PCN127 Health State Utility Assessment for Breast Cancer

OBJECTIVESagittal craniosynostosis results in a characteristic scaphocephalic head shape that is typically corrected surgically during a child’s 1st year of life. The authors’ objective was to determine the potential impact of being born with sagittal craniosynostosis by using validated health state utility assessment measures.METHODSAn online utility assessment was designed to generate health utility scores for scaphocephaly, monocular blindness, and binocular blindness using standardized utility assessment tools, namely the visual analog scale (VAS) and the standard gamble (SG) and time trade-off (TTO) tests. Utility scores were compared between health states using the Wilcoxon and Kruskal-Wallis tests. Univariate regression was performed using age, sex, income, and education as independent predictors of utility scores.RESULTSOver a 2-month enrollment period, 122 participants completed the online survey. One hundred eighteen participants were eligible for analysis. Participants rated scaphocephaly due to sagittal craniosynostosis with significantly higher (p < 0.001) median utility scores (VAS 0.85, IQR 0.76–0.95; SG 0.92, IQR 0.84–0.98; TTO 0.91, IQR 0.84–0.95) than both monocular blindness (VAS 0.60, IQR 0.50–0.70; SG 0.84, IQR 0.68–0.94; TTO 0.84, IQR 0.67–0.91) and binocular blindness (VAS 0.25, IQR 0.20–0.40; SG 0.51, IQR 0.18–0.79; TTO 0.55, IQR 0.36–0.76). No differences were noted in utility scores based on participant age, sex, income, or education.CONCLUSIONSUsing objective health state utility scores, authors of the current study demonstrated that the preoperatively perceived burden of scaphocephaly in a child’s 1st year of life is less than that of monocular blindness. These relatively high utility scores for scaphocephaly suggest that the burden of disease as perceived by the general population is low and should inform surgeons’ discussions when offering morbid corrective surgery, particularly when driven by aesthetic concerns.

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Health State Utility Impact of Breast Cancer in U.S. Women Aged 18–44 Years

American Journal of Preventive Medicine ◽

10.1016/j.amepre.2015.07.020 ◽

2016 ◽

Vol 50 (2) ◽

pp. 255-261 ◽

Cited By ~ 10

Author(s):

Derek S. Brown ◽

Justin G. Trogdon ◽

Donatus U. Ekwueme ◽

Linda Chamiec-Case ◽

Gery P. Guy ◽

...

Keyword(s):

Breast Cancer ◽

Health State Utility ◽

Health State

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Changes in Health State Utility Values in Japanese Patients with End-Stage Breast Cancer

Current Oncology ◽

10.3390/curroncol28050356 ◽

2021 ◽

Vol 28 (5) ◽

pp. 4203-4212

Author(s):

Tsuguo Iwatani ◽

Shinichi Noto ◽

Koichiro Tsugawa

Keyword(s):

Breast Cancer ◽

Mean Squared Error ◽

Metastatic Breast ◽

Absolute Error ◽

Japanese Patients ◽

Health State Utility ◽

Health State ◽

Utility Values ◽

Health State Utility Values ◽

End Stage

We aimed to determine the dynamic trends in health state utility values (HSUVs) in patients with end-stage breast cancer. We selected 181 patients comprising 137 with primary breast cancer (PBC) and 44 with metastatic breast cancer (MBC) (28 survivors and 16 patients with MBC death). HSUVs were 0.90 and 0.89 in patients with PBC and 0.83 and 0.80 in those with MBC (survivors) at 6 and 3 months, respectively, before the end of the observation period; these values were 0.73 and 0.66, respectively, in those with MBC (deceased) during the aforementioned period. The root-mean-squared error (RMSE) for the decrease in HSUVs over 3 months was 0.10, 0.096, and 0.175 for patients with PBC, MBC (survivors), and MBC (deceased), respectively. One-way analysis of variance for differences in absolute error among the groups was significant (p = 0.0102). Multiple comparisons indicated a difference of 0.068 in absolute error between patients with PBC and those with MBC (deceased) (p = 0.0082). Patients with end-stage breast cancer had well-controlled HSUVs 3 months before death, with a sharp decline in HSUVs in the 3 months leading up to death.

