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Quality of Life Research

, 16:509 | Cite as

Responsiveness of disease-specific and generic utility instruments in prostate cancer patients

  • Murray Krahn
  • Karen E. Bremner
  • George Tomlinson
  • Paul Ritvo
  • Jane Irvine
  • Gary Naglie
Article

Abstract

Background

Preferences (utilities) for health outcomes have an important role in decisions about prostate cancer screening and treatment. The responsiveness of utility instruments has not been evaluated.

Subjects

Prostate cancer outpatients from the Princess Margaret Hospital, Toronto (n = 248) were allocated into three cohorts: N — newly diagnosed and treated; M — metastatic disease; O — all others.

Measures

We measured quality of life at 3 points within 12 months using 3 disease-specific utility instruments (Patient Oriented Prostate Utility Scales), 3 generic utility instruments (Health Utilities Index, EQ-5D, Quality of Well-Being Scale), and 3 profile scales (PORPUS-P profile, Prostate Cancer Index, QLQ-C-30). Responsiveness was assessed using measures of internal responsiveness (standardized effect size, standardized response mean) and external responsiveness (receiver operator curve analysis, mixed model regression).

Results

Cohort N patients showed post-treatment declines followed by improvement in global health and functional status. Disease specific instruments detected moderate (0.4–1.3) decrements followed by small increments (0.1–0.4) in standardized effect size and standardized response mean. Most instruments detected change using external responsiveness measures (all cohorts).

Conclusions

Disease-specific utility instruments appeared to be more responsive than generic instruments. Use of generic instruments should be supplemented with a responsive disease-specific instrument, particularly for applications in early prostate cancer.

Keywords

Measurement Psychometrics Urologic diseases Utility measurement 

Abbreviations

AUROC

area under the receiver operator curve

EQ-5D

EuroQol 5 dimension quality of life instrument

HRQL

health related quality of life

HUI

Health Utilities Index

PCI

Prostate Cancer Index

PORPUS

Patient Oriented Prostate Utility Scales

PORPUSI

health index version of PORPUS

PORPUSP

health profile version of PORPUS

PORPUSRS

direct utility elicitation version of the PORPUS, using rating scale scaling

PORPUSSG

direct utility elicitation version of the PORPUS, using standard gamble scaling

QLQ-C30

European Organisation for the Research and Treatment of Cancer quality of life questionnaire, core module

QWB

Quality of Well Being Scale

RS

rating scale

SES

standardized effect size

SG

standard gamble

SRM

standardized response mean

Notes

Acknowledgements

Support was provided by the Canadian Institutes for Health Research (CIHR), (Grant #006169), Zeneca Canada Inc., an Investigator Award from the Canadian Institutes for Health Research (Dr.␣Krahn), the F. Norman Hughes Chair in Pharmacoeconomics (Dr. Krahn) and the Mary Trimmer Chair in Geriatric Medicine Research (Dr. Naglie).

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Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Murray Krahn
    • 1
    • 2
    • 8
  • Karen E. Bremner
    • 1
  • George Tomlinson
    • 1
    • 4
    • 5
  • Paul Ritvo
    • 3
    • 6
  • Jane Irvine
    • 3
    • 7
  • Gary Naglie
    • 1
    • 5
  1. 1.Department of MedicineUniversity of TorontoTorontoCanada
  2. 2.Faculty of Pharmacy University of TorontoTorontoCanada
  3. 3.Department of PsychologyUniversity of TorontoTorontoCanada
  4. 4.Department of Public Health SciencesUniversity of TorontoTorontoCanada
  5. 5.Departments of Health Policy, Management, and EvaluationUniversity of TorontoTorontoCanada
  6. 6.Ontario Cancer InstituteTorontoCanada
  7. 7.York UniversityTorontoCanada
  8. 8.Department ofMedicineUniversity of Toronto, The Toronto General HospitalTorontoCanada

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