Health and Quality of Life Outcomes最新文献

Background: Pancreatic cancer has an aggressive nature, and treatment severely impacts patients' quality of life. There is limited understanding how patients weigh treatment benefits against side effects, which hampers the development of patient-centered care and shared decision-making programs.

Methods: Two discrete-choice surveys were designed: one comprising pancreatic cancer patients with (borderline) resectable disease (early-stage disease), and one including patients with non-resectable or metastatic disease (late-stage disease). Relevant criteria for describing treatments were identified by literature review and validated through patient and expert interviews. Selected criteria were likelihood of adverse events causing hospitalization, impact on daily functioning, gastrointestinal symptoms, life expectancy and frequency of hospital visits. Interim analysis was executed after 109 inclusions, optimizing the choice task combinations. Patients were recruited from a local center and a nationwide questionnaire project.

Results: Overall, 428 surveys were sent out and 53% of the participants answered at least one choice task. This included 165 participants with early-stage disease and 62 participants with late-stage disease. Most participants had treatment experience before completing the survey. For both disease stages, participants had a significant preference for the treatment options instead of receiving best supportive care only, although there was significant heterogeneity for this preference among the participants. Life expectancy was the most important treatment characteristic of the pre-selected criteria.

Conclusions: Pancreatic cancer patients, both with early-stage and late-stage disease, choose for anti-cancer treatment over best supportive care and value life expectancy as the most important treatment attribute, although significant differences exist between patients.

Objective: To validate and compare the measurement properties of the EQ-5D-5L and SF-6Dv2 among patients with diabetes in China.

Methods: A quota sampling method was used to recruit a representative sample, social-demographic characteristics, self-reported EQ-5D-5L and SF-6Dv2 responses were collected through online survey. Test-retest reliability and the agreement between EQ-5D-5L and SF-6Dv2 utility values were assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman plot. Hypotheses testing including convergent validity and known-group validity were examined using Spearman's rank correlation and effect sizes, respectively. Sensitivity was compared using relative efficiency and receiver operating characteristic.

Results: A total of 600 respondents (53.67% male; mean age 60 years; 90% type 2, 10% type 1 diabetes) were included in this study. A higher ceiling effect was observed for EQ-5D-5L than for SF-6Dv2 (10.5% vs. 0.5%). The mean (SD) utility was 0.771 (0.196) for EQ-5D-5L and 0.671 (0.153) for SF-6Dv2. Agreement between the two instruments was good with an ICC of 0.776. The ICC values for the test-retest analysis were 0.982 for EQ-5D-5L and 0.986 for SF-6Dv2 among the subgroup (N = 100). The Spearman's rank correlation (range: 0.312-0.661) indicated an acceptable convergent validity between the dimensions of EQ-5D-5L and SF-6Dv2. Hypotheses for known-group validity were fulfilled in both instruments. The EQ-5D-5L showed basically equivalent discriminative capacities with the SF-6Dv2 (ES: 0.92-2.08 vs. 1.03-2.05). The SF-6Dv2 had 14.7-445.8% higher efficiency than the EQ-5D-5L at revealing differences in self-reported health status, except for the group dichotomized by "very good, good, fair or bad versus very bad".

Conclusions: EQ-5D-5L and SF-6Dv2 showed generally comparable reliability, validity, and sensitivity in this sample of Chinese patients with diabetes. However, the utility values derived from the two instruments differed, indicating that they may not be used interchangeably. Further research is needed to evaluate and compare their responsiveness.