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, Szu Chun
AU - Lai, Wu Wei
AU - Chang, Han Yu
AU - Su, Wu Chou
AU - Chen, Helen H.W.
AU - Wang, Jung Der
N1 - Funding Information:
This research was, in part, supported by the Ministry of Education, Taiwan, R.O.C., The Aim for the Top University Project to the National Cheng Kung University and grants from the National Cheng Kung University Hospital ( NCKUH-10302010 ) and National Science Council ( NSC102-2314-B-006-029-MY2 ). The funders had no role in study design, data collection and analysis, or preparation of the manuscript.
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.
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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 -