前列腺癌治疗后 EPIC-26、AQoL-6D 和 SF-6D 的反应性和结构效度。

Responsiveness and construct validity of EPIC-26, AQoL-6D and SF-6D following treatment in prostate cancer.

机构信息

Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia.

Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.

出版信息

BMC Cancer. 2023 Apr 1;23(1):297. doi: 10.1186/s12885-023-10732-6.

DOI:10.1186/s12885-023-10732-6

PMID:37005587

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10067207/

Abstract

PURPOSE

To assess construct validity and responsiveness of the Expanded Prostate Cancer Index Composite Instrument (EPIC-26) relative to the Short-Form Six-Dimension (SF-6D) and Assessment of Quality of Life 6-Dimension (AQoL-6D) in patients following treatment for prostate cancer.

METHODS

Retrospective prostate cancer registry data were used. The SF-6D, AQoL-6D, and EPIC-26 were collected at baseline and one year post treatment. Analyses were based on Spearman's correlation coefficient, Bland-Altman plots and intra-class correlation coefficient, Kruskal Wallis, and Effect Size and the Standardised Response Mean for responsiveness.

RESULTS

The study sample was comprised of 1915 patients. Complete case analysis of 3,697 observations showed moderate evidence of convergent validity between EPIC-26 vitality/hormonal domain and AQoL-6D (r = 0.45 and 0.54) and SF-6D (r = 0.52 and 0.56) at both timepoints. Vitality/hormonal domain also showed moderate convergent validity with coping domain of AQoL-6D (r = 0.45 and 0.54) and with role (r = 0.41 and 0.49) and social function (r = 0.47 and 0.50) domains of SF-6D at both timepoints, and with independent living (r = 0.40) and mental health (r = 0.43) of AQoL-6D at one year. EPIC-26 sexual domain had moderate convergent validity with relationship domain (r = 0.42 and 0.41) of AQoL-6D at both timepoints. Both AQoL-6D and SF-6D did not discriminate between age groups and tumour stage at both timepoints but AQoL-6D discriminated between outcomes for different treatments at one year. All EPIC-26 domains discriminated between age groups and treatment at both timepoints. The EPIC-26 was more responsive than AQoL-6D and SF-6D between baseline and one year following treatment.

CONCLUSIONS

AQoL-6D can be used in combination with EPIC-26 in place of SF-12. Although EPIC-26 is not utility based, its popularity amongst clinicians and ability to discriminate between disease-specific characteristics and post-treatment outcomes in clinical trials makes it a candidate for use within cost-effectiveness analyses. The generic measure provides a holistic assessment of quality of life and is suitable for generating quality adjusted life years (QALYs).

摘要

目的

评估扩展前列腺癌指数综合量表（EPIC-26）相对于短期六维度（SF-6D）和生活质量六维度评估（AQoL-6D）在前列腺癌治疗后的患者中的结构有效性和反应性。

方法

使用回顾性前列腺癌登记数据。SF-6D、AQoL-6D 和 EPIC-26 在基线和治疗后一年收集。分析基于 Spearman 相关系数、Bland-Altman 图和内类相关系数、Kruskal Wallis 检验以及效应大小和标准反应均值的反应性。

结果

研究样本由 1915 名患者组成。对 3697 次观察的完整病例分析显示，EPIC-26 活力/激素域与 AQoL-6D（r=0.45 和 0.54）和 SF-6D（r=0.52 和 0.56）在两个时间点均具有中等程度的收敛有效性。活力/激素域还与 AQoL-6D 的应对域（r=0.45 和 0.54）以及 SF-6D 的角色（r=0.41 和 0.49）和社会功能（r=0.47 和 0.50）在两个时间点均具有中等程度的收敛有效性，与 AQoL-6D 的独立生活（r=0.40）和心理健康（r=0.43）在一年时也具有中等程度的收敛有效性。EPIC-26 性域与 AQoL-6D 的关系域（r=0.42 和 0.41）在两个时间点均具有中等程度的收敛有效性。AQoL-6D 和 SF-6D 均不能在两个时间点区分年龄组和肿瘤分期，但 AQoL-6D 能在一年时区分不同治疗方法的结果。所有 EPIC-26 域均能在两个时间点区分年龄组和治疗方法。与治疗前相比，EPIC-26 在治疗后一年时比 AQoL-6D 和 SF-6D 更具反应性。

结论

AQoL-6D 可以与 EPIC-26 联合使用，以替代 SF-12。尽管 EPIC-26 不是基于效用的，但它在临床医生中的普及程度及其在临床试验中区分疾病特异性特征和治疗后结果的能力，使其成为在成本效益分析中使用的候选者。通用措施提供了对生活质量的全面评估，适合生成质量调整生命年（QALYs）。