QLU-C10D: a health state classification system for a multi-attribute utility measure based on the EORTC QLQ-C30

Abstract

Abstract:Purpose: To derive a health state classification system (HSCS) from the cancerspecific quality of life questionnaire, the EORTC QLQ-C30, as the basis for a multiattribute utility instrument.Methods: The conceptual model for the HSCS was based on the established domain structure of the QLQ-C30. Several criteria were considered to select a subset of dimensions and items for the HSCS. Expert opinion and patient input informed a priori Powered by Edit orial Manager® and ProduXion Manager® from Aries Syst em s Corporat ionselection of key dimensions. Psychometric criteria were assessed via secondary analysis of a pooled dataset comprising HRQOL and clinical data from 2616 patients from eight countries and a range of primary cancer sites, disease stages, and treatments. We used confirmatory factor analysis (CFA) to assess the conceptual model's robustness and generalisability. We assessed item floor effects (>75% observations at lowest score), disordered item response thresholds, coverage of the latent variable and differential item function (DIF) using Rasch analysis. We calculated effect sizes for known group comparisons based on disease stage and responsiveness to change. Seventy-nine cancer patients assessed the relative importance of items within dimensions.Results: CFA supported the conceptual model and its generalizability across primary cancer sites. After considering all criteria, 12 items were selected representing 10 dimensions: physical functioning (mobility), role functioning, social functioning, emotional functioning, pain, fatigue, sleep, appetite, nausea, bowel problems.

U.K. utility weights for the EORTC QLU‐C10D

“…Problems with sleep and fatigue had smaller decrements, perhaps because problems with sleep and fatigue are relatively common even in a general population, therefore were less influential in survey respondents' choices between health states than other DCE attributes. The results presented here are similar in range to the Australian QLU‐C10D valuation results (King et al, ). In the Australian value set, the value of the worst health state was −0.096, compared with a value of −0.083 in this U.K. value set.…”

“…Table shows the QLU‐C10D descriptive system and explains how the 10 dimensions, each with four levels, map to 13 of the 30 items in the QLQ‐C30. The derivation of this health state classification system is described elsewhere (King et al, ). It is important to note that the wording of the 10 dimensions are based on the original wording of the QLQ‐C30.…”

“…Previous work by Rowen et al () used factor analysis and Rasch analysis on QLQ‐C30 data from a sample of 655 U.K.‐based multiple myeloma patients to derive a descriptive system and then valued a subset of health states using the time trade‐off in face‐to‐face interviews conducted in a U.K. general population sample of 350. The present study uses a somewhat different descriptive system based on a secondary analysis of larger ( n = 2,616) and more diverse collection of cancer‐related datasets, including 13 countries, 15 primary cancer types, localised/regional ( n = 1,037), and recurrent/metastatic stages ( n = 1,579; King et al, ). The resultant descriptive system contains 13 of the QLQ‐C30's 30 items across 10 dimensions (Table ), forms the basis of the EORTC QLU‐C10D, and is endorsed by the EORTC as its official PBM (King et al, ).…”

“…The present study uses a somewhat different descriptive system based on a secondary analysis of larger ( n = 2,616) and more diverse collection of cancer‐related datasets, including 13 countries, 15 primary cancer types, localised/regional ( n = 1,037), and recurrent/metastatic stages ( n = 1,579; King et al, ). The resultant descriptive system contains 13 of the QLQ‐C30's 30 items across 10 dimensions (Table ), forms the basis of the EORTC QLU‐C10D, and is endorsed by the EORTC as its official PBM (King et al, ).…”

Beurteilung der Lebensqualität bei Patienten mit nicht‐melanozytärem Hautkrebs – psychometrische Validierung des EORTC QLQ‐C30‐Fragebogens

“… haben vorgeschlagen, dass der Patientenwunsch nach professioneller Unterstützung bei Patienten mit Hautkrebs ebenfalls beurteilt werden sollte, da die psychosoziale Belastung und der Wunsch nach Unterstützung einander oft nicht entsprechen. In jüngster Zeit wurde ein Klassifizierungssystem für den Gesundheitszustand mit mehreren Attributen vorgeschlagen, das den EORTC QLQ‐C30 für Kosten‐Nutzen‐ und gesundheitsökonomische Analysen geeignet macht .…”