Comparison of the quality of life between patients with non-small-cell lung cancer and healthy controls

Lee, Lukas Jyuhn-Hsiarn; Chung, Chih-Wen; Chang, Yu-Yin; Lee, Yung-Chie; Yang, James Chih‐Hsin; Liou, Saou-Hsing; Liu, Pang-Hsiang; Wang, Jung‐Der

doi:10.1007/s11136-010-9761-y

Cited by 40 publications

(30 citation statements)

References 26 publications

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“…Therefore, the inclusion of a nation-wide healthy subjects as our control group is the strength of this study. Some of QOL studies for variable diseases from Asia use nation-wide healthy referents, such as irritable bowel syndrome by Jamali et al, epilepsy by Liou et al [34], lung cancer by Lee et al [37, 38], obesity by Chang et al [30]. …”

Section: Discussionmentioning

confidence: 99%

Health-related quality of life in patients with Barrett’s esophagus

Chang

Lee

Wang

et al. 2016

Health Qual Life Outcomes

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BackgroundGastroesophageal reflux disease (GERD) has become a major health problem globally, affecting patients’ health-related quality of life (HRQOL). Barrett’s esophagus (BE) is a precancerous lesion associated with GERD. BE patients might not only suffer from HRQOL losses by GERD but also face psychological distress due to the increased risk of developing cancer. However, the majority of patients in Asia have shorter BE segment which is different from the West. This study aimed to determine whether the HRQOL in BE patients were worse than in healthy referents in Taiwan.MethodsPatients who received referral esophagogastroduodenoscopy for various symptoms were evaluated for the existence of BE. Lesions were judged as endoscopically suspected esophageal metaplasia (ESEM) if they showed morphological resemblances to BE by endoscopy. The diagnosis of BE was confirmed by histology with intestinal metaplasia or gastric metaplasia based on the Montreal definition. The World Health Organization Quality of Life (WHOQOL-BREF) was administered to BE patients before treatment. For each BE patient, we selected 2 age-, sex-, educational background and municipality-matched healthy referents, sampled by simple randomization method from a national survey in Taiwan. Multiple linear regression models were constructed to control the potential confounders.ResultsA total of 84 patients diagnosed with BE were enrolled as BE group and then compared with 168 healthy referents. The BE group had significantly lower WHOQOL-BREF scores than those of healthy referents in the physical domain (P < 0.05) but higher scores in the environment domain (P < 0.05). In the physical domain, the BE group had significantly lower scores in various facets, including pain, discomfort, sleep and rest and dependence on medications or treatments. There was no significant difference in social and psychological domains between the BE group and healthy referents.ConclusionsBE patients suffer from poor sleep and rest and high dependence on medications, which significantly reduce their quality of life. Individual facets of each domain warrants a better clinical healthcare to improve quality of life of BE patients.

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Section: Discussionmentioning

confidence: 99%

Health-related quality of life in patients with Barrett’s esophagus

Chang

Lee

Wang

et al. 2016

Health Qual Life Outcomes

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“…They were thus less likely to have any severe adverse effects and would have higher utility values [20]. Second, because insight into the diagnosis of lung cancer was one of the inclusion criteria required by the Institutional Review Board, the utility values of our patients would usually be higher [25]. Third, we assumed that patients remained at the same level of QoL near the end of the follow-up period while extrapolating the QoL function to lifetime.…”

Section: Discussionmentioning

confidence: 99%

Estimation of loss of quality-adjusted life expectancy (QALE) for patients with operable versus inoperable lung cancer: Adjusting quality-of-life and lead-time bias for utility of surgery

