Utility evaluations for Markov states of lung cancer for PET-based disease management.

Abstract

Background: Utilities for the health outcomes states (Markov states) of non-small cell lung carcinoma (NSCLC) should be measured to evaluate management options for patients because patients are key participants in the process of care, and their assessment of diagnostic and therapeutic value in the options presented to them ultimately impacts their net health outcomes. This investigation sought to measure utilities for stage-dependent outcomes states of NSCLC.

Methods: Persons (n = 23) with suspected NSCLC based on physical findings and computed tomography completed a short utilities survey. Utility valuations were obtained according to severity of morbidity and varied considerably. Respondents rated these health states according to accuracy measures for 18flurodeoxyglucose (18FDG) positron emission tomography (PET) imaging and medastinoscopy.

Results: The results demonstrate that stage-dependent morbidity is an important consideration for patients with NSCLC and should be included in any decision analysis regarding the evaluation or treatment of NSCLC. Respondents valued the quality of information obtained from non-invasive PET and invasive mediastinoscopy comparably. The utilities obtained from this investigation are useful in clinical decision-making based on Markov processes because they provide an initial estimation of utility assessment for 18FDG-based diagnostic evaluation of lung cancer.

Conclusions: Consequently, these utilities will be useful in future decision analyses that require patient preference in the assignment of the evaluation of decision options (branches).