Abstract

BackgroundTo develop direct and indirect (response) mapping algorithms from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the Functional Assessment of Cancer Therapy General (FACT-G) onto the EQ-5D-5L index.MethodsWe conducted the QOL-MAC study where EQ-5D-5L, EORTC QLQ-C30, and FACT-G were cross-sectionally evaluated in patients receiving drug treatment for solid tumors in Japan. We developed direct and indirect mapping algorithms using 7 regression methods. Direct mapping was based on the Japanese value set. We evaluated the predictive performances based on root mean squared error (RMSE), mean absolute error, and correlation between the observed and predicted EQ-5D-5L indexes.ResultsBased on data from 903 and 908 patients for EORTC QLQ-C30 and FACT-G, respectively, we recommend two-part beta regression for direct mapping and ordinal logistic regression for indirect mapping for both EORTC QLQ-C30 and FACT-G. Cross-validated RMSE were 0.101 in the two methods for EORTC QLQ-C30, whereas they were 0.121 in two-part beta regression and 0.120 in ordinal logistic regression for FACT-G. The mean EQ-5D-5L index and cumulative distribution function simulated from the recommended mapping algorithms generally matched with the observed ones except for very good health (both source measures) and poor health (only FACT-G).ConclusionsThe developed mapping algorithms can be used to generate the EQ-5D-5L index from EORTC QLQ-C30 or FACT-G in cost-effectiveness analyses, whose predictive performance would be similar to or better than those of previous algorithms.

Highlights

  • To develop direct and indirect mapping algorithms from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the Functional Assessment of Cancer Therapy General (FACT-G) onto the EQ-5D-5L index

  • Based on our literature survey and the latest mapping algorithm database [22], we find that there are no direct mapping algorithms for EQ-5D-5L based on the Japanese value set and no indirect mapping algorithms for EQ-5D-5L from EORTC QLQ-C30 and FACT-G

  • The aim of the present study is to develop direct and indirect mapping algorithms from EORTC QLQ-C30 and FACT-G onto the EQ-5D-5L index using data from the Quality Of Life Mapping Algorithm for Cancer (QOLMAC) study, where EQ-5D-5L, EORTC QLQ-C30, and FACT-G data are cross-sectionally obtained from patients with cancer

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Summary

Introduction

To develop direct and indirect (response) mapping algorithms from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the Functional Assessment of Cancer Therapy General (FACT-G) onto the EQ-5D-5L index. We need to evaluate the effectiveness of cancer treatments and their costeffectiveness [3]. In cost-effectiveness analyses of cancer treatments, the most important and commonly used health outcome is quality-adjusted life year (QALY). QALY incorporates both the duration and quality of life, the two most important aspects for patients with cancer, and enables us to compare the cost-effectiveness of treatments in resource allocation irrespective of the disease area [4]. The National Institute for Health and Care Excellence in the United Kingdom prefers the use of EQ-5D in cost-effectiveness analyses [6], whereas the Center for Outcomes Research and Economic Evaluation for Health in Japan recommends a preference-based measure based on the time trade-off method [7, 8], which virtually indicates EQ-5D in the current situation. Since EQ-5D with 3 levels (EQ5D-3L) has several limitations, such as ceiling effect and multimodality [9, 10], EQ-5D with 5 levels (EQ-5D-5L) was developed and the value sets for it are available in many countries [11]

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