University Hospital of Psychiatry II, Medial University of Innsbruck, Innsbruck, Austria.
Department of Nuclear Medicine, Medical University of Innsbruck, Austria.
Thyroid. 2024 Nov;34(11):1356-1370. doi: 10.1089/thy.2024.0396. Epub 2024 Oct 30.
Health economic appraisals often rely on the assessment of health utilities using preference-based measures (PBM). The cancer-specific PBM, European Organisation for Research and Treatment of Cancer Quality of Life Utility - Core 10 Dimensions (EORTC QLU-C10D), was developed recently, and now needs to be validated in various clinical populations. In a multicenter, multinational prospective cohort study, we longitudinally collected EORTC QLQ-C30 and EQ-5D-5L data from patients with thyroid cancer. We applied seven country-specific value sets to the QLQ-C30 data to derive country-specific utility values and used the EQ-5D-5L as a comparator PBM. Criterion validity was assessed by correlating index scores and Bland-Altman plots. Construct validity was investigated by correlating domain scores. Known-group comparisons and responsiveness were assessed using external clinical criteria. A total of 181 patients with thyroid cancer from nine countries (three continents) provided analyzable data. Patients were included if they had differentiated, medullary, or anaplastic thyroid cancer. Mean utility values of both instruments were generally lower compared to general population norms. No floor or ceiling effects were present for the QLU-C10D. The intra-class correlation for EQ-5D-5L and QLU-C10D index values ranged from 0.761 to 0.901 across the measurement timepoints, supporting criterion validity. Spearman's correlation coefficients ranged from 0.289 to 0.716 for theoretically corresponding domain pairs. The QLU-C10D detected differences in 9 of 15 known-group comparisons, supporting sensitivity. Clinically important changes were detected by all QLU-C10D country specific value sets, supporting responsiveness. Further, the QLU-C10D had higher statistical efficiency than the EQ-5D-5L in 74.7% of comparisons. The QLU-C10D is a valid PBM for health economic evaluations in thyroid cancer studies. We recommend its use to estimate health utilities in economic evaluations of thyroid cancer therapies.
健康经济评估通常依赖于使用偏好测量（PBM）来评估健康效用。最近开发了特定于癌症的 PBM，即欧洲癌症研究与治疗组织生活质量效用核心 10 维度（EORTC QLU-C10D），现在需要在各种临床人群中进行验证。在一项多中心、多国前瞻性队列研究中，我们纵向收集了甲状腺癌患者的 EORTC QLQ-C30 和 EQ-5D-5L 数据。我们将七个国家特有的价值体系应用于 QLQ-C30 数据，得出了国家特有的效用值，并将 EQ-5D-5L 用作比较性 PBM。通过相关指数得分和 Bland-Altman 图来评估标准有效性。通过相关域得分来研究构效关系。使用外部临床标准评估已知组比较和反应性。共有来自 9 个国家（三大洲）的 181 名甲状腺癌患者提供了可分析的数据。如果患者患有分化型、髓样或间变性甲状腺癌，则纳入研究。两种工具的平均效用值通常低于一般人群的正常值。QLU-C10D 没有地板或天花板效应。EQ-5D-5L 和 QLU-C10D 指数值的组内相关在测量时间点的范围为 0.761 至 0.901，支持标准有效性。理论上相应的域对之间的 Spearman 相关系数范围为 0.289 至 0.716。QLU-C10D 在 15 个已知组比较中的 9 个中检测到差异，支持敏感性。所有 QLU-C10D 国家特定值集都检测到了临床重要的变化，支持反应性。此外，在 74.7%的比较中，QLU-C10D 比 EQ-5D-5L 具有更高的统计效率。QLU-C10D 是甲状腺癌研究中健康经济评估的有效 PBM。我们建议在甲状腺癌治疗的经济评估中使用它来估计健康效用。
