Abstract
Background
To improve the precision of health economics analyses in oncology, reference datasets of health utility (HU) scores are needed from cancer survivors across different disease sites. These data are particularly sparse amongst Canadian survivors.
Methods
A survey was completed by 1759 ambulatory cancer survivors at the Princess Margaret Cancer Centre which contained demographic questions and the EuroQol-5D (EQ-5D) instrument. Clinical information was abstracted from electronic records and HU scores were calculated using Canadian health state valuations. Construct validity was assessed through correlation of HU and visual analog scale (VAS) scores (Spearman) and by comparing HU scores between performance status groups (effect size). The influence of socio-demographic clinical variables on HU was analyzed by non-parametric between-group comparisons and multiple linear regression.
Results
Mean EQ-5D HU scores were derived for 26 cancers. Among all survivors, the mean ± standard error of the mean EQ-5D utility score was 0.81 ± 0.004. Scores varied significantly by performance status (p < 0.0001) and correlated with VAS (Spearman r = 0.61). The cancer sites with the lowest mean HU scores were acute lymphoblastic leukemia (0.70 ± 0.03) and pancreatic cancer (0.76 ± 0.03); testicular cancer (0.89 ± 0.02) and chronic lymphocytic leukemia (0.90 ± 0.05) had the highest mean scores. A multiple regression model showed that scores were influenced by disease site (p < 0.001), education level (p < 0.001), partner status (p < 0.001), disease extent (p = 0.0029), and type of most recent treatment (p = 0.0061).
Conclusions
This work represents the first set of HU scores for numerous cancer sites derived using Canadian preference weights. The dataset demonstrated construct validity and HU scores varied by general socio-demographic and clinical parameters.
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Acknowledgments
The authors would like to acknowledge the following individuals for contributing to data collection: Brandon Tse, Elizabeth Hall, Emily Tam, Judy Chen, Michael Borean, Tiffany Tse, Vivian Tam, Yuchen Li, and Kishan Shani.
Author Contributions
HN, GL, NM, and DH designed the study. HN, GL, MCB, AV, and DH planned and coordinated data collection. HN, MI, VP, HS, TW, HH, LE, MM, HT, and VH performed the majority of data collection. HN, GL, WX, SJS, and NM planned, designed, and assisted with data analyses. HN, JS, and XQ conducted the data analyses. HN, GL, and NM wrote the paper. All authors reviewed and approved of the final manuscript.
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This study was funded by the Ontario Patient Reported Outcomes of Symptoms and Toxicity (ON-PROST), Cancer Care Ontario, the Alan B. Brown Chair, Lusi Wong Fund, and The Comprehensive Research Experience for Medical Students (University of Toronto). The authors HN, DH, JS, XQ, MCB, AV, MI, VP, HS, TW, HH, LE, MM, HT, VH, WX, SJS, NM, and GL have no conflicts of interest to declare.
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Naik, H., Howell, D., Su, S. et al. EQ-5D Health Utility Scores: Data from a Comprehensive Canadian Cancer Centre. Patient 10, 105–115 (2017). https://doi.org/10.1007/s40271-016-0190-z
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DOI: https://doi.org/10.1007/s40271-016-0190-z