Preference-Based Measurement of Health-Related Quality of Life (HRQL) in Children with Chronic Musculoskeletal Disorders (MSKDs) Estimation of a Preference-Based Index from a Condition-Specific Measure: The King's Health Questionnaire Multiattribute utility function for a comprehensive health status classification system. Health Utilities Index Mark 2. 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. Multiattribute and Single‐Attribute Utility Functions for the Health Utilities Index Mark 3 System Choosing who shall not be treated in the NHS. Validity of the Assessment of Quality of Life (AQoL) utility instrument in patients with operable and inoperable lung cancer. The Minimally Clinically Important Difference in Generic Utility-Based Measures Valuing SF-6D Health States Using a Discrete Choice Experiment Estimating a Preference-Based Index for an Eight-Dimensional Health State Classification System for Multiple Sclerosis. Valuing the Child Health Utility 9D: Using profile case best worst scaling methods to develop a new adolescent specific scoring algorithm. Can Utility-Weighted Health-Related Quality-of-Life Estimates Capture Health Effects of Quality Improvement for Depression? Study protocol for valuing EQ-5D-3L and EORTC-8D health states in a representative population sample in Sri Lanka Predictors of utilities for health states in early stage prostate cancer. Scoring the Child Health Utility 9D instrument: estimation of a Chinese child and adolescent-specific tariff Development of a Preference-Weighted Health Status Classification System in France: The Health Utilities Index 3 Derivation of Utility Values from European Organization for Research and Treatment of Cancer Quality of Life-Core 30 Questionnaire Values in Lung Cancer
Background . Health-related quality of life can be measured by patients ' health preferences ( utilities or values ) . No method for measuring health state preferences has been st and ardized for children with arthritis or other musculoskeletal disorders ( MSKDs ) . Such a method is needed for economic evaluations of current and new pediatric treatments . Objectives . 1 ) To assess the feasibility of utility measurements in children with MSKDs , 2 ) to test the validity of the Health Utility Index ( HUI ) for these children , 3 ) to assess whether rating scale values can be mathematically converted into meaningful st and ard gamble ( SG ) utilities , and 4 ) to study whether parents can act as proxies for their children with respect to health state preferences . Methods . Eighty parents of children with MSKDs were consecutively sample d. Their children , if 8 years of age or older ( n = 55 ) , were studied concurrently . Utilities of current health states were obtained by using the SG and the HUI in r and om order . In addition , health state preferences were assessed using categorical and analog rating scales . Traditional nonutility measures of health status ( the Childhood Health Assessment Question naire [ CHAQ ] and the Activities Scale for Kids [ ASK ] ) were also completed . Intraclass correlation coefficients ( ICCs ) were calculated to assess concordance between the different utility measures and also between the ratings of the parents and their children . Results . Children 8 years of age or older were able to express the strength of their health state preferences using the HUI and rating scales . Children older than 10 years of age were able to use the SG method . The health state utilities of the parents were higher than those of their children . The utilities varied widely depending on the elicitation method . The expected high agreement between the SG and the HUI was not found ( ICC = 0.028 for parents , ICC = 0.016 for patients ) . Unlike the SG , the global utilities derived from the HUI agreed better with preferences derived from rating scales ( ICC = 0.23 - 0.25 ) and correlated with traditional health status measures ( with CHAQ , r = -0.56 ; with ASK , r = 0.46 ) both for parents and children . It was not possible to mathematically convert rating scale preferences into SG utilities . The SG utilities were unrelated to results from the rating scales , the CHAQ , and the ASK . Especially for parents , the SG utilities were very high , even when ratings of the other measures indicated poor health . Conclusions . Although it is possible to measure health utilities for children with MSKDs , the results are highly method dependent . The properties of the HUI in this population are more like those of the traditional health status measures rather than those of the SG . Preferences derived from rating scales , although easily performed , can not readily be converted into SG utilities . Parents ' ratings for their children are impaired by risk aversion Background . Generic preference-based measures of health may not adequately cover the impact of some conditions . There is therefore increasing interest in developing condition-specific preference-based measures . Objectives . The purpose of this study was to estimate a preference-based measure from a condition-specific measure of health