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Estimating health-state utility values for patients with recurrent ovarian cancer using Functional Assessment of Cancer Therapy - General mapping algorithms.

Hettle R, Borrill J, Suri G, Wulff J - Clinicoecon Outcomes Res (2015)

Bottom Line: Under the preferred algorithm, treatment-related adverse events had no statistically significant effect on HSU (P>0.05).Discontinuation of the study treatment and breast cancer antigen mutation status were both associated with a reduction in HSUVs (-0.06, P=0.0009; and -0.03, P=0.0511, respectively).For this reason, it is important to test whether the choice of a specific algorithm changes the conclusions of an economic evaluation.

View Article: PubMed Central - PubMed

Affiliation: Parexel Consulting, London, UK.

ABSTRACT

Objectives: In the absence of EuroQol 5D data, mapping algorithms can be used to predict health-state utility values (HSUVs) for use in economic evaluation. In a placebo-controlled Phase II study of olaparib maintenance therapy (NCT00753545), health-related quality of life was measured using the Functional Assessment of Cancer Therapy - Ovarian (FACT-O) questionnaire. Our objective was to generate HSUVs from the FACT-O data using published mapping algorithms.

Materials and methods: Algorithms were identified from a review of the literature. Goodness-of-fit and patient characteristics were compared to select the best-performing algorithm, and this was used to generate base-case HSUVs for the intention-to-treat population of the olaparib study and for patients with breast cancer antigen mutations.

Results: Four FACT - General (the core component of FACT-O) mapping algorithms were identified and compared. Under the preferred algorithm, treatment-related adverse events had no statistically significant effect on HSU (P>0.05). Discontinuation of the study treatment and breast cancer antigen mutation status were both associated with a reduction in HSUVs (-0.06, P=0.0009; and -0.03, P=0.0511, respectively). The mean HSUV recorded at assessment visits was 0.786.

Conclusion: FACT - General mapping generated credible HSUVs for an economic evaluation of olaparib. As reported in other studies, different algorithms may produce significantly different estimates of HSUV. For this reason, it is important to test whether the choice of a specific algorithm changes the conclusions of an economic evaluation.

No MeSH data available.


Related in: MedlinePlus

Distribution of utilities, total FACT-G scores, and total FACT-O scores across all observations in the study.Abbreviations: EQ, EuroQol; TTO, time trade-off; FACT-G, Functional Assessment of Cancer Therapy – General; FACT-O, FACT – Ovarian; OLS, ordinary least squares.
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f1-ceor-7-615: Distribution of utilities, total FACT-G scores, and total FACT-O scores across all observations in the study.Abbreviations: EQ, EuroQol; TTO, time trade-off; FACT-G, Functional Assessment of Cancer Therapy – General; FACT-O, FACT – Ovarian; OLS, ordinary least squares.

Mentions: All four algorithms were applied to patient-level FACT-O data from NCT00753545. HSUVs were generated for 247 of the 264 patients in NCT00753545 (Table 3). Applying the preferred algorithm (OLS), mean utility values in the ITT population were 0.786 (interquartile range: 0.699–0.885) and 0.720 (interquartile range: 0.632–0.820) for scheduled routine and unscheduled assessments, respectively. In the BRCAm subpopulation, mean utility values were 0.768 (0.681–0.871, scheduled routine assessments) and 0.708 (0.594–0.811, unscheduled assessments). Figure 1 shows the distribution of predicted HSUV, total FACT-G, and total FACT-O scores. The OLS and Cheung et al HSUVs were left-skewed, with values clustered toward the upper limit of 1. The Tobit and Dobrez et al HSUVs had a multimodal distribution, with values clustered in the ranges 0.80–0.85 and 0.95–1.00. The total FACT-G and FACT-O scores were left-skewed.


Estimating health-state utility values for patients with recurrent ovarian cancer using Functional Assessment of Cancer Therapy - General mapping algorithms.

Hettle R, Borrill J, Suri G, Wulff J - Clinicoecon Outcomes Res (2015)

Distribution of utilities, total FACT-G scores, and total FACT-O scores across all observations in the study.Abbreviations: EQ, EuroQol; TTO, time trade-off; FACT-G, Functional Assessment of Cancer Therapy – General; FACT-O, FACT – Ovarian; OLS, ordinary least squares.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664440&req=5

f1-ceor-7-615: Distribution of utilities, total FACT-G scores, and total FACT-O scores across all observations in the study.Abbreviations: EQ, EuroQol; TTO, time trade-off; FACT-G, Functional Assessment of Cancer Therapy – General; FACT-O, FACT – Ovarian; OLS, ordinary least squares.
Mentions: All four algorithms were applied to patient-level FACT-O data from NCT00753545. HSUVs were generated for 247 of the 264 patients in NCT00753545 (Table 3). Applying the preferred algorithm (OLS), mean utility values in the ITT population were 0.786 (interquartile range: 0.699–0.885) and 0.720 (interquartile range: 0.632–0.820) for scheduled routine and unscheduled assessments, respectively. In the BRCAm subpopulation, mean utility values were 0.768 (0.681–0.871, scheduled routine assessments) and 0.708 (0.594–0.811, unscheduled assessments). Figure 1 shows the distribution of predicted HSUV, total FACT-G, and total FACT-O scores. The OLS and Cheung et al HSUVs were left-skewed, with values clustered toward the upper limit of 1. The Tobit and Dobrez et al HSUVs had a multimodal distribution, with values clustered in the ranges 0.80–0.85 and 0.95–1.00. The total FACT-G and FACT-O scores were left-skewed.

Bottom Line: Under the preferred algorithm, treatment-related adverse events had no statistically significant effect on HSU (P>0.05).Discontinuation of the study treatment and breast cancer antigen mutation status were both associated with a reduction in HSUVs (-0.06, P=0.0009; and -0.03, P=0.0511, respectively).For this reason, it is important to test whether the choice of a specific algorithm changes the conclusions of an economic evaluation.

View Article: PubMed Central - PubMed

Affiliation: Parexel Consulting, London, UK.

ABSTRACT

Objectives: In the absence of EuroQol 5D data, mapping algorithms can be used to predict health-state utility values (HSUVs) for use in economic evaluation. In a placebo-controlled Phase II study of olaparib maintenance therapy (NCT00753545), health-related quality of life was measured using the Functional Assessment of Cancer Therapy - Ovarian (FACT-O) questionnaire. Our objective was to generate HSUVs from the FACT-O data using published mapping algorithms.

Materials and methods: Algorithms were identified from a review of the literature. Goodness-of-fit and patient characteristics were compared to select the best-performing algorithm, and this was used to generate base-case HSUVs for the intention-to-treat population of the olaparib study and for patients with breast cancer antigen mutations.

Results: Four FACT - General (the core component of FACT-O) mapping algorithms were identified and compared. Under the preferred algorithm, treatment-related adverse events had no statistically significant effect on HSU (P>0.05). Discontinuation of the study treatment and breast cancer antigen mutation status were both associated with a reduction in HSUVs (-0.06, P=0.0009; and -0.03, P=0.0511, respectively). The mean HSUV recorded at assessment visits was 0.786.

Conclusion: FACT - General mapping generated credible HSUVs for an economic evaluation of olaparib. As reported in other studies, different algorithms may produce significantly different estimates of HSUV. For this reason, it is important to test whether the choice of a specific algorithm changes the conclusions of an economic evaluation.

No MeSH data available.


Related in: MedlinePlus