将 FACT-G、FAACT 和 FACIT-F 的健康相关生活质量评分映射到非小细胞肺癌恶病质的基于偏好的 EQ-5D-5L 效用值上。
Mapping health-related quality of life scores from FACT-G, FAACT, and FACIT-F onto preference-based EQ-5D-5L utilities in non-small cell lung cancer cachexia.
机构信息
CeRGAS (Research Centre on Health and Social Care Management), Bocconi University, Via Roentgen 1, 20136, Milan, Italy.
Department of Health Services Research, London School of Hygiene and Tropical Medicine (LSHTM), London, UK.
出版信息
Eur J Health Econ. 2019 Mar;20(2):181-193. doi: 10.1007/s10198-017-0930-6. Epub 2017 Sep 25.
BACKGROUND
Health-related quality of life (HRQoL) measurements from disease-specific tools cannot be directly used in economic evaluations. This study aimed to develop and validate mapping algorithms that predicted EuroQol 5-Dimensions 5-Levels (EQ-5D-5L) utilities from Functional Assessment of Anorexia-Cachexia Therapy (FAACT) and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and their common component (Functional Assessment of Cancer Therapy-General-FACT-G) in patients with non-small cell lung cancer cachexia.
METHODS
Data were collected on five occasions over a 12-week period in two multicenter placebo-controlled trials. EQ-5D-5L utilities were calculated using both English and Dutch value sets. The study sample was divided into development and validation datasets according to patients' geographical residence. Generalized estimating equations were applied to five different sets of independent variables including overall, Trial Outcome Index (TOI), and individual subscales results. The best performing models were selected based on mean absolute error (MAE) and root-mean square error (RMSE).
RESULTS
EQ-5D-5L and FAACT/FACIT-F results were available for 96 patients. The developed algorithms showed a good predictive performance, with acceptable MAE/RMSE and small differences between mean observed and predicted EQ-5D-5L utilities. In FACT-G models, Physical Well-Being had the highest explanatory value, while Emotional Well-Being did not significantly affect the EQ-5D-5L score; Anorexia-Cachexia and Fatigue subscales were highly statistically significant in FAACT and FACIT-F models, respectively, as well as the TOI scores. The Eastern Cooperative Oncology Group status was included as covariate in all models.
CONCLUSION
The developed algorithms enable the estimation of EQ-5D-5L utilities from three cancer-specific instruments when preference-based HRQoL data are missing.
背景
疾病特异性工具的健康相关生活质量(HRQoL)测量值不能直接用于经济评估。本研究旨在开发和验证映射算法,该算法可从功能性评估厌食症-恶病质疗法(FAACT)和慢性疾病治疗疲劳的功能性评估-疲乏(FACIT-F)及其共同组成部分(癌症治疗的功能性评估-一般-FACT-G)预测非小细胞肺癌恶病质患者的欧洲五维健康量表 5 维度 5 级(EQ-5D-5L)效用。
方法
在两项多中心安慰剂对照试验中,在 12 周的时间内收集了五次数据。使用英语和荷兰值集计算 EQ-5D-5L 效用。根据患者的地理位置,将研究样本分为开发和验证数据集。广义估计方程应用于包括整体、试验结果指数(TOI)和各个子量表结果在内的五套独立变量。基于平均绝对误差(MAE)和均方根误差(RMSE),选择表现最佳的模型。
结果
96 例患者的 EQ-5D-5L 和 FAACT/FACIT-F 结果可用。开发的算法具有良好的预测性能,MAE/RMSE 可接受,平均观察值与预测的 EQ-5D-5L 效用之间的差异较小。在 FACT-G 模型中,身体状况具有最高的解释价值,而情感健康对 EQ-5D-5L 评分没有显著影响;在 FAACT 和 FACIT-F 模型中,厌食症-恶病质和疲劳子量表以及 TOI 评分分别具有高度统计学意义。东部合作肿瘤组状态被纳入所有模型的协变量。
结论
当偏好健康相关生活质量数据缺失时,开发的算法可从三种癌症特异性工具中估算 EQ-5D-5L 效用。