Flinders Centre for Innovation in Cancer, College of Medicine and Public Health, Flinders University, Adelaide, SA, 5041, Australia.
Centre for Health Economics, Monash Business School, Monash University, Melbourne, Australia.
World J Surg. 2019 Jun;43(6):1554-1562. doi: 10.1007/s00268-019-04936-w.
Research assessing health-related quality of life (HRQoL) which can be applied to economic evaluation in Barrett's esophagus (BE) and esophageal cancer is limited. This study derived health state utilities for various 'stages' of BE and Cancer.
A cross-sectional survey was conducted, including patients with non-dysplastic BE, low-grade dysplasia, high-grade dysplasia, or esophageal adenocarcinoma. HRQoL was assessed using generic instruments-EQ-5D-5L and SF-36, and a cancer-specific instrument-EORTC QLQ-C30. Outcomes were compared for health states following different treatments. Correlations and agreements for the three instruments were investigated using Spearman's correlation coefficient (r) and intraclass correlation coefficient (ICC).
A total of 97 respondents (80% male, mean age 68 years) returned questionnaires. The mean (standard deviation) health state utilities for the total sample were 0.79 (0.24) for the EQ-5D-5L, 0.57 (0.29) for the SF-6D (derived from SF-36) and 0.73 (0.20) for the QLU-C10D (derived from EORTC QLQ-C30). There were strong correlations (r > 0.80) and absolute agreement (except EQ-5D-5L and SF-6D with an ICC of 0.69) among the three instruments. No significant differences were observed for different stages of BE or interventions. However, following surgery for cancer patients reported better psychological well-being than those under surveillance or following endoscopic treatments.
HRQoL for BE surveillance and following cancer treatment was similar. Esophagectomy was associated with better psychological functioning, and this might be attributed to a reduction in the perceived risk of cancer. The correlation between the EORTC QLU-C10D and the other health state utility instruments supports the validity of this new instrument.
评估健康相关生活质量（HRQoL）的研究可应用于 Barrett 食管（BE）和食管癌的经济评估，但此类研究有限。本研究得出了 BE 和癌症各“阶段”的健康状况效用值。
进行了一项横断面调查，包括非异型增生 BE、低级别异型增生、高级别异型增生或食管腺癌患者。使用通用量表 EQ-5D-5L 和 SF-36 以及癌症特异性量表 EORTC QLQ-C30 评估 HRQoL。对不同治疗方法后的健康状况进行了比较。使用 Spearman 相关系数（r）和组内相关系数（ICC）评估了三种工具的相关性和一致性。
共有 97 名（80%为男性，平均年龄 68 岁）患者回复了问卷。总样本的平均（标准差）健康状况效用值为 EQ-5D-5L 为 0.79（0.24），SF-6D（来自 SF-36）为 0.57（0.29），QLU-C10D（来自 EORTC QLQ-C30）为 0.73（0.20）。三种工具之间存在很强的相关性（r＞0.80）和绝对一致性（除 EQ-5D-5L 和 SF-6D 的 ICC 为 0.69 外）。不同阶段的 BE 或干预措施之间未见显著差异。然而，癌症患者手术后报告的心理幸福感优于接受监测或内镜治疗的患者。
BE 监测和癌症治疗后的 HRQoL 相似。食管切除术与更好的心理功能相关，这可能归因于癌症风险降低。EORTC QLU-C10D 与其他健康状况效用工具之间的相关性支持了该新工具的有效性。
