Health and Quality of Life Outcomes最新文献

Background: To investigate the cognitive experiences of completing composite time trade-off (C-TTO) and discrete choice experiment (DCE) tasks for the valuation of the Chinese Short Warwick-Edinburgh Mental Well-being Scale (C-SWEMWBS) in Hong Kong in order to inform an appropriate preference elicitation protocol for this population.

Methods: Eighteen think-aloud interviews employing concurrent and retrospective think-aloud techniques were conducted with Cantonese-speaking adult members of the general population. Each participant completed five C-TTO and five DCE tasks with tailor-made C-SWEMWBS states. Interview transcripts were transcribed verbatim, translated into English, and analysed thematically to identify patterns in participants' thoughts and understanding during task completion.

Results: Participants generally found the C-TTO and DCE tasks manageable. Four themes were identified that reflected participants' experiences: (1) Interview design and structure, bringing attention to potential refinements in presentation and instructions; (2) Representation of items and levels, illustrating participants' comprehension of the different C-SWEMWBS items and levels; (3) Influences on decision-making, identifying personal and external factors that shaped participant's decisions; and (4) Appropriateness of measures, reflecting participant's experiences in imagining and deriving utility values for mental well-being states.

Conclusion: Despite highlighting areas that could be refined to minimise unnecessary cognitive burden, findings indicate that the design of the C-TTO and DCE tasks is both feasible and appropriate for the preference elicitation of C-SWEMWBS states in Hong Kong. This provides the basis for conducting a large-scale study to derive a preference-based value set for the C-SWEMWBS in Hong Kong for economic evaluations of interventions aimed at improving public mental well-being.

Background: To overcome the limitations of existing health-related quality of life (HRQoL) instruments, the HRQoL Instrument with 8 Items (HINT-8) was developed for the Korean population. We aimed to evaluate the validity, interrater reliability, and agreement of the HINT-8 compared to the EQ-5D-5 L among patients with oropharyngeal cancer (OPC).

Methods: A total of 327 patients with OPC aged ≥ 19 years who received treatment at 14 hospitals in South Korea were recruited between August 2023 and February 2024. HRQoL was assessed using the two instruments. The psychometric evaluation included analyses of validity (convergent and known-group validity), agreement (intraclass correlation coefficient and Bland-Altman analysis), and reliability (internal consistency measured by Cronbach's alpha). The ceiling effects and score distributions were also examined.

Results: In total, 299 respondents were included in the final analysis. Both instruments demonstrated high internal consistency (HINT-8: α = 0.872; EQ-5D-5 L: α = 0.845) and good agreement (intraclass correlation coefficient [ICC] = 0.80; 95% confidence interval [CI]: 0.76-0.84). The convergent validity was supported by strong correlations between the HINT-8 index and both the EQ-5D-5 L index (r = 0.805) and EQ VAS (r = 0.715). The ceiling effect of HINT-8 (12.7%) was substantially lower than the EQ-5D-5 L (32.8%).

Conclusions: The HINT-8 is a valid, reliable, and responsive instrument for measuring HRQoL in patients with oropharyngeal cancer. These findings suggest that HINT-8 can serve as a valuable complementary instrument to the EQ-5D-5 L.

Background: Health utility measurement is critical for cost-utility analysis (CUA). However, clinical studies often lack direct utility data, and methods of measuring health utility vary across different periods and regions, resulting in missing utility information. Mapping, a method employed to infer utility when direct utility data is absent, has been widely applied in recent years but still faces challenges. This systematic review evaluates the current landscape, trends, and limitations of mapping studies and provides recommendations for improving study design and reporting standards.

Methods: A literature search was conducted in PubMed, Web of Science, and the HERC Database of Mapping Studies from 2018 to 2024. The study extracted information from the included studies and performed quality assessments based on existing mapping guidelines.

Results: One hundred thirty-one studies were included, 92 focused on Mapping as the primary objective, five were reviews, 13 focused on methodology, and 21 focused on economic evaluation. The source measure, target measure, and models in mapping functions development remain EORTC-QLQ-C30 (n = 13), EQ-5D (n = 79), and OLS (n = 93). Studies now use larger sample sizes and a higher proportion of response Mapping, and model applications have increased in diversity. However, 32 studies still lack conceptual overlap analysis, and only 16 studies with repeated measurements addressed its issue. Additionally, two studies did not report the region of the sample and value set, while 27 had inconsistencies between the two regions.

