Catalog and Comparison of Societal Preferences (Utilities) for Lung Cancer Health States
Catalog and Comparison of Societal Preferences (Utilities) for Lung Cancer Health States
复制标题
肺癌健康状况的社会偏好（实用程序）目录和比较
作者：
A. Tramontano;D. Schrag;Jennifer Malin;Melecia C. Miller;J. Weeks;J. Swan;P. McMahon
背景EQ-5D和SF-6D是2个健康相关生活质量指数，提供了用于成本效果分析的偏好加权指标。方法.美国国家癌症研究所的癌症护理结果研究和监测（CanCORS）联盟将EQ-5D和SF-12 v2纳入了对新诊断肺癌患者的调查中。根据患者提供的EQ-5D或SF-6D各领域评分计算效用。计算了癌症类型、分期和治疗类别的效用。结果有5015例入组的肺癌患者在CanCORS中接受了基线调查; 2396例（47.8%）完成了EQ-5D，2344例（46.7%）还完成了SF-12 v2。EQ-5D的平均（标准差）效用为0.78（0.18），SF-6D（源自SF-12 v2）的平均（标准差）效用为0.68（0.14）。EQ-5D表现出天花板效应，20%的患者报告满分，转换为效用1.0。未观察到显著的SF-6D下限效应。效用随年龄增加而增加，随分期和合并症而降低。健康状况的患者报告（EQ-5D）视觉模拟量表评分与效用呈中度（r = 0.48，p < 0.0001）正相关。一个子集（n = 1474）在诊断后11-13个月完成随访EQ-5D问卷。在这些患者中，IV期的平均效用无显著降低，I、II和III期的平均效用增加。结论本研究生成了一个适用于肺癌干预的社会视角成本效益分析的社区加权效用目录，并基于EQ-5D和SF-6D比较了效用。这些评分的潜在使用者应了解其局限性，并仔细考虑其在特定研究中的使用。
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.