QOL-25EVALUATION OF THE UTILITY OF THE EQ-5D AND MDASI-BT IN PRIMARY BRAIN TUMOR PATIENTS

Abstract

BACKGROUND: Patients with malignant glioma are highly symptomatic and often have functional limitations beginning from the time of diagnosis. The utility of measuring general health status may have value in determining impact of disease. This study provided a description of health status and utility scores in glioma patients throughout the illness trajectory using the EQ-5D. Furthermore, it evaluated the additive information provided by MD Anderson Symptom Inventory-Brain Tumor (MDASI-BT) in describing health-related quality of life as assessed by the EQ-5D. METHODS: Malignant glioma patients completed the EQ-5D and MDASI-BT self-reports. The MDASI-BT is a measure of symptom burden and interference whereas the EQ-5D is a functional measure of general health status. Linear regression evaluated whether MDASI-BT scores adequately predict patient health outcomes measured by the EQ-5D. RESULTS: The sample included 100 patients [65% male, 75% with a GBM, median age 52 (range 20-75), 56% in active treatment]. Thirty percent of patients reported no problems on any of the 5 areas measured by the EQ-5D. The remaining 70% reported some/moderate problems in at least 1 area. The most extreme cases reported inability to perform usual activities (8%) and significant anxiety/depression (5%). The MDASI-BT neurologic factor score and the WAW (Walking/Activity/Work) interference score explained 52% of the variability in the EQ-5D in this patient population while adjusting for the effect of tumor grade, recurrence status, and Karnofsky Performance Status (KPS). Residual diagnostics confirmed the adequacy of model fit. CONCLUSIONS: The majority of brain tumor patients reported at least one functional limitation on the EQ-5D. Over half of the variance in the EQ-5D was explained by the MDASI-BT, KPS, tumor grade, and recurrence status underscoring the benefit of using this information for planning patient care. The resultant model demonstrates the significant contribution symptom burden has on determining health status in this patient population.