The FACT-8D, a new cancer-specific utility algorithm based on the Functional Assessment of Cancer Therapies-General (FACT-G): a Canadian valuation study
Abstract Introduction Utility instruments are used to assess patients’ health-related quality of life for cost-utility analysis (CUA). However, for cancer patients, the dimensions of generic utility instruments may not capture all the information relevant to the impact of cancer. Cancer-specific uti...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Health and Quality of Life Outcomes |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12955-022-02002-z |
| _version_ | 1828821789696851968 |
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| author | Helen McTaggart-Cowan Madeleine T. King Richard Norman Daniel S. J. Costa A. Simon Pickard Rosalie Viney Stuart J. Peacock the Canadian MAUCa Team |
| author_facet | Helen McTaggart-Cowan Madeleine T. King Richard Norman Daniel S. J. Costa A. Simon Pickard Rosalie Viney Stuart J. Peacock the Canadian MAUCa Team |
| author_sort | Helen McTaggart-Cowan |
| collection | DOAJ |
| description | Abstract Introduction Utility instruments are used to assess patients’ health-related quality of life for cost-utility analysis (CUA). However, for cancer patients, the dimensions of generic utility instruments may not capture all the information relevant to the impact of cancer. Cancer-specific utilities provide a useful alternative. Under the auspices of the Multi-Attribute Utility in Cancer Consortium, a cancer-specific utility algorithm was derived from the FACT-G. The new FACT-8D contains eight dimensions: pain, fatigue, nausea, sleep, work, support from family/friends, sadness, and worry health will get worse. The aim of the study was to obtain a Canadian value set for the FACT-8D. Methods A discrete choice experiment was administered to a Canadian general population online panel, quota sampled by age, sex, and province/territory of residence. Respondents provided responses to 16 choice sets. Each choice set consisted of two health states described by the FACT-8D dimensions plus an attribute representing survival duration. Sample weights were applied and the responses were analyzed using conditional logistic regression, parameterized to fit the quality-adjusted life year framework. The results were converted into utility weights by evaluating the marginal rate of substitution between each level of each FACT-8D dimension with respect to duration. Results 2228 individuals were recruited. The analysis dataset included n = 1582 individuals, who completed at least one choice set; of which, n = 1501 completed all choice sets. After constraining to ensure monotonicity in the utility function, the largest decrements were for the highest levels of pain (− 0.38), nausea (− 0.30), and problems doing work (− 0.23). The decrements of the remaining dimensions ranged from − 0.08 to − 0.18 for their highest levels. The utility of the worst possible health state was defined as − 0.65, considerably worse than dead. Conclusions The largest impacts on utility included three generic dimensions (i.e., pain, support, and work) and nausea, a symptom caused by cancer (e.g., brain tumours, gastrointestinal tumours, malignant bowel obstruction) and by common treatments (e.g., chemotherapy, radiotherapy, opioid analgesics). This may make the FACT-8D more informative for CUA evaluating in many cancer contexts, an assertion that must now be tested empirically in head-to-head comparisons with generic utility measures. |
| first_indexed | 2024-12-12T13:01:18Z |
| format | Article |
| id | doaj.art-015207dd535649519afb63066e920bf4 |
| institution | Directory Open Access Journal |
| issn | 1477-7525 |
| language | English |
| last_indexed | 2024-12-12T13:01:18Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Health and Quality of Life Outcomes |