for urinary incontinence , the 21-item King 's Health Question naire , for use in economic evaluation . Methods . The King 's Health Question naire ( KHQ ) was revised into a 5-dimensional health state classification amenable to valuation using items selected using psychometric evidence . Forty-nine states were valued using st and ard gamble by a representative sample of patients with urinary incontinence attending UK hospital outpatient clinics . Each respondent was asked to value 9 health states . Models have been estimated for predicting health state valuations for all 1024 states defined by the KHQ classification . The modeling had to cope with the clustering of data by respondent and its skewed distribution . Results . In total , 110 usable interviews were obtained from 169 patients approached to participate in the study . These responders generated 959 health state valuations . Mean health state values ranged from 0.77 to 0.98 . Models were estimated using mean health state values and r and om effects models of individual-level health state values . These models generated robust estimates of the ` main effects , ` and in general , the results support the ordinality of the KHQ health state classification . There were problems modeling interaction effects , and a number of alternatives were explored . Conclusion . The recommended model for estimating a preference-based measure from the condition-specific KHQ is presented The Health Utilities Index Mark 2 ( HUI:2 ) is a generic multiattribute , preference-based system for assessing health-related quality of life .  Health Utilities Index Mark 2 consists of two components : a seven-attribute health status classification system and a scoring formula . The seven attributes are sensation , mobility , emotion , cognition , self-care , pain , and fertility . A r and om sample of general population parents were interviewed to determine cardinal preferences for the health states in the system . The health states were defined as lasting for a 60-year lifetime , starting at age 10 . Values were measured using visual analogue scaling . Utilities were measured using a st and ard gamble technique . A scoring formula is provided , based on a multiplicative multiattribute utility function from the responses of 194 subjects . The utility scores are death-anchored ( death = 0.0 ) and form an interval scale . Health Utilities Index Mark 2 and its utility scores can be useful to other research ers in a wide variety of setting s who wish to document health status and assign preference scores 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 question naires were used to prospect ively measure the quality -of-life ( QoL ) of a 518 consecutive , cross-sectional sub sample . 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 assessment s to improve patients ' values Background . The Health Utilities Index Mark 3 ( HUI3 ) is a generic multiattribute preference‐based measure of health status and health‐related quality of life that is widely used as an outcome measure in clinical studies , in population health surveys , in the estimation of quality ‐adjusted life years , and in economic evaluations . HUI3 consists of eight attributes ( or dimensions ) of health status : vision , hearing , speech , ambulation , dexterity , emotion , cognition , and pain with 5 or 6 levels per attribute , varying from highly impaired to normal . Objectives . The objectives are to present a multiattribute utility function and eight single‐attribute utility functions for the HUI3 system based on community preferences . Study Design . Two preference surveys were conducted . One , the modeling survey , collected preference scores for the estimation of the utility functions . The other , the direct survey , provided independent scores to assess the predictive validity of the utility functions . Measures . Preference measures included value scores obtained on the Feeling Thermometer and st and ard gamble utility scores obtained using the Chance Board . Respondents . A r and om sample of the general population ( ≥16 years of age ) in Hamilton , Ontario , Canada . Results . Estimates were obtained for eight single‐attribute utility functions and an overall multiattribute utility function . The intraclass correlation coefficient between directly measured utility scores and scores generated by the multiattribute function for 73 health states was 0.88 . Conclusions . The HUI3 scoring function has strong theoretical and empirical foundations . It performs well in predicting directly measured scores . The HUI3 system provides a practical way to obtain utility scores based on community preferences In the face of severe re source constraints , health care systems are seeking both to control costs and to ensure maximum benefits for the re sources consumed . The use of  Quality Adjusted Life Years ( QALYs )  is becoming more widely advocated as a decision aid in the solution of re source allocation problems . The QALY combines two dimensions of health outcome --the quantity of life and its quality --in such a way that choices