Health variations among breast-cancer patients from different disease states: evidence from China

Abstract

Background This study aimed to obtain health utility parameters among Chinese breast cancer patients in different disease states for subsequent health economics model. In addition, we aimed to explore the feasibility of establishing a breast cancer health utility mapping model in China. Methods Multiple patient-reported health attributes were assessed, including quality of life, which was measured by the Functional Assessment of Cancer Therapy-Breast (FACT-B) instrument; health utility and self-rated health, which were measured by the EuroQol-5 Dimension-5 Level (EQ-5D-5L) questionnaire. Multivariate regression models, including a linear regression model, an ordinal logistic regression model and a Tobit model, were employed to analyze health differences among 446 breast cancer patients. Subgroup analyses were performed to examine differences in multiple dimensions of health derived from the FACT-B and EQ-5D-5L instruments. A mapping function was used to estimate health utility from quality of life. Rank correlation analyses were employed to examine the correlation between estimated and observed health utility values. Results A total of 446 breast cancer patients with different disease states were analyzed. The health utility values of breast cancer patients in the P state (without cancer recurrence and metastasis), R state (with cancer recurrence within a year), S state (with primary and recurrent breast cancer for the second year and above), and M state (metastatic cancer) were 0.81 (SD ± 0.23), 0.90 (SD ± 0.12), 0.78 (SD ± 0.31), and 0.74 (SD ± 0.27), respectively. There were positive correlations between all scores, including every domain of the FACT-B instrument (p < 0.001). Results from multivariate analysis suggested that patients in the R and M states had lower scores for overall quality of life (R, β = − 9.45, p < 0.01; M, β = − 6.72, p < 0.05). Patients in the M state had lower health utility values than patients in the P state (β = − 0.11, p < 0.05). Estimated health utility values, which were derived from quality of life by using a mapping function, were significantly correlated with directly measured health utility values (p < 0.001). Conclusions We obtained the health utility and health-related quality of life (HRQoL) scores of Chinese breast cancer patients in different disease states. Mapping health utility values from quality of life using four disease states could be feasible in health economic modelling, but the mapping function may need further revision.

Meta-analysis of health state utility values measured by EuroQol 5-dimensions (EQ5D) questionnaire in Chinese women with breast cancer

“…Eight studies were the incorrect study design, six of which were economic evaluations/cost effectiveness studies and two of which were pilot studies. One duplicate study was identified which reports the same patient sample (personal communication) and values, the most recent paper has been included in the analysis [ 19 , 20 ]. Five studies met the eligibility criteria [ 20 – 24 ].…”

“…One duplicate study was identified which reports the same patient sample (personal communication) and values, the most recent paper has been included in the analysis [ 19 , 20 ]. Five studies met the eligibility criteria [ 20 – 24 ]. A PRISMA flow diagram is shown in Fig 1 .…”

“…Study overview: Four of the five studies were full published papers [ 20 , 21 , 23 , 24 ] and one was in poster format and provided all data required [ 22 ]. Yang (2020) performed a survey of 446 patients in a tertiary oncology hospital in China between November 2017 and May 2018 [ 20 ].…”

Evidence and assessment of parenchymal patterns of ultrasonography for breast cancer detection among Chinese women: a cross-sectional study

“…Breast cancer is the most common in Chinese women [ 1 , 2 ]. Screening of breast cancer in asymptomatic women is important to evaluate for the early diagnosis [ 3 ].…”

“…Screening of breast cancer in asymptomatic women is important to evaluate for the early diagnosis [ 3 ]. Considering various risks for breast cancer, various breast cancer assessment models are developed to identify the risk of breast cancer [ 1 ] but there is a lack of a consistent breast cancer assessment model for Chinese women [ 4 ]. A proper screening method of breast cancer for Chinese women is necessary [ 5 ].…”