Mapping the EORTC QLQ-C30 to EQ-5D-3L in patients with breast cancer
Abstract Background The types of outcomes measured collected in clinical studies and those required for cost-effectiveness analysis often differ. Decision makers routinely use quality adjusted life years (QALYs) to compare the benefits and costs of treatments across different diseases and treatments...
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| Format: | Article |
| Language: | English |
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BMC
2021-11-01
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| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-021-08964-5 |
| _version_ | 1818345135364112384 |
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| author | Laura A. Gray Monica Hernandez Alava Allan J. Wailoo |
| author_facet | Laura A. Gray Monica Hernandez Alava Allan J. Wailoo |
| author_sort | Laura A. Gray |
| collection | DOAJ |
| description | Abstract Background The types of outcomes measured collected in clinical studies and those required for cost-effectiveness analysis often differ. Decision makers routinely use quality adjusted life years (QALYs) to compare the benefits and costs of treatments across different diseases and treatments using a common metric. QALYs can be calculated using preference-based measures (PBMs) such as EQ-5D-3L, but clinical studies often focus on objective clinician or laboratory measured outcomes and non-preference-based patient outcomes, such as QLQ-C30. We model the relationship between the generic, preference-based EQ-5D-3L and the cancer specific quality of life questionnaire, QLQ-C30 in patients with breast cancer. This will result in a mapping that allows users to convert QLQ-C30 scores into EQ-5D-3L scores for the purposes of cost-effectiveness analysis or economic evaluation. Methods We use data from a randomized trial of 602 patients with HER2-positive advanced breast cancer provided 3766 EQ-5D-3L observations. Direct mapping using adjusted, limited dependent variable mixture models (ALDVMM) is compared to a random effects linear regression and indirect mapping using seemingly unrelated ordered probit models. EQ-5D-3L was estimated as a function of the summary scales of the QLQ-C30 and other patient characteristics. Results A four component mixture model outperformed other models in terms of summary fit statistics. A close fit to the observed data was observed across the range of disease severity. Simulated data from the model closely aligned to the original data and showed that mapping did not significantly underestimate uncertainty. In the simulated data, 22.15% were equal to 1 compared to 21.93% in the original data. Variance was 0.0628 in the simulated data versus 0.0693 in the original data. The preferred mapping is provided in Excel and Stata files for the ease of users. Conclusion A four component adjusted mixture model provides reliable, non-biased estimates of EQ-5D-3L from the QLQ-C30, to link clinical studies to economic evaluation of health technologies for breast cancer. This work adds to a growing body of literature demonstrating the appropriateness of mixture model based approaches in mapping. |
| first_indexed | 2024-12-13T16:57:33Z |
| format | Article |
| id | doaj.art-45189f29fd5d41dfb4a1065fe8a3e5c4 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-13T16:57:33Z |
| publishDate | 2021-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-45189f29fd5d41dfb4a1065fe8a3e5c42022-12-21T23:37:53ZengBMCBMC Cancer1471-24072021-11-0121111010.1186/s12885-021-08964-5Mapping the EORTC QLQ-C30 to EQ-5D-3L in patients with breast cancerLaura A. Gray0Monica Hernandez Alava1Allan J. Wailoo2Health Economics and Decision Science, School of Health and Related Research, University of SheffieldHealth Economics and Decision Science, School of Health and Related Research, University of SheffieldHealth Economics and Decision Science, School of Health and Related Research, University of SheffieldAbstract Background The types of outcomes measured collected in clinical studies and those required for cost-effectiveness analysis often differ. Decision makers routinely use quality adjusted life years (QALYs) to compare the benefits and costs of treatments across different diseases and treatments using a common metric. QALYs can be calculated using preference-based measures (PBMs) such as EQ-5D-3L, but clinical studies often focus on objective clinician or laboratory measured outcomes and non-preference-based patient outcomes, such as QLQ-C30. We model the relationship between the generic, preference-based EQ-5D-3L and the cancer specific quality of life questionnaire, QLQ-C30 in patients with breast cancer. This will result in a mapping that allows users to convert QLQ-C30 scores into EQ-5D-3L scores for the purposes of cost-effectiveness analysis or economic evaluation. Methods We use data from a randomized trial of 602 patients with HER2-positive advanced breast cancer provided 3766 EQ-5D-3L observations. Direct mapping using adjusted, limited dependent variable mixture models (ALDVMM) is compared to a random effects linear regression and indirect mapping using seemingly unrelated ordered probit models. EQ-5D-3L was estimated as a function of the summary scales of the QLQ-C30 and other patient characteristics. Results A four component mixture model outperformed other models in terms of summary fit statistics. A close fit to the observed data was observed across the range of disease severity. Simulated data from the model closely aligned to the original data and showed that mapping did not significantly underestimate uncertainty. In the simulated data, 22.15% were equal to 1 compared to 21.93% in the original data. Variance was 0.0628 in the simulated data versus 0.0693 in the original data. The preferred mapping is provided in Excel and Stata files for the ease of users. Conclusion A four component adjusted mixture model provides reliable, non-biased estimates of EQ-5D-3L from the QLQ-C30, to link clinical studies to economic evaluation of health technologies for breast cancer. This work adds to a growing body of literature demonstrating the appropriateness of mixture model based approaches in mapping.https://doi.org/10.1186/s12885-021-08964-5QLQ-C30EQ-5D-3LUtility mappingMixture modelsALDVMM |
| spellingShingle | Laura A. Gray Monica Hernandez Alava Allan J. Wailoo Mapping the EORTC QLQ-C30 to EQ-5D-3L in patients with breast cancer BMC Cancer QLQ-C30 EQ-5D-3L Utility mapping Mixture models ALDVMM |
| title | Mapping the EORTC QLQ-C30 to EQ-5D-3L in patients with breast cancer |
| title_full | Mapping the EORTC QLQ-C30 to EQ-5D-3L in patients with breast cancer |
| title_fullStr | Mapping the EORTC QLQ-C30 to EQ-5D-3L in patients with breast cancer |
| title_full_unstemmed | Mapping the EORTC QLQ-C30 to EQ-5D-3L in patients with breast cancer |
| title_short | Mapping the EORTC QLQ-C30 to EQ-5D-3L in patients with breast cancer |
| title_sort | mapping the eortc qlq c30 to eq 5d 3l in patients with breast cancer |
| topic | QLQ-C30 EQ-5D-3L Utility mapping Mixture models ALDVMM |
| url | https://doi.org/10.1186/s12885-021-08964-5 |
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