between different services with different purpose s can be made using comparisons based on common units of measurement . The combination of these two dimensions allows comparisons between services with different objectives , such as curing and caring services . The QALY , however , lacks a third dimension which is vital to the decision-making process to which it is intended to contribute : the worth of a specific life relative to others . This paper presents results based on interviews of 719 residents of Cardiff drawn at r and om from the electoral register . The results suggest that further development of the novel methodology used to establish the relative value placed on various human lives is worthwhile . Evidence is given which indicates that the public consider lives to be of unequal worth . The results also show that these values are consistent for different types of choices phrased in different ways on a large number of control variables , implying the existence of a cultural stable value system which is a necessary prerequisite if consensus values of human life are to be used to assist decision-making in non-private health care systems . ( ABSTRACT TRUNCATED AT 250 WORDS There have been few longitudinal studies of quality of life in patients with all stages of lung cancer , particularly those that have included measures of utility . The purpose of this study was to examine the psychometric properties of the Assessment of Quality of Life instrument ( AQoL )  in patients with lung cancer . The AQoL is a health-related quality of life question naire and provides a descriptive system for a multi-attribute utility instrument ( MAU ) , so that scores can be used in cost-utility evaluations . In the present study the reliability ( internal consistency ) of the AQoL was examined and the concurrent validity was assessed using the Medical Outcomes 36-item Short Form Health Survey ( SF-36 ) as the comparator instrument . The sensitivity to different health states of the AQoL and the responsiveness to change over time was also examined . A prospect i ve , non-experimental cohort study was undertaken . Ninety-two participants with all stages of lung cancer were recruited from a tertiary multi-disciplinary lung cancer clinic . Ninety participants had non-small cell lung cancer ( NSCLC ) and two had limited stage small cell lung cancer . The  AQOL and SF-36 surveys  were administered concurrently at baseline . In patients with NSCLC the surveys were then repeated 3 and 6 months later . Correlations between the baseline AQoL summary scales and SF-36 summary scales support the divergent and convergent validity of the AQoL.  Reliability was also found to be sufficient ( Cronbach 's Alpha=0.76 ) . In addition , in patients with inoperable NSCLC , baseline AQoL scores were found to be predictive of survival at 6 months in Cox proportional hazards multivariate analysis . However , the physical components summary score of the SF-36 was more sensitive to differences in health states between patients with different stages of NSCLC at 6 months of follow-up and more responsive to change over time in both operable and inoperable patients with NSCLC than the AQoL. The findings support the construct validity and reliability of the  AQoL  in this population . However , there remains some uncertainty about whether the AQoL has sufficient sensitivity to different health states in this population . Further studies using other MAU instruments may determine whether alternative instruments are more sensitive to different health states in individuals with lung cancer Purpose : To evaluate the use of utility-based generic quality of life measures for establishing the minimally clinical ly important difference ( MCID ) . Background : Utility-based quality of life measures place levels of wellness on a continuum anchored by death ( 0.00 ) and optimum function ( 1.00 ) . Preference measurement studies are used to define the meaning of points along the continuum . Health states that differ by less than 0.03 units can not be discriminated by panels of judges as different from one another . Thus , 0.03 is a reasonable MCID for these measures . Method : Three published studies of patients with Chronic Obstructive Pulmonary Disease ( COPD ) reported data on the Quality of Well-being Scale ( QWB ) before and after pulmonary rehabilitation . One of the studies also r and omly assigned patients to lung volume reduction surgery or to maximal medical therapy . These patients were followed for an average of 29 months . Results : All three evaluations of pulmonary rehabilitation showed changes on the QWB in excess of the proposed 0.03 MCID . QWB changes for patients assigned to lung volume reduction surgery were close to the MCID threshold at one year but grew stronger in subsequent years . Using Norman 's 0.50 st and ard deviation method , all three estimates of rehabilitation effectiveness and the outcomes one year following surgery fall below the MCID . Conclusion : Different methods for estimating MCID lead to different conclusions about the meaning of quality of life