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Mapping the FACT-B Instrument to EQ-5D-3L in Patients with Breast Cancer Using Adjusted Limited Dependent Variable Mixture Models versus Response Mapping.

Published on Dec 1, 2018in Value in Health5.037
· DOI :10.1016/j.jval.2018.06.006
Laura A. Gray3
Estimated H-index: 3
(University of Sheffield),
Allan Wailoo30
Estimated H-index: 30
(University of Sheffield),
Mónica Hernández Alava13
Estimated H-index: 13
(University of Sheffield)
Abstract
Abstract Background Preference-based measures of health, such as the three-level EuroQol five-dimensional questionnaire (EQ-5D-3L), are required to calculate quality-adjusted life-years for use in cost-effectiveness analysis, but are often not recorded in clinical studies. In these cases, mapping can be used to estimate preference-based measures. Objectives To model the relationship between the EQ-5D-3L and the Functional Assessment of Cancer Therapy—Breast Cancer (FACT-B) instrument, comparing indirect and direct mapping methods, and the use of FACT-B summary score versus FACT-B subscale scores. Methods We used data from three clinical studies for advanced breast cancer providing 11,958 observations with full information on FACT-B and the EQ-5D-3L. We compared direct mapping using adjusted limited dependent variable mixture models (ALDVMMs) with indirect mapping using seemingly unrelated ordered probit models. The EQ-5D-3L was estimated as a function of FACT-B and other patient-related covariates. Results The use of FACT-B subscale scores was better than using the total FACT-B score. A good fit to the observed data was observed across the entire range of disease severity in all models. ALDVMMs outperformed the indirect mapping. The breast cancer–specific scale had a strong influence in predicting the pain/discomfort and self-care dimensions of the EQ-5D-3L. Conclusions This article adds to the growing literature that demonstrates the performance of the ALDVMM method for mapping. Regardless of which model is used, the subscales of FACT-B should be included as independent variables wherever possible. The breast cancer–specific subscale of FACT-B is important in predicting the EQ-5D-3L. This suggests that generic cancer measures should not be used for utility mapping in patients with breast cancer.
  • References (19)
  • Citations (2)
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References19
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#1Laura A. Gray (University of Sheffield)H-Index: 3
#2Mónica Hernández Alava (University of Sheffield)H-Index: 13
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#1Laura A. Gray (University of Sheffield)H-Index: 3
#2Mónica Hernández Alava (University of Sheffield)H-Index: 13
Last. Allan Wailoo (University of Sheffield)H-Index: 30
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#1Allan Wailoo (University of Sheffield)H-Index: 30
#2Monica Hernandez-Alava (University of Sheffield)H-Index: 5
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#1Mónica Hernández Alava (University of Sheffield)H-Index: 13
#2Allan Wailoo (University of Sheffield)H-Index: 30
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Background. Clinical trials in cancer frequently include cancer-specific measures of health but not preference-based measures such as the EQ-5D that are suitable for economic evaluation. Mapping functions have been developed to predict EQ-5D values from these measures, but there is considerable uncertainty about the most appropriate model to use, and many existing models are poor at predicting EQ-5D values. This study aims to investigate a range of potential models to develop mapping functions f...
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Abstract Objectives Cost-effectiveness analyses of technologies for patients with ankylosing spondylitis frequently require estimates of health utilities as a function of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI). Methods Linear regression, bespoke mixture models, and generalized ordered probit models were used to model the EuroQol five-dimensional questionnaire as a function of BASDAI and BASFI. Data were drawn f...
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The Functional Assessment of Cancer Therapy-Breast (FACT-B) is the most commonly used scale for assessing quality of life in patients with breast cancer. The lack of preference-based measures limits the cost-utility of breast cancer in China. The goal of this study was to explore whether a mapping function can be established from the FACT-B to the EQ-5D-5 L when the EQ-5D health-utility index is not available. A cross-sectional survey of adults with breast cancer was conducted in China. All pati...
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