School of Health Care Management, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
Patient. 2020 Oct;13(5):537-555. doi: 10.1007/s40271-020-00422-x.
This study aimed to develop mapping algorithms from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-BR53, including EORTC QLQ-C30 and QLQ-BR23) onto the 5-level EQ-5D (EQ-5D-5L) and Short Form 6D (SF-6D) utility scores.
The data were taken from 607 breast cancer patients in mainland China. The EQ-5D-5L and SF-6D instruments were scored using Chinese-specific tariffs. Three model specifications and seven statistical techniques were used to derive mapping algorithms, including ordinary least squares (OLS), Tobit, censored least absolute deviation (CLAD) model, generalized linear model (GLM), robust MM-estimator, finite mixtures of beta regression model for directly estimating health utility, and using ordered logit regression (OLOGIT) to predict response levels. A five-fold cross-validation approach was conducted to test the generalizability of each model. Two key goodness-of-fit statistics (mean absolute error and mean squared error) and three secondary statistics were employed to choose the optimal models.
Participants had a mean ± standard deviation (SD) age of 49.0 ± 9.8 years. The mean ± SD health state utility scores were 0.828 ± 0.184 (EQ-5D-5L) and 0.646 ± 0.125 (SF-6D). Mapping performance was better when both the QLQ-C30 and QLQ-BR23 dimensions were considered rather than when either of these dimensions were used alone. The mapping functions from the optimal direct mapping and indirect mapping approaches were reported.
The algorithms reported in this paper enable EORTC QLQ-BR53 breast cancer data to be mapped into utilities predicted from the EQ-5D-5L and SF-6D. The algorithms allow for the calculation of quality-adjusted life years for use in breast cancer cost-effectiveness analyses studies.
本研究旨在开发从欧洲癌症研究与治疗组织生活质量问卷(EORTC QLQ-BR53,包括 EORTC QLQ-C30 和 QLQ-BR23)到 5 级 EQ-5D(EQ-5D-5L)和简短形式 6D(SF-6D)效用评分的映射算法。
数据来自中国大陆的 607 名乳腺癌患者。EQ-5D-5L 和 SF-6D 工具使用中国特定的关税进行评分。使用三种模型规范和七种统计技术来推导映射算法,包括普通最小二乘法(OLS)、Tobit、截尾最小绝对偏差(CLAD)模型、广义线性模型(GLM)、稳健 MM 估计器、直接估计健康效用的 Beta 回归模型的有限混合模型,以及使用有序逻辑回归(OLOGIT)预测反应水平。采用五折交叉验证方法检验每个模型的可推广性。使用两个关键的拟合优度统计量(平均绝对误差和平均平方误差)和三个次要统计量来选择最佳模型。
参与者的平均年龄为 49.0 ± 9.8 岁。平均健康状态效用评分分别为 0.828 ± 0.184(EQ-5D-5L)和 0.646 ± 0.125(SF-6D)。当同时考虑 QLQ-C30 和 QLQ-BR23 维度时,映射性能优于仅使用这些维度之一时。报告了来自最佳直接映射和间接映射方法的映射函数。
本文报告的算法可将 EORTC QLQ-BR53 乳腺癌数据映射到 EQ-5D-5L 和 SF-6D 预测的效用值中。这些算法允许计算用于乳腺癌成本效益分析研究的质量调整生命年。