McMaster University, 3N27, 1280 Main Street W, Hamilton, ON, L8N 3Z5, Canada.
McMaster University, CRL-223, 1280 Main Street W, Hamilton, ON, L8N 3Z5, Canada.
BMC Womens Health. 2021 Jan 6;21(1):8. doi: 10.1186/s12905-020-01125-z.
Generic preference-based measures (PBM), though commonly used, may not be optimal for use in economic evaluations of breast cancer interventions. No breast cancer-specific PBM currently exists, and the generic PBMs fail to capture the unique concerns of women with breast cancer (e.g., body image, appearance, treatment-specific adverse effects). Hence, the objective of this study was to develop a breast cancer-specific PBM, the BREAST-Q Utility module.
Women diagnosed with breast cancer (stage 0-4, any treatment) were recruited from two tertiary hospitals in Canada and one in the US. The study followed an exploratory sequential mixed methods approach, whereby semi-structured interviews were conducted and at the end of the interview, participants were asked to list their top five health-related quality of life (HRQOL) concerns and to rate the importance of each item on the BREAST-Q. Interviews were audio-recorded, transcribed verbatim, and coded. Constant comparison was used to refine the codes and develop a conceptual framework. Qualitative and quantitative data were triangulated to develop the content of the Utility module that was refined through 2 rounds of cognitive debriefing interviews with women diagnosed with breast cancer and feedback from experts.
Interviews were conducted with 57 women aged 55 ± 10 years. A conceptual framework was developed from 3948 unique codes specific to breasts, arms, abdomen, and cancer experience. Five top-level domains were HRQOL (i.e., physical, psychological, social, and sexual well-being) and appearance. Data from the interviews, top 5 HRQOL concerns, and BREAST-Q item ratings were used to inform dimensions for inclusion in the Utility module. Feedback from women with breast cancer (N = 9) and a multidisciplinary group of experts (N = 27) was used to refine the module. The field-test version of the HSCS consists of 10 unique dimensions. Each dimension is measured with 1 or 2 candidate items that have 4-5 response levels each.
The field-test version of the BREAST-Q Utility module was derived from extensive patient and expert input. This comprehensive approach ensured that the content of the Utility module is relevant, comprehensive, and includes concerns that matter the most to women with breast cancer.
通用偏好量表（PBM）虽然应用广泛，但可能并不适合用于乳腺癌干预措施的经济评估。目前尚无专门针对乳腺癌的 PBM，而通用 PBM 无法捕捉到乳腺癌患者的独特关注点（例如，身体形象、外观、治疗相关的不良反应）。因此，本研究旨在开发一种乳腺癌专用的 PBM，即 BREAST-Q 效用模块。
从加拿大的两家三级医院和美国的一家医院招募了患有乳腺癌（0-4 期，任何治疗）的女性。本研究采用探索性序贯混合方法，进行半结构化访谈，访谈结束时，要求参与者列出他们前五个与健康相关的生活质量（HRQOL）关注点，并对 BREAST-Q 中的每个项目进行重要性评分。访谈进行了录音、逐字转录，并进行了编码。使用恒定比较来完善这些代码并开发一个概念框架。定性和定量数据进行了三角分析，以开发效用模块的内容，并通过对乳腺癌患者进行两轮认知访谈和专家反馈进行了细化。
对 57 名年龄为 55±10 岁的女性进行了访谈。从特定于乳房、手臂、腹部和癌症经历的 3948 个独特代码中开发了一个概念框架。五个顶级领域是 HRQOL（即身体、心理、社会和性健康）和外观。访谈、前五个 HRQOL 关注点和 BREAST-Q 项目评分的数据用于为效用模块的纳入提供信息。乳腺癌患者（N=9）和多学科专家小组（N=27）的反馈用于细化模块。HSCS 的现场测试版本包含 10 个独特的维度。每个维度都使用具有 4-5 个响应级别的 1 个或 2 个候选项目进行测量。
BREAST-Q 效用模块的现场测试版本是从广泛的患者和专家投入中得出的。这种全面的方法确保了效用模块的内容是相关的、全面的，并包含了对乳腺癌患者最重要的关注点。