Conclusions: In the last seven years, mapping studies have improved sample size, model application, and result reporting. However, limitations remain in analysing conceptual overlap, ensuring alignment between the sample and value set regions, and processing repeated measurements. To advance the quality of mapping studies, it is necessary to update mapping guidelines and ensure that all mapping functions are developed in compliance with them.

Background: Liver cirrhosis (LC) significantly impairs health-related quality of life (HR-QoL) due to physical, psychological, and nutritional challenges. Despite its growing burden in India, limited evidence exists on how disease severity, alcohol dependence, and malnutrition influence HR-QoL in Indian LC patients.

Methods: This cross-sectional study included 565 LC patients attending a tertiary care hospital over 30 months. HR-QoL was assessed using SF-36. Disease severity was graded using the Child-Turcotte-Pugh (CTP) score, while nutritional status and alcohol dependence were evaluated using the RFH-NPT and AUDIT tools. Associations were analysed using Pearson's correlation, ANOVA, and logistic regression.

Results: The mean age of participants was 42.5 ± 14.9 years; 81.9% were male, and 58.6% resided in rural areas. Malnutrition was present in 80.9% of patients, and 50.6% were alcohol-dependent. Patients with severe liver cirrhosis (CTP Class C) had significantly lower HR-QoL scores across all domains (p < 0.001). Malnutrition was associated with higher odds of severe liver cirrhosis (OR 1.53; 95% CI: 1.27-1.85), and lower physical function scores were also significantly associated with disease severity (OR 0.89; 95% CI: 0.89-0.95). Severe cirrhosis was additionally marked by elevated serum bilirubin and INR levels, and reduced albumin concentrations.

Conclusion: HR-QoL declines substantially with worsening cirrhosis, especially in malnourished and alcohol-dependent patients. These findings highlight the need for multidisciplinary interventions focusing on nutrition, lifestyle modification, and psychological support to improve outcomes in LC patients.

Background: Dermatologic toxicities are common among metastatic colorectal cancer (mCRC) patients receiving epidermal growth factor receptor inhibitors (EGFRIs), adversely affecting their well-being and quality of life (QoL). Currently, no validated tool exists in China to measure these symptoms. This study validated the Simplified Chinese version of the Functional Assessment of Cancer Therapy-EGFRI 18 (FACT-EGFRI-18-sC) for QoL assessment in mCRC patients.

Methods: A cross-sectional study was performed via convenience sampling to recruit mCRC patients from two tertiary hospitals in Shenyang, China. Sample size adequacy was confirmed by post hoc power analysis (G*Power 3.1; >80% power for r ≥ 0.3, α = 0.05). Acceptability was assessed by item-level missing data. Reliability was evaluated by Cronbach's α and a 2-week test-retest intraclass correlation coefficient (ICC). Criterion validity was evaluated against the Simplified Chinese version of the patient-reported version of CTCAE (PRO-CTCAE-sC) through non-parametric analyses. Construct validity was assessed via correlations with the Simplified Chinese Body Image Scale (BIS-sC), Karnofsky Performance Status (KPS), and cetuximab cycles using Spearman tests. Diagnostic accuracy and cutoff value were determined via receiver operating characteristic (ROC) analysis.

Results: The final sample (n = 184) provided sufficient statistical power, with post hoc analysis revealing 98% power (α = 0.05) to detect correlations exceeding 0.3. The FACT-EGFRI-18-sC showed excellent acceptability (no missing data) and satisfactory reliability (Cronbach's α = 0.899, ICC = 0.875). Moderate to strong negative correlations with PRO-CTCAE-sC (r = -0.436 to -0.803, p < 0.001) and significant FACT-EGFRI-18-sC score differences by dermatologic toxicity status (Z = -4.823 to -7.457, p < 0.001) supported criterion validity. Scores of the FACT-EGFRI-18-sC correlated negatively with BIS-sC (r = -0.565 to -0.619, p < 0.001), positively with KPS physical/functional subscales (r = 0.424/0.541, p < 0.001), but not with the social/emotional subscale (r = 0.125, p > 0.05), confirming construct validity. ROC analysis yielded an area under the curve (AUC) of 0.844 and identified an optimal cutoff of 60.00.

Conclusions: The validated FACT-EGFRI-18-sC is a robust tool for QoL assessment in mCRC patients experiencing EGFRI-related dermatologic toxicities, providing a standardized measure to guide toxicity management.