changes following pulmonary rehabilitation and lung volume reduction surgery . The preference scaling system in generic utility-based quality of life measures provides a metric that is directly interpretable and avoids many of the criticisms of MCID measures . The method is sensitive enough to suggest clinical ly meaningful benefits of rehabilitation and surgery . Further , quality adjusted life years offer a valuable metric for policy analysis . Utility-based measures of health related quality of life should gain greater use in COPD outcomes research Background . SF-6D utility weights are conventionally produced using a st and ard gamble ( SG ) . SG-derived weights consistently demonstrate a floor effect not observed with other elicitation techniques . Recent advances in discrete choice methods have allowed estimation of utility weights . The objective was to produce Australian utility weights for the SF-6D and to explore the application of discrete choice experiment ( DCE ) methods in this context . We hypothesized that weights derived using this method would reflect the largely monotonic construction of the SF-6D . Methods . We design ed an online DCE and administered it to an Australia-representative online panel ( n = 1017 ) . A range of specifications investigating nonlinear preferences with respect to additional life expectancy were estimated using a r and om-effects probit model . The preferred model was then used to estimate a preference index such that full health and death were valued at 1 and 0 , respectively , to provide an algorithm for Australian cost-utility analyses . Results . Physical functioning , pain , mental health , and vitality were the largest drivers of utility weights . Combining levels to remove illogical orderings did not lead to a poorer model fit . Relative to international SG-derived weights , the range of utility weights was larger with 5 % of health states valued below zero . Conclusion s. DCEs can be used to investigate preferences for health profiles and to estimate utility weights for multi-attribute utility instruments . Australian cost-utility analyses can now use domestic SF-6D weights . The comparability of DCE results to those using other elicitation methods for estimating utility weights for quality -adjusted life-year calculations should be further investigated BACKGROUND Condition-specific measures are frequently used to assess the health-related quality of life of people with multiple sclerosis ( MS ) . Such measures are unsuitable for use in economic evaluations that require estimates of cost per quality -adjusted life-year because they are not based on preferences . OBJECTIVES To report the estimation of a preference-based single index for an eight-dimensional instrument for MS , the Multiple Sclerosis Impact Scale - Eight Dimensions ( MSIS-8D ) , derived from an MS-specific measure of health-related quality of life , the 29-item Multiple Sclerosis Impact Scale ( MSIS-29 ) . METHODS We elicited preferences for a sample of MSIS-8D states ( n = 169 ) from a sample ( n = 1702 ) of the UK general population . Preferences were elicited using the time trade-off technique via an Internet-based survey . We fitted regression models to these data to estimate values for all health states described by the MSIS-8D . Estimated values were assessed against MSIS-29 scores and values derived from generic preference-based measures in a large , representative sample of people with MS . RESULTS Participants reported that the time trade-off questions were easy to underst and . Observed health state values ranged from 0.08 to 0.89 . The best-performing model was a main effects , r and om effects model ( mean absolute error = 0.04 ) . Validation analyses support the performance of the MSIS-8D index : it correlated more strongly than did generic measures with MSIS-29 scores , and it discriminated effectively between subgroups of people with MS . CONCLUSIONS The MSIS-8D enables health state values to be estimated from the MSIS-29 , adding to the methods available to assess health outcomes and to estimate quality -adjusted life-years for MS for use in health technology assessment and decision-making context In contrast to the recent proliferation of studies incorporating ordinal methods to generate health state values from adults , to date relatively few studies have utilised ordinal methods to generate health state values from adolescents . This paper reports upon a study to apply profile case best worst scaling methods to derive a new adolescent specific scoring algorithm  for the Child Health Utility 9D ( CHU9D ) , a generic preference based instrument that has been specifically design ed for the estimation of quality adjusted life years for the economic evaluation of health care treatment and preventive programs targeted at young people . A survey was developed for administration in an on-line format in which consenting community based Australian adolescents aged 11 - 17 years ( N = 1982 ) indicated the best and worst features of a series of 10 health states derived from the CHU9D descriptive system . The data were analyzed using latent class conditional logit models to estimate values ( part worth utilities ) for each level of the nine attributes relating to the CHU9D . A marginal utility matrix was then estimated to generate an adolescent-specific scoring algorithm  on the full health = 1 and dead = 0 scale required for the calculation of QALYs . It was evident that different decision processes were being used in the best and worst choices . Whilst respondents appeared readily able to choose ' best ' attribute levels for the CHU9D health states , a large amount of r and om variability and indeed different decision rules were evident for the choice of ' worst ' attribute levels , to the extent that the best and worst data should not be pooled from the statistical perspective . The optimal  adolescent-specific scoring algorithm  was therefore derived using data obtained from the best choices only . The study provides important insights into the use of profile case best worst scaling methods to generate health state values with adolescent population Background .Utility methods that are responsive to changes in desirable outcomes are needed for cost-effectiveness ( CE ) analyses and to help in decisions about re source allocation . Objectives .Evaluated is the responsiveness of different methods that assign utility weights to subsets of SF-36 items to average improvements in health result ing from quality improvement ( QI ) interventions for depression . Design .A group level , r and omized , control trial in 46 primary care clinics in six managed care organizations . Clinics were r and omized to one of two QI interventions or usual care . Subjects . One thous and one hundred thirty-six patients with current depressive symptoms and either 12-month , lifetime , or no depressive disorder identified through screening 27,332 consecutive patients . Measures .Utility weighted SF-12 or SF-36 measures , probable depression , and physical and mental health-related quality of life scores . Results .Several utility-weighted measures showed increases in utility values for patients in one of the interventions , relative to usual care , that paralleled the improved health effects for depression and emotional well being . However , QALY gains were small . Directly elicited utility values showed a paradoxical result of lower utility during the first year of the study for intervention patients relative to controls . Conclusions .The results raise concerns about the use of direct single-item utility measures or utility measures derived from generic health status measures in effectiveness studies for depression . Choice of measure may lead to different conclusions about the benefit and CE of treatment . Utility measures that capture the mental health and non-health outcomes associated with treatment for depression are needed Background Economic evaluations to inform decisions about allocation of health re sources are scarce in Low and Middle Income Countries , including in Sri Lanka . This is in part due to a lack of country-specific utility weights , which are necessary to derive appropriate Quality Adjusted Life Years . The EQ-5D-3L , a generic multi-attribute instrument ( MAUI ) , is most widely used to measure and value health states in high income countries ; nevertheless , the sensitivity of generic MAUIs has been criticised in some conditions such as cancer . This article describes a protocol to produce both a generic EQ-5D-3L and cancer specific EORTC-8D utility index in Sri Lanka . Method EQ-5D-3L and EORTC-8D health states will be valued using the Time Trade-Off technique , by a representative population sample ( n = 780 invited ) identified using stratified multi-stage cluster sampling with probability proportionate to size method . Households will be r and omly selected within 30 clusters across four districts ; one adult ( ≥18 years ) within each household will be selected using the Kish grid method . Data will be collected via face-to-face interview , with a Time Trade-Off board employed as a visual aid . Of the 243 EQ-5D-3L and 81,290 EORTC-8D health states , 196 and 84 respectively will be directly valued . In EQ-5D-3L , all health states that combine level 3 on mobility with either level 1 on usual activities or self-care were excluded . Each participant will first complete the EQ-5D-3L , rank and value 14 EQ-5D-3L states ( plus the worst health state and “ immediate death ” ) , and then rank and value seven EORTC-8D states ( plus “ immediate death ” ) . Participant demographic and health characteristics will be also collected . Regression models will be fitted to estimate utility indices for EQ-5D-3L and EORTC-8D health states for Sri Lanka . The dependent variable will be the utility value . Different specifications of independent variables will be derived from the ordinal EQ-5D-3L to test for the best-fitting model . Discussion In Sri Lanka , a LMIC health state valuation will have to be carried out using face to face interview instead of online methods . The proposed study will provide the first country-specific health state