et al. 2014

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a b s t r a c tObjectives: This study attempts to quantify the difference in loss of quality-adjusted life expectancy (QALE) for patients with operable and inoperable non-small-cell lung cancer (NSCLC). Patients and methods: A cohort consisting of 1652 pathologically verified NSCLC patients with performance status 0-1 was monitored for 7 years (2005)(2006)(2007)(2008)(2009)(2010)(2011) to obtain the survival function. This was further extrapolated to lifetime, based on the survival ratios between patients and age-and sex-matched referents simulated from the life tables of the National Vital Statistics of Taiwan. Between 2011 and 2012, EuroQol 5-dimension questionnaires were used to prospectively measure the quality-of-life (QoL) of a 518 consecutive, cross-sectional subsample. We adjusted the lifetime survival function by the utility values of QoL for the cancer cohort to obtain the QALE, while that for the age and sex-matched referents were adjusted to the values collected from the 2009 National Health Interview Survey, and the difference between them was the loss-of-QALE. Results: The QALE for patients with operable and inoperable NSCLC were 11.66 ± 0.18 and 1.43 ± 0.05 quality-adjusted life year (QALY), with the corresponding loss-of-QALE of 5.25 ± 0.18 and 14.24 ± 0.05 QALY, respectively. The lifetime utility difference for patients with operable and inoperable NSCLC was 9.00 ± 0.18 QALY, after adjustment for QoL and lead-time bias. Conclusion: The utility gained from surgical operation for operable lung cancer is substantial, even after adjustment for lead-time bias. Future studies should compare screening programs with treatment strategies when carrying out cost-utility assessments to improve patients' values.

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“…In addition, 59.1% (365 of 618 patients) of our subjects did not have any evidence of metastasis, which would make the average scores of our patients be higher than those with 63.2% of metastasis [31]. Second, because insight into the diagnosis of lung cancer was one of the inclusion criteria required by the Institutional Review Board, the utility values of our patients were usually higher [32]. Third, while extrapolating the QoL function to lifetime, it was assumed that patients remained at the same level of QoL near the end of the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Estimating the lifelong health impact and financial burdens of different types of lung cancer

Yang

Lai

et al. 2013

BMC Cancer

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BackgroundOwing to the high mortality and rapidly growing costs related to lung cancer, it is worth examining the health benefits of prevention for major types of lung cancer. This study attempts to quantify the quality-adjusted life expectancy (QALE), loss-of-QALE, and lifetime healthcare expenditures of patients with different pathological types of lung cancer.MethodsA national cohort consisting of 66,535 patients with pathologically verified lung cancer was followed for 13 years (1998–2010) to obtain the survival function, which was further extrapolated to lifetime. Between 2011 and 2012, EuroQol 5-dimension questionnaires were used to measure the quality of life (QoL) for 1,314 consecutive, cross-sectional samples. After multiplying the lifetime survival function by the utility values of QoL, we estimated the QALE and loss-of-QALE. We also collected the monthly healthcare expenditures, which included National Health Insurance-reimbursed and out-of-pocket direct medical costs, for 2,456 patients from 2005 to 2012. These values were multiplied by the corresponding survival probabilities to calculate lifetime healthcare expenditures after adjustments with medical care inflation rates and annual discount rates.ResultsThe QALE for patients with small cell lung cancer, squamous cell carcinoma, and adenocarcinoma were 1.21, 2.37, and 3.03 quality-adjusted life year (QALY), with the corresponding loss-of-QALE of 13.69, 12.22, and 15.03 QALY, respectively. The lifetime healthcare expenditures were US$ 18,455 ± 1,137, 20,599 ± 1,787, and 36,771 ± 1,998, respectively.ConclusionsThe lifelong health impact and financial burdens in Taiwan are heavier for adenocarcinoma than for squamous cell carcinoma. The cost-effectiveness of prevention programs could be directly compared with that of treatment strategies to improve patient value. And the methodology could be applied to other chronic diseases for resources planning of healthcare services.

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Comparison of the quality of life between patients with non-small-cell lung cancer and healthy controls

Abstract: QOL was significantly associated with staging and duration of NSCLC. Disease insight appears to be a positive factor for operable NSCLC patients of the Taiwanese culture, which implies that clinicians should respect patient autonomy in diagnosis disclosure.

Cited by 40 publications

References 26 publications

Health-related quality of life in patients with Barrett’s esophagus

Health-related quality of life in patients with Barrett’s esophagus

Estimation of loss of quality-adjusted life expectancy (QALE) for patients with operable versus inoperable lung cancer: Adjusting quality-of-life and lead-time bias for utility of surgery

Estimating the lifelong health impact and financial burdens of different types of lung cancer

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