University of Sydney, Faculty of Science, School of Psychology, Psycho-Oncology Co-operative Research Group, Quality of Life Office, Chris O'Brien Lifehouse (C39Z), Sydney, NSW, 2006, Australia.
University of Sydney, Faculty of Medicine, Sydney Medical School, Sydney, NSW, Australia.
Pharmacoeconomics. 2018 Feb;36(2):225-238. doi: 10.1007/s40273-017-0582-5.
The EORTC QLU-C10D is a new multi-attribute utility instrument derived from the widely used cancer-specific quality-of-life (QOL) questionnaire, EORTC QLQ-C30. The QLU-C10D contains ten dimensions (Physical, Role, Social and Emotional Functioning; Pain, Fatigue, Sleep, Appetite, Nausea, Bowel Problems), each with four levels. To be used in cost-utility analysis, country-specific valuation sets are required.
The aim of this study was to provide Australian utility weights for the QLU-C10D.
An Australian online panel was quota-sampled to ensure population representativeness by sex and age (≥ 18 years). Participants completed a discrete choice experiment (DCE) consisting of 16 choice-pairs. Each pair comprised two QLU-C10D health states plus life expectancy. Data were analysed using conditional logistic regression, parameterised to fit the quality-adjusted life-year framework. Utility weights were calculated as the ratio of each QOL dimension-level coefficient to the coefficient on life expectancy.
A total of 1979 panel members opted in, 1904 (96%) completed at least one choice-pair, and 1846 (93%) completed all 16 choice-pairs. Dimension weights were generally monotonic: poorer levels within each dimension were generally associated with greater utility decrements. The dimensions that impacted most on choice were, in order, Physical Functioning, Pain, Role Functioning and Emotional Functioning. Oncology-relevant dimensions with moderate impact were Nausea and Bowel Problems. Fatigue, Trouble Sleeping and Appetite had relatively small impact. The value of the worst health state was -0.096, somewhat worse than death.
This study provides the first country-specific value set for the QLU-C10D, which can facilitate cost-utility analyses when applied to data collected with the EORTC QLQ-C30, prospectively and retrospectively.
EORTC QLU-C10D 是一种新的多属性效用工具，源自广泛使用的癌症特异性生活质量（QOL）问卷 EORTC QLQ-C30。QLU-C10D 包含十个维度（身体、角色、社交和情绪功能；疼痛、疲劳、睡眠、食欲、恶心、肠道问题），每个维度有四个级别。为了在成本效用分析中使用，需要有特定国家的估值集。
本研究旨在为 QLU-C10D 提供澳大利亚效用权重。
澳大利亚在线小组采用配额抽样，以确保按性别和年龄（≥18 岁）进行人口代表性抽样。参与者完成了由 16 对选择组成的离散选择实验（DCE）。每对包括两个 QLU-C10D 健康状况加预期寿命。使用条件逻辑回归分析数据，参数化以适应质量调整生命年框架。效用权重计算为每个 QOL 维度级别的系数与预期寿命系数的比值。
共有 1979 名小组参与者选择参与，1904 名（96%）参与者至少完成了一对选择，1846 名（93%）参与者完成了所有 16 对选择。维度权重通常是单调的：每个维度中的较差水平通常与更大的效用下降相关。对选择影响最大的维度依次为身体功能、疼痛、角色功能和情绪功能。具有中度影响的肿瘤学相关维度为恶心和肠道问题。疲劳、睡眠困难和食欲的影响相对较小。最差健康状况的价值为-0.096，略逊于死亡。
本研究为 QLU-C10D 提供了首个特定国家的价值集，当应用于前瞻性和回顾性收集的 EORTC QLQ-C30 数据进行成本效用分析时，可以提供便利。
