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

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives: 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 (2005-2011) 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.

Original languageEnglish
Pages (from-to)96-101
Number of pages6
JournalLung Cancer
Volume86
Issue number1
DOIs
Publication statusPublished - 2014 Oct 1

Fingerprint

Life Expectancy
Lung Neoplasms
Quality of Life
Non-Small Cell Lung Carcinoma
Quality-Adjusted Life Years
Survival
Value of Life
Vital Statistics
Life Tables
Health Surveys
Taiwan
Interviews
Costs and Cost Analysis
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

@article{6dc5fd498d0d4cd8a6de648f74068fba,
title = "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",
abstract = "Objectives: 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 (2005-2011) 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.",
author = "Seu-Chun Yang and Wu-Wei Lai and Han-Yu Chang and Wu-Chou Su and Chen, {Helen H.W} and Jung-Der Wang",
year = "2014",
month = "10",
day = "1",
doi = "10.1016/j.lungcan.2014.08.006",
language = "English",
volume = "86",
pages = "96--101",
journal = "Lung Cancer",
issn = "0169-5002",
publisher = "Elsevier Ireland Ltd",
number = "1",

}

TY - JOUR

T1 - Estimation of loss of quality-adjusted life expectancy (QALE) for patients with operable versus inoperable lung cancer

T2 - Adjusting quality-of-life and lead-time bias for utility of surgery

AU - Yang, Seu-Chun

AU - Lai, Wu-Wei

AU - Chang, Han-Yu

AU - Su, Wu-Chou

AU - Chen, Helen H.W

AU - Wang, Jung-Der

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Objectives: 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 (2005-2011) 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.

AB - Objectives: 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 (2005-2011) 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.

UR - http://www.scopus.com/inward/record.url?scp=84908405123&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908405123&partnerID=8YFLogxK

U2 - 10.1016/j.lungcan.2014.08.006

DO - 10.1016/j.lungcan.2014.08.006

M3 - Article

C2 - 25178685

AN - SCOPUS:84908405123

VL - 86

SP - 96

EP - 101

JO - Lung Cancer

JF - Lung Cancer

SN - 0169-5002

IS - 1

ER -