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Health state utilities in non-small cell lung cancer : an international study

Author
Organization
Abstract
Aim: Quality of life weights (utilities) are an important input in economic evaluation and evidence suggests that there can be important differences between countries. This study was designed to capture utilities for metastatic non-small cell lung cancer and common grade III/IV toxicities associated with treatment from local populations in the United Kingdom, Australia, France, China, Taiwan, and Korea. Toxicities included neutropenia, febrile neutropenia, fatigue, diarrhea, nausea and vomiting, rash, bleeding, hypertension, and hair loss. Methods: Existing health state descriptions of non-small cell lung cancer were adapted to represent descriptions of patients on first-line treatment. Twenty-three states were translated and assessed in cognitive debrief content validation interviews with oncologists in each country. Seventy-five respondents per country completed a time trade-off interview to evaluate the states. Variation between countries for all states was explored with a Generalized Estimating Equations model. Results: The mean utility for stable disease and no side effects (base state) varied between 0.84 (United Kingdom) and 0.54 (Taiwan). The largest utility decrements were found for febrile neutropenia (0.47) and neutropenia (0.35) across all countries. Asian countries regarded bleeds as a severe toxicity whereas non-Asian countries did not and valued diarrhea and fatigue as more severe. Significant differences in utilities between countries emerged with the Taiwanese population in particular rating states as significantly worse than other countries. Conclusion: This study improves our understanding of how utilities for the same states can vary across countries. The study shows the importance of capturing utilities that reflect the preferences of the local population.
Keywords
non-small cell lung cancer, patient preference, quality of life, QUALITY-OF-LIFE, TIME TRADE-OFF, DECISION-MAKING, CHEMOTHERAPY, POPULATION, VALUES, TRIAL

Citation

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MLA
Nafees, Beenish et al. “Health State Utilities in Non-small Cell Lung Cancer : an International Study.” ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY 13.5 (2017): e195–e203. Print.
APA
Nafees, B., Lloyd, A. J., Dewilde, S., Rajan, N., & Lorenzo, M. (2017). Health state utilities in non-small cell lung cancer : an international study. ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, 13(5), e195–e203.
Chicago author-date
Nafees, Beenish, Andrew J Lloyd, Sarah Dewilde, Narayan Rajan, and Maria Lorenzo. 2017. “Health State Utilities in Non-small Cell Lung Cancer : an International Study.” Asia-pacific Journal of Clinical Oncology 13 (5): e195–e203.
Chicago author-date (all authors)
Nafees, Beenish, Andrew J Lloyd, Sarah Dewilde, Narayan Rajan, and Maria Lorenzo. 2017. “Health State Utilities in Non-small Cell Lung Cancer : an International Study.” Asia-pacific Journal of Clinical Oncology 13 (5): e195–e203.
Vancouver
1.
Nafees B, Lloyd AJ, Dewilde S, Rajan N, Lorenzo M. Health state utilities in non-small cell lung cancer : an international study. ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY. 2017;13(5):e195–e203.
IEEE
[1]
B. Nafees, A. J. Lloyd, S. Dewilde, N. Rajan, and M. Lorenzo, “Health state utilities in non-small cell lung cancer : an international study,” ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, vol. 13, no. 5, pp. e195–e203, 2017.
@article{8579764,
  abstract     = {Aim: Quality of life weights (utilities) are an important input in economic evaluation and evidence suggests that there can be important differences between countries. This study was designed to capture utilities for metastatic non-small cell lung cancer and common grade III/IV toxicities associated with treatment from local populations in the United Kingdom, Australia, France, China, Taiwan, and Korea. Toxicities included neutropenia, febrile neutropenia, fatigue, diarrhea, nausea and vomiting, rash, bleeding, hypertension, and hair loss. 
Methods: Existing health state descriptions of non-small cell lung cancer were adapted to represent descriptions of patients on first-line treatment. Twenty-three states were translated and assessed in cognitive debrief content validation interviews with oncologists in each country. Seventy-five respondents per country completed a time trade-off interview to evaluate the states. Variation between countries for all states was explored with a Generalized Estimating Equations model. 
Results: The mean utility for stable disease and no side effects (base state) varied between 0.84 (United Kingdom) and 0.54 (Taiwan). The largest utility decrements were found for febrile neutropenia (0.47) and neutropenia (0.35) across all countries. Asian countries regarded bleeds as a severe toxicity whereas non-Asian countries did not and valued diarrhea and fatigue as more severe. Significant differences in utilities between countries emerged with the Taiwanese population in particular rating states as significantly worse than other countries. 
Conclusion: This study improves our understanding of how utilities for the same states can vary across countries. The study shows the importance of capturing utilities that reflect the preferences of the local population.},
  author       = {Nafees, Beenish and Lloyd, Andrew J and Dewilde, Sarah and Rajan, Narayan and Lorenzo, Maria},
  issn         = {1743-7555},
  journal      = {ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY},
  keywords     = {non-small cell lung cancer,patient preference,quality of life,QUALITY-OF-LIFE,TIME TRADE-OFF,DECISION-MAKING,CHEMOTHERAPY,POPULATION,VALUES,TRIAL},
  language     = {eng},
  number       = {5},
  pages        = {e195--e203},
  title        = {Health state utilities in non-small cell lung cancer : an international study},
  url          = {http://dx.doi.org/10.1111/ajco.12477},
  volume       = {13},
  year         = {2017},
}

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