMI construct validity. Moderate to strong correlation of the baseline CS-VAS with standard indexes was observed (r = 0.54-0.81). CONCLUSION The TMI appears responsive and exhibits further evidence of construct validity.
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Affiliation(s)
- J Shannon Swan
- Massachusetts General Hospital Institute for Technology Assessment, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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Swan JS, Kong CY, Lee JM, Itauma O, Halpern EF, Lee PA, Vavinskiy S, Williams O, Zoltick ES, Donelan K. Patient and societal value functions for the testing morbidities index. Med Decis Making 2013; 33:819-38. [PMID: 23689044 DOI: 10.1177/0272989x13487605] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We developed preference-based and summated scale scoring for the Testing Morbidities Index (TMI) classification, which addresses short-term effects on quality of life from diagnostic testing before, during, and after testing procedures. METHODS The two TMI preference functions use multiattribute value techniques; one is patient-based and the other has a societal perspective, informed by 206 breast biopsy patients and 466 (societal) subjects. Because of a lack of standard short-term methods for this application, we used the visual analog scale (VAS). Waiting tradeoff (WTO) tolls provided an additional option for linear transformation of the TMI. We randomized participants to 1 of 3 surveys: The first derived weights for generic testing morbidity attributes and levels of severity with the VAS; a second developed VAS values and WTO tolls for linear transformation of the TMI to a "dead-healthy" scale; the third addressed initial validation in a specific test (breast biopsy). The initial validation included 188 patients and 425 community subjects. Direct VAS and WTO values were compared with the TMI. Alternative TMI scoring as a nonpreference summated scale was included, given evidence of construct and content validity. RESULTS The patient model can use an additive function, whereas the societal model is multiplicative. Direct VAS and the VAS-scaled TMI were correlated across modeling groups (r = 0.45-0.62). Agreement was comparable to the value function validation of the Health Utilities Index 2. Mean absolute difference (MAD) calculations showed a range of 0.07-0.10 in patients and 0.11-0.17 in subjects. MAD for direct WTO tolls compared with the WTO-scaled TMI varied closely around 1 quality-adjusted life day. CONCLUSIONS The TMI shows initial promise in measuring short-term testing-related health states.
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Affiliation(s)
- J Shannon Swan
- Massachusetts General Hospital Institute for Technology Assessment, Boston, MA (JSS, CYK, JML, OA, EFH, PL, OW, ESZ, KD),Harvard Medical School, Boston, MA (JSS, CYK, JML, EFH, KD)
| | - Chung Yin Kong
- Massachusetts General Hospital Institute for Technology Assessment, Boston, MA (JSS, CYK, JML, OA, EFH, PL, OW, ESZ, KD),Harvard Medical School, Boston, MA (JSS, CYK, JML, EFH, KD)
| | - Janie M Lee
- Massachusetts General Hospital Institute for Technology Assessment, Boston, MA (JSS, CYK, JML, OA, EFH, PL, OW, ESZ, KD),Harvard Medical School, Boston, MA (JSS, CYK, JML, EFH, KD)
| | - Omosalewa Itauma
- Massachusetts General Hospital Institute for Technology Assessment, Boston, MA (JSS, CYK, JML, OA, EFH, PL, OW, ESZ, KD),Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI (OA)
| | - Elkan F Halpern
- Massachusetts General Hospital Institute for Technology Assessment, Boston, MA (JSS, CYK, JML, OA, EFH, PL, OW, ESZ, KD),Harvard Medical School, Boston, MA (JSS, CYK, JML, EFH, KD)
| | - Pablo A Lee
- Massachusetts General Hospital Institute for Technology Assessment, Boston, MA (JSS, CYK, JML, OA, EFH, PL, OW, ESZ, KD)
| | - Sergey Vavinskiy
- Indiana University Department of Radiology, Indianapolis, IN (SV),Indiana State Government, Indianapolis, IN (SV)
| | - Olubunmi Williams
- Massachusetts General Hospital Institute for Technology Assessment, Boston, MA (JSS, CYK, JML, OA, EFH, PL, OW, ESZ, KD)
| | - Emilie S Zoltick
- Massachusetts General Hospital Institute for Technology Assessment, Boston, MA (JSS, CYK, JML, OA, EFH, PL, OW, ESZ, KD),Boston University School of Public Health, Boston, MA (ESZ)
| | - Karen Donelan
- Massachusetts General Hospital Institute for Technology Assessment, Boston, MA (JSS, CYK, JML, OA, EFH, PL, OW, ESZ, KD),Harvard Medical School, Boston, MA (JSS, CYK, JML, EFH, KD),Mongan Institute for Health Policy and Massachusetts General Hospital, Boston, MA (KD)
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A reference set of health utilities for long-term survivors of prostate cancer: population-based data from Ontario, Canada. Qual Life Res 2013; 22:2951-62. [PMID: 23564620 DOI: 10.1007/s11136-013-0401-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2013] [Indexed: 12/29/2022]
Abstract
PURPOSE To measure quality of life (QOL) and utilities for prostate cancer (PC) patients and determine their predictors. METHODS A population-based, community-dwelling, geographically diverse sample of long-term PC survivors in Ontario, Canada, was identified from the Ontario Cancer Registry and contacted through their referring physician. Consenting patients completed questionnaires by mail: Health Utilities Index (HUI 2/3), Patient Oriented Prostate Utility Scale PORPUS-U (utility), PORPUS-P (health profile), Functional Assessment of Cancer Therapy-Prostate (FACT-P), and Prostate Cancer Index (PCI). Clinical data were obtained from chart reviews. Regression models determined the effects of a series of variables on QOL and utility. RESULTS We received questionnaires and reviewed charts for 585 patients (mean age 72.6, 2-13 years postdiagnosis). Mean utility scores were as follows: PORPUS-U = 0.92, HUI2 = 0.85, and HUI3 = 0.78. Mean health profile scores were as follows: PORPUS-P = 71.7, PCI sexual, urinary, and bowel function = 23.7, 79.1, and 84.6, respectively (0 = worst, 100 = best), and FACT-P = 125.1 (0 = worst, 156 = best). In multiple regression analyses, comorbidity and PCI urinary, sexual, and bowel function were significant predictors of other QOL measures. With all variables, 32-50 % of the variance in utilities was explained. CONCLUSIONS Many variables affect global QOL of PC survivors; only prostate symptoms and comorbidity have independent effects. Our model allows estimation of the effects of multiple factors on utilities. These utilities for long-term outcomes of PC and its treatment are valuable for decision/cost-effectiveness models of PC treatment.
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Kerr C, Lloyd A, Rowen D, Maslen T, Brazier J. Androgen Deprivation Therapy for Prostate Cancer Prevention: What Impact Do Related Adverse Events Have on Quality of Life? ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.ehrm.2012.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Schwartz A. Measuring Health-Related Quality of Life. Med Decis Making 2012; 32:9-10. [DOI: 10.1177/0272989x11434207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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