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Which approach is better in eliciting health state utilities from breast cancer patients? Evidence from mainland China
Author(s) -
Li Shunping,
Wang Min,
Liu Liu,
Chen Gang
Publication year - 2019
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/ecc.12965
Subject(s) - medicine , breast cancer , mainland china , intraclass correlation , eq 5d , china , time trade off , cancer , gynecology , quality of life (healthcare) , clinical psychology , psychometrics , nursing , health related quality of life , disease , political science , law
Accurately measuring health state utilities is crucial for health economic evaluation. This study empirically investigated both indirect approaches (including using the latest version of five‐level EQ‐5D questionnaire, EQ‐5D‐5L and the popular SF‐6D), as well as a direct approach (the time trade‐off, TTO) for eliciting utilities in breast cancer patients. A valid sample of 608 breast cancer patients (48% TNM Stages III/IV) in mainland China was analysed. Mean utilities elicited from the TTO, EQ‐5D‐5L and SF‐6D were 0.80, 0.83 and 0.65 respectively. There is poor to fair agreement between direct and indirect approaches on measuring health state utilities with breast cancer patients. The absolute agreement was higher between EQ‐5D‐5L and SF‐6D utilities (intraclass correlation coefficient, ICC = 0.55) than between TTO and EQ‐5D‐5L/SF‐6D utilities (ICCs < 0.3). Regression analyses found that both EQ‐5D‐5L and SF‐6D utilities were responsive to five out of eight breast cancer‐specific symptom and functional scales. In sum, criterion and known‐group validities of three health state utility measures which were investigated in this research suggest that, the EQ‐5D‐5L is currently the optimal approach (followed by the SF‐6D) to elicit health state utilities from breast cancer patients in mainland China.