Condition-specific or generic preference-based measures in oncology? A comparison of the EORTC-8D and the EQ-5D-3L
journal contributionposted on 2022-04-08, 04:19 authored by PK Lorgelly, B Doble, D Rowen, J Brazier, DM Thomas, SB Fox, H Thorne, JP Parisot, K Doig, A Fellowes, Alexander DobrovicAlexander Dobrovic, PA James, L Lipton, D Ashley, T Hayes, P McMurrick, G Richardson, P Lorgelly, M Lucas, JJ McNeil, T John
Purpose: It has been argued that generic health-related quality of life measures are not sensitive to certain disease-specific improvements; condition-specific preference-based measures may offer a better alternative. This paper assesses the validity, responsiveness and sensitivity of a cancer-specific preference-based measure, the EORTC-8D, relative to the EQ-5D-3L. Methods: A longitudinal prospective population-based cancer genomic cohort, Cancer 2015, was utilised in the analysis. EQ-5D-3L and the EORTC QLQ-C30 (which gives EORTC-8D values) were asked at baseline (diagnosis) and at various follow-up points (3 months, 6 months, 12 months). Baseline values were assessed for convergent validity, ceiling effects, agreement and sensitivity. Quality-adjusted life-years (QALYs) were estimated and similarly assessed. Multivariate regression analyses were employed to understand the determinants of the difference in QALYs. Results: Complete case analysis of 1678 patients found that the EQ-5D-3L values at baseline were significantly lower than the EORTC-8D values (0.748 vs 0.829, p < 0.001). While the correlation between the instruments was high, agreement between the instruments was poor. The baseline health state values using both instruments were found to be sensitive to a number of patient and disease characteristics, and discrimination between disease states was found to be similar. Mean generic QALYs (estimated using the EQ-5D-3L) were significantly lower than condition-specific QALYs (estimated using the EORTC-8D) (0.860 vs 0.909, p < 0.001). The discriminatory power of both QALYs was similar. Conclusions: When comparing a generic and condition-specific preference-based instrument, divergences are apparent in both baseline health state values and in the estimated QALYs over time for cancer patients. The variability in sensitivity between the baseline values and the QALY estimations means researchers and decision makers are advised to be cautious if using the instruments interchangeably.
Paula Lorgelly was a recipient of a Victorian Government Translational Research Grant through the Victorian Cancer Agency. Brett Doble was supported by research scholarships from Monash University. The funding sources had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review and approval of the manuscript; or decision to submit the manuscript for publication.
JournalQuality of Life Research
Pagination11p. (p. 562-572)
Rights Statement© The Author(s) 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creative commons.org/licenses/by/4.0/), which permits unrestricted use, distri- bution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Science & TechnologyLife Sciences & BiomedicineHealth Care Sciences & ServicesHealth Policy & ServicesPublic, Environmental & Occupational HealthCancerCondition-specific non-preferencebased measuresGeneric preference-based measuresQuality of lifeQUALITY-OF-LIFEHEALTH STATE CLASSIFICATIONOUTCOME MEASURESSINGLE INDEXCANCERVALIDITYDISEASEQLQ-C30SYSTEMQUESTIONNAIRECondition-specific non-preference-based measuresAgedCohort StudiesFemaleHumansLongitudinal StudiesMaleMedical OncologyMiddle AgedProspective StudiesQuality of LifeSurveys and QuestionnairesCancer 2015 investigators