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Health and Quality of Life Outcomes

, 6:84

First Online: 21 October 2008Received: 18 December 2007Accepted: 21 October 2008


BackgroundExisting reports of utility values for metastatic non-small cell lung cancer NSCLC vary quite widely and are not all suitable for use in submissions in the UK. The aim of this study was to elicit UK societal based utility values for different stages of NSCLC and different grade III-IV toxicities commonly associated with chemotherapy treatments. Toxicities included neutropenia, febrile neutropenia, fatigue, diarrhoea, nausea and vomiting, rash and hair loss.

MethodsExisting health state descriptions of metastatic breast cancer were revised to make them suitable as descriptions of metastatic NSCLC patients on second-line treatment. The existing health states were used in cognitive debrief interviews with oncologists n = 5 and oncology specialist nurses n = 5. Changes were made as suggested by the clinical experts. The resulting health states n = 17 were piloted and used in a societal based valuation study n = 100. Participants rated half of the total health states in a standard gamble interview to derive health state utility scores. Data were analysed using a mixed model analysis.

ResultsEach health state described the symptom burden of disease and impact on different levels of functioning physical, emotional, sexual, and social. The disutility related to each disease state and toxicity was estimated and were combined to give health state values. All disease states and toxicities were independent significant predictors of utility p < 0.001. Stable disease with no toxicity our base state had a utility value of 0.653. Utility scores ranged from 0.673 responding disease with no toxicity to 0.473 for progressive disease.

ConclusionThis study reflects the value that society place on the avoidance of disease progression and severe toxicities in NSCLC.

AbbreviationsBLTBig Lung Trial

EORTC QLQ-C30European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-Cancer-30 items

EORTC QLQ-LC-17European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-Lung Cancer-17 items

EQ-5DEuroQoL-5 Dimensions

HRQLHealth-related Quality of Life

NSCLCNon-Small Cell Lung Cancer

SF-36Short-Form 36 items

SGStandard Gamble

UBCUnited BioSource Corporation

UKUnited Kingdom

VASVisual Analogue Scale

Electronic supplementary materialThe online version of this article doi:10.1186-1477-7525-6-84 contains supplementary material, which is available to authorized users.

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Autor: Beenish Nafees - Megan Stafford - Sonia Gavriel - Shkun Bhalla - Jessamy Watkins


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