University of Washington, Seattle, WA, USA.
Qual Life Res. 2010 Apr;19(3):391-400. doi: 10.1007/s11136-010-9589-5.
To elicit preference values for health states associated with Stage III colon cancer (CRC) and to explore the effect of neuropathy associated with current adjuvant treatment.
We used time trade-off (TTO) techniques to elicit preferences from 49 CRC patients and 49 community members. We elicited preferences for 7 health states: remission; adjuvant therapy with no, mild, moderate, and severe neuropathy; metastatic stable; and metastatic progressive disease. Mean TTO values were adjusted for the covariates age, education, and current health.
Patients' adjusted mean TTO value for remission was 0.83; adjuvant chemotherapy health states ranged from 0.48 to 0.61. Significant differences were observed for both patient and community groups between TTO for remission and all adjuvant health states (P < 0.001), and between adjuvant therapy with no neuropathy and metastatic health states (P < or = 0.001). Across all health states, patients' values were on average 0.12 higher than community members (P < 0.05).
The findings highlight the trade-offs between the disutility of adjuvant treatment, the higher utility of remission, and the severe utility loss during metastatic disease. The preference values obtained from this study will be useful for informing patients' treatment decisions and payer cost-utility analyses of adjuvant treatment for colon cancer.
确定与 III 期结肠癌（CRC）相关的健康状态的偏好值，并探讨与当前辅助治疗相关的神经病变的影响。
我们使用时间权衡（TTO）技术从 49 名 CRC 患者和 49 名社区成员中获得偏好。我们对 7 种健康状态进行了偏好评估：缓解；无、轻度、中度和重度神经病变的辅助治疗；转移性稳定；转移性进行性疾病。对年龄、教育和当前健康状况等协变量进行了 TTO 值的调整。
患者缓解的调整后 TTO 值平均值为 0.83；辅助化疗健康状态范围为 0.48 至 0.61。患者和社区组之间在缓解和所有辅助健康状态之间（P<0.001），以及无神经病变的辅助治疗与转移性健康状态之间（P<或=0.001）都观察到了显著差异。在所有健康状态下，患者的价值平均比社区成员高 0.12（P<0.05）。
这些发现强调了辅助治疗的不适、缓解的更高效用以及转移性疾病期间严重的效用损失之间的权衡。本研究获得的偏好值将有助于为患者的治疗决策提供信息，并对结肠癌的辅助治疗进行支付者成本效用分析。
