Iskedjian Michael, De Vol Edward, Elshenawy Mahmoud, Bazarbashi Shouki
PharmIdeas USA, Williamsville, NY.
Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada.
JCO Glob Oncol. 2020 Oct;6:1609-1616. doi: 10.1200/GO.20.00234.
Health utilities (HUs) are quantitative measures of quality of life that are used to derive outcomes such as quality-adjusted life years in cost-effectiveness analyses. In the Kingdom of Saudi Arabia, there are no HUs for cancer. This study aimed to generate HU estimates for various health states associated with cancer in the Kingdom of Saudi Arabia.
Adult citizens of the Kingdom of Saudi Arabia, patients with cancer, and patients without cancer were recruited to participate in an online version of the Time Trade-Off (TTO) survey, a direct method that asks participants to indicate the amount of time they are willing to trade off in return for full health. The time horizon was 10 years. Patients were surveyed on their own health state; patients without cancer were presented with a scenario describing stage III colon cancer and were asked to act as proxies.
Mean HU score was 0.398 (n = 398), 0.315 for patients with cancer (n = 199), and 0.482 for patients without cancer (n = 199). Among patients, the largest subgroup with colorectal cancer (n = 105), had a mean HU of 0.296; the subgroup with the lowest mean HU was patients with hepatocellular cancer (n = 3; 0.047), and the subgroup with the highest mean HU was patients with cholangiocarcinoma (n = 5; 0.508). Overall, the initial stage I subgroup (n = 7) had a mean HU of 0.456; initial stage II (n = 25), 0.240; stage II (n = 67), 0.319; and initial stage IV (n = 77), 0.320.
To our knowledge, this is the first study of this size to elicit HU scores for cancer in the Kingdom of Saudi Arabia. Patients may have had clinically worse disease than the patients in the scenario that was presented to patients without cancer. Further analyses are warranted for specific types of cancer. These HUs can in turn be applied in cost-utility analyses.
健康效用值（HUs）是生活质量的定量衡量指标，用于在成本效益分析中得出诸如质量调整生命年等结果。在沙特阿拉伯王国，尚无癌症的健康效用值。本研究旨在得出沙特阿拉伯王国与癌症相关的各种健康状态的健康效用值估计数。
招募沙特阿拉伯王国成年公民、癌症患者和非癌症患者参与在线时间权衡（TTO）调查，这是一种直接方法，要求参与者表明他们愿意用多少时间来换取完全健康。时间跨度为10年。对患者自身的健康状态进行调查；向非癌症患者呈现一个描述III期结肠癌的情景，并要求他们充当代理人。
平均健康效用值得分为0.398（n = 398），癌症患者为0.315（n = 199），非癌症患者为0.482（n = 199）。在患者中，结直肠癌患者这一最大亚组（n = 105）的平均健康效用值为0.296；平均健康效用值最低的亚组是肝细胞癌患者（n = 3；0.047），平均健康效用值最高的亚组是胆管癌患者（n = 5；0.508）。总体而言，I期初始亚组（n = 7）的平均健康效用值为0.456；II期初始（n = 25）为0.240；II期（n = 67）为0.319；IV期初始（n = 77）为0.320。
据我们所知，这是沙特阿拉伯王国首次进行如此规模的研究以得出癌症的健康效用值得分。患者的临床疾病状况可能比向非癌症患者呈现的情景中的患者更差。有必要对特定类型的癌症进行进一步分析。这些健康效用值反过来可应用于成本效用分析。