| spelling | doaj.art-015207dd535649519afb63066e920bf42022-12-22T00:23:46ZengBMCHealth and Quality of Life Outcomes1477-75252022-06-0120111210.1186/s12955-022-02002-zThe FACT-8D, a new cancer-specific utility algorithm based on the Functional Assessment of Cancer Therapies-General (FACT-G): a Canadian valuation studyHelen McTaggart-Cowan0Madeleine T. King1Richard Norman2Daniel S. J. Costa3A. Simon Pickard4Rosalie Viney5Stuart J. Peacock6the Canadian MAUCa TeamCancer Control Research, BC CancerSchool of Psychology, University of SydneySchool of Public Health, Curtin UniversitySchool of Psychology, University of SydneyDepartment of Pharmacy Systems, Outcomes, and Policy, University of Illinois at ChicagoCentre for Health Economics Research and Evaluation, University of TechnologyCancer Control Research, BC CancerAbstract Introduction Utility instruments are used to assess patients’ health-related quality of life for cost-utility analysis (CUA). However, for cancer patients, the dimensions of generic utility instruments may not capture all the information relevant to the impact of cancer. Cancer-specific utilities provide a useful alternative. Under the auspices of the Multi-Attribute Utility in Cancer Consortium, a cancer-specific utility algorithm was derived from the FACT-G. The new FACT-8D contains eight dimensions: pain, fatigue, nausea, sleep, work, support from family/friends, sadness, and worry health will get worse. The aim of the study was to obtain a Canadian value set for the FACT-8D. Methods A discrete choice experiment was administered to a Canadian general population online panel, quota sampled by age, sex, and province/territory of residence. Respondents provided responses to 16 choice sets. Each choice set consisted of two health states described by the FACT-8D dimensions plus an attribute representing survival duration. Sample weights were applied and the responses were analyzed using conditional logistic regression, parameterized to fit the quality-adjusted life year framework. The results were converted into utility weights by evaluating the marginal rate of substitution between each level of each FACT-8D dimension with respect to duration. Results 2228 individuals were recruited. The analysis dataset included n = 1582 individuals, who completed at least one choice set; of which, n = 1501 completed all choice sets. After constraining to ensure monotonicity in the utility function, the largest decrements were for the highest levels of pain (− 0.38), nausea (− 0.30), and problems doing work (− 0.23). The decrements of the remaining dimensions ranged from − 0.08 to − 0.18 for their highest levels. The utility of the worst possible health state was defined as − 0.65, considerably worse than dead. Conclusions The largest impacts on utility included three generic dimensions (i.e., pain, support, and work) and nausea, a symptom caused by cancer (e.g., brain tumours, gastrointestinal tumours, malignant bowel obstruction) and by common treatments (e.g., chemotherapy, radiotherapy, opioid analgesics). This may make the FACT-8D more informative for CUA evaluating in many cancer contexts, an assertion that must now be tested empirically in head-to-head comparisons with generic utility measures.https://doi.org/10.1186/s12955-022-02002-zCanadaCancerDiscrete choice experimentFACT-G, health-related quality of life, utility |
| spellingShingle | Helen McTaggart-Cowan Madeleine T. King Richard Norman Daniel S. J. Costa A. Simon Pickard Rosalie Viney Stuart J. Peacock the Canadian MAUCa Team The FACT-8D, a new cancer-specific utility algorithm based on the Functional Assessment of Cancer Therapies-General (FACT-G): a Canadian valuation study Health and Quality of Life Outcomes Canada Cancer Discrete choice experiment FACT-G, health-related quality of life, utility |
| title | The FACT-8D, a new cancer-specific utility algorithm based on the Functional Assessment of Cancer Therapies-General (FACT-G): a Canadian valuation study |
| title_full | The FACT-8D, a new cancer-specific utility algorithm based on the Functional Assessment of Cancer Therapies-General (FACT-G): a Canadian valuation study |
| title_fullStr | The FACT-8D, a new cancer-specific utility algorithm based on the Functional Assessment of Cancer Therapies-General (FACT-G): a Canadian valuation study |
| title_full_unstemmed | The FACT-8D, a new cancer-specific utility algorithm based on the Functional Assessment of Cancer Therapies-General (FACT-G): a Canadian valuation study |
| title_short | The FACT-8D, a new cancer-specific utility algorithm based on the Functional Assessment of Cancer Therapies-General (FACT-G): a Canadian valuation study |
| title_sort | fact 8d a new cancer specific utility algorithm based on the functional assessment of cancer therapies general fact g a canadian valuation study |
| topic | Canada Cancer Discrete choice experiment FACT-G, health-related quality of life, utility |
| url | https://doi.org/10.1186/s12955-022-02002-z |
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