Preference-weighted quality of life: Findings from the Selenium and Vitamin E Cancer Prevention Trial (SELECT).

Abstract

144 Background: The differences in preference-weighted health-related quality of life (HRQOL) among racial and ethnic groups have been previously reported. The Selenium and Vitamin E Cancer Prevention Trial (SELECT) enrolled 35,533 men aged 50 years and older, among whom 20% were minorities. HRQOL, using the SF-36V, was examined for a subset of participants. Using these survey data, we examined the preference-weighted HRQOL differences across the racial/ethnic categories included in SELECT. Methods: SELECT participants who completed the SF-36V at baseline, and subsequently in at least one of years 1, 3, and 5 were included. We used the SF-6D to calculate an HRQOL score ranging between 0 (worst possible) and 1 (best possible) for every participant using data from the SF-36V. We modeled the association of race/ethnicity with SF-6D scores using a linear mixed model adjusting for demographic and clinical characteristics. Results: At baseline, 9,691 men were eligible for analysis. Hispanic and non-Hispanic white participants had higher unadjusted mean SF-6D scores than non-Hispanic Black participants at baseline and every subsequent time point (p<0.05; Table). Non-Hispanic white participants had lower mean scores than Hispanic participants at every time point after baseline. After adjusting for demographic and clinical characteristics there are statistically significant differences in HRQOL among all three groups. In particular, Hispanic participants had higher scores than white participants by.074 (p<.001),.076 (p<.001), and.039 (p<.001) in years 1, 3, and 5 after baseline. Conversely, compared to non-Hispanic White participants, non-Hispanic Black participants had lower scores by.009 (p=.004) and.008 (p=.02) in years 1 and 3 after baseline. Conclusions: In this sample of men enrolled in a prostate cancer chemoprevention trial, preference-weighted HRQOL using the SF-6D was higher for Hispanic men than for white and Black men, and lower for Black men than for white men. Understanding how individuals belonging to different racial and/or ethnic categories view their own HRQOL is necessary not only for delivering culturally competent care but also for conducting accurate cost effectiveness analyses of new interventions and programs. Further research that includes a sample with women, reports on more categories of race/ethnicity, and explores underlying potential cultural and social differences is necessary. [Table: see text]