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Meta-analysis of health state utility values measured by EuroQol 5-dimensions (EQ5D) questionnaire in Chinese women with breast cancer

BMC Cancer ◽

10.1186/s12885-021-09140-5 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Tamlyn Rautenberg ◽

Brent Hodgkinson ◽

Ute Zerwes ◽

Martin Downes

Keyword(s):

Breast Cancer ◽

Random Effects ◽

Chinese Women ◽

Meta Analysis ◽

Cost Utility ◽

Health State Utility ◽

First Year ◽

Health State ◽

Utility Values ◽

Health State Utility Values

Abstract Background To synthesise EQ5D health state utility values in Chinese women with breast cancer for parameterising a cost utility model. Methods Eligible studies had to report health state utility values measured by EQ-5D in Chinese women diagnosed with breast cancer. Risk of bias was assessed using the Newcastle Ottawa Scale (NOS). Data from single arm studies was pooled using meta-analysis of single proportions to provide overall point estimates and 95% confidence intervals for fixed and random effects models using the inverse variance and Der Simonian-Laird methods respectively. Heterogeneity was evaluated using the I2 statistic and sensitivity analysis and meta-regression were conducted. Results Five papers were included, when all studies were combined (n = 4,100) the mean utility (95% confidence interval) for random effects model was 0.83 (0.78, 0.89); for TNM 0-1 0.85 (0.75, 0.95); for TNM II 0.85 (0.78, 0.93); for TNM III 0.83 (0.77, 0.90) and for TNM IV 0.73 (0.63, 0.82).The utility of patients in State P (first year after primary breast cancer) 0.84 (0.80, 0.88); in State R (first year after recurrence) 0.73 (0.69, 0.76), in State S (second and following years after primary breast cancer or recurrence) 0.88 (0.83, 0.92); and in State M (metastatic disease) 0.78 (0.74, 0.82). Mean utility for duration since diagnosis 13 to 36 months was 0.88 (0.80, 0.96, I2 =95%); for 37 to 60 months 0.89 (0.82, 0.96, I2 =90%); for more than 60 months 0.86 (0.76, 0.96, I2 =90%). Mean utility for chemotherapy was 0.86 (0.79, 0.92, I2 =97%); for radiotherapy 0.83 (0.69, 0.96, I2 =97%); surgery 0.80 (0.69, 0.91, I2 =98%); concurrent chemo-radiation 0.70 (0.60, 0.81, I2 =86%) and endocrine therapy 0.90 (0.83, 0.97, I2 =91%). Conclusion: This study synthesises the evidence for health state utility values for Chinese women with breast cancer which is useful to inform cost utility models.

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Validation of the predictive accuracy of health-state utility values based on the Lloyd model for metastatic or recurrent breast cancer in Japan

BMJ Open ◽

10.1136/bmjopen-2020-046273 ◽

2021 ◽

Vol 11 (12) ◽

pp. e046273

Author(s):

Tsuguo Iwatani ◽

Eisuke Inoue ◽

Koichiro Tsugawa

Keyword(s):

Breast Cancer ◽

Predictive Model ◽

Predictive Accuracy ◽

Japanese Patients ◽

Health State Utility ◽

Health State ◽

Altman Analysis ◽

Bland Altman Analysis ◽

Utility Values ◽

Health State Utility Values

IntroductionAlthough there is a lack of data on health-state utility values (HSUVs) for calculating quality-adjusted life-years in Japan, cost–utility analysis has been introduced by the Japanese government to inform decision making in the medical field since 2016.ObjectivesThis study aimed to determine whether the Lloyd model which was a predictive model of HSUVs for metastatic breast cancer (MBC) patients in the UK can accurately predict actual HSUVs for Japanese patients with MBC.DesignThe prospective observational study followed by the validation study of the clinical predictive model.Setting and participantsForty-four Japanese patients with MBC were studied at 336 survey points.MethodsThis study consisted of two phases. In the first phase, we constructed a database of clinical data prospectively and HSUVs for Japanese patients with MBC to evaluate the predictive accuracy of HSUVs calculated using the Lloyd model. In the second phase, Bland-Altman analysis was used to determine how accurately predicted HSUVs (based on the Lloyd model) correlated with actual HSUVs obtained using the EuroQol 5-Dimension 5-Level questionnaire, a preference-based measure of HSUVs in patients with MBC.ResultsIn the Bland-Altman analysis, the mean difference between HSUVs estimated by the Lloyd model and actual HSUVs, or systematic error, was −0.106. The precision was 0.165. The 95% limits of agreement ranged from −0.436 to 0.225. The t value was 4.6972, which was greater than the t value with 2 degrees of freedom at the 5% significance level (p=0.425).ConclusionsThere were acceptable degrees of fixed and proportional errors associated with the prediction of HSUVs based on the Lloyd model for Japanese patients with MBC. We recommend that sensitivity analysis be performed when conducting cost-effectiveness analyses with HSUVs calculated using the Lloyd model.

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