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Comparison of time trade-off utility with neurocognitive function, performance status, and quality of life measures in patients with metastatic brain disease

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objective

The objective of this study is to evaluate the concordance between neurocognitive function (NCF), Karnofsky performance status (KPS), quality of life, symptom burden, and time trade-off (TTO) over time.

Methods

We retrospectively analyzed secondary data from a randomized study of 58 patients who completed tests determining TTO utility with each of the three time horizons (10, 5, and 1 years), NCF, KPS, quality of life (Functional Assessment of Cancer Therapy-Brain (FACT-BR)), and symptoms (MD Anderson Symptom Inventory-Brain Tumor (MDASI-BT)). Multiple linear regression analyses were used to estimate the relationships between TTO utility and other outcome variables, including a time of data collection variable (baseline, 1, 2, 4, 6, 9, 12, 15, 18, 21, and 24 months) to capture within-patient change over time.

Results

Significant but weak associations were found between the 10-year TTO utility and FACT-BR scores (p < 0.01), the 10-year TTO utility and MDASI-BT (sleep) scores (p = 0.039), the 5-year TTO utility and FACT-BR scores (p < 0.01), and the 5-year TTO utility and MDASI-BT (sleep) scores (p = 0.039). NCF and KPS scores were not significantly associated with TTO utility. The analysis of within-patient changes over time indicated significant mean group increases in the 10-year TTO utility (p = 0.021) and NCF (HVLT-R Total Recall) scores (p = 0.032); however, KPS score significantly decreased (p < 0.01).

Conclusions

Patients’ quality of life and sleep disturbance symptoms have significant but small effects on the patients’ willingness to trade time. The lack of correlation between TTO utility and functional status as well as cognitive function suggests that patients’ preferences for better health and for quantity of life are primarily influenced by the expected length of time until death and not by their current health state.

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Acknowledgments

The authors acknowledge the editorial comments from the Department of Scientific Publications, The University of Texas MD Anderson Cancer Center, which enhanced this manuscript.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. Division of Management, Policy and Community Health, The University of Texas School of Public Health, 1200 Herman Pressler, E933, Houston, TX, 77030, USA

    Suthira Taychakhoonavudh, Luisa Franzini, Lincy S. Lal & J. Michael Swint

  2. Department of Radiation Oncology, USC Norris Cancer Hospital, Keck School of Medicine of USC, Los Angeles, CA, USA

    Eric L. Chang

  3. Department of Radiation Oncology, Keck Hospital of USC Los Angeles County + USC Medical Center, Keck School of Medicine of USC, Los Angeles, CA, USA

    Eric L. Chang

  4. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Eric L. Chang

  5. The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Christina A. Meyers

  6. Section of Neuropsychology, Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Jeffrey S. Wefel

  7. The Center for Clinical Research and Evidence-Based Medicine, The University of Texas School of Medicine-Houston, Houston, TX, USA

    J. Michael Swint

Authors
  1. Suthira Taychakhoonavudh
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  2. Luisa Franzini
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  3. Lincy S. Lal
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  4. Eric L. Chang
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  5. Christina A. Meyers
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  6. Jeffrey S. Wefel
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  7. J. Michael Swint
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Corresponding author

Correspondence to J. Michael Swint.

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Taychakhoonavudh, S., Franzini, L., Lal, L.S. et al. Comparison of time trade-off utility with neurocognitive function, performance status, and quality of life measures in patients with metastatic brain disease. J Radiat Oncol 3, 215–221 (2014). https://doi.org/10.1007/s13566-013-0093-8

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  • DOI: https://doi.org/10.1007/s13566-013-0093-8

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