valuations for Sri Lanka , and one of the first valuations to be completed in a South Asian Country PURPOSE When faced with treatment choices for early stage prostate cancer , patients must balance the survival benefit of a treatment with its morbidity . Little is known about how patients balance these trade-offs . To further our underst and ing of patient decision making we assessed patient utilities for prostate cancer treatment related morbidities . We determined whether patient utilities were predicted by sociodemographic characteristics or baseline genitourinary function . MATERIAL S AND METHODS We evaluated 401 men undergoing prostate needle biopsy for suspicion of prostate cancer at university , Veterans Affairs and public hospitals . Study design included a prospect i ve cross-sectional cohort with correlation and multivariate analysis . Subjects were studied with 2 established health related quality of life instruments . Patient  utilities  were assessed with an interactive software application . RESULTS On multivariate analysis utility for current general health was a significant predictor of utilities for treatment related morbidities . Surprisingly baseline urinary , sexual and bowel function scores did not correlate well with respective utilities for potential incontinence , impotence or radiation proctitis . In other words , men with good and imperfect baseline function were equally willing to risk impairment to preserve life . CONCLUSIONS Men who perceived that general health was better appear to place higher value on quantity of life , while those who already are suffering from poor general health place higher value on quality of life . Ethnicity appears to modify some effects of other variables on patient preference . Utility assessment provides a quantitative tool to aid physicians in counseling patients when making treatment decisions for localized prostate cancer Purpose To derive children and adolescents ’ preferences for health states defined by the Chinese version of Child Health Utility 9D ( CHU9D-CHN ) instrument in China that can be used to estimate quality -adjusted life years ( QALYs ) for economic evaluation . Methods A profile case best – worst scaling ( BWS ) and a time trade-off ( TTO ) method were combined to derive a Chinese-specific tariff for the CHU9D-CHN . The BWS survey  recruited students from primary and high schools using a multi-stage r and om sampling method and was administered in a classroom setting , whilst the TTO survey adopted an interviewer-administrated conventional TTO task and was administered to a convenience sample of undergraduate students . A latent class modelling framework was adopted for analysing the BWS data . Results Two independent surveys were conducted in Nanjing , China , including a valid sample of 902 students ( mean age 13 years ) from the BWS survey and a valid sample of 38 students ( mean age 18 years ) from the TTO survey . The poolability of the best and the worst responses was rejected and the optimal result based on the best responses only . The optimal model suggests the existence of two latent classes . The BWS estimates were further re-anchored onto the QALY scale using the TTO generated health state values via a mapping approach . Conclusion This study provides further insights into the use of the BWS method to generate health state values with young people and highlights the potential different decision rules that young people may employ for determining best vs. worst choices in this context The Health Utilities Index is a generic multiattribute preference-based system for assessing health-related quality of life , devised by Torrance et al. It is being used in cost-effectiveness evaluations in North America and in international multicentre studies but was not available in France . Following adaptation of the HUI3 classification in France , the purpose of the reported investigation was to derive French preference weights . This article provides a reminder of the theoretical foundations used to model the multiattribute utility function . Within this framework , a multiattribute multiplicative aggregate utility function was constructed in accordance with the explicitly decomposed approach . The study took place in June 1999 over a sample of 365 persons from the French general population , aged between 20 and 65 , and not suffering from any chronic or incapacitating illness . The recruitment procedure was based upon a r and om selection of individuals , using the phone book . Interviews took place in the homes of the interviewees . The methods of revelation ( VAS and SG ) were applied by setting the value of the best possible state of the HUI3 a priori at 1 , and leaving a choice between two states ( worst possible state , death ) for 0 . The aggregated individuals ( person-mean and median ) were calculated and the multiplicative utility functions constructed . A comparison of the calculated utilities with the observed ones provides a primary indicator of the validity of the person-mean or median functions constructed . The slight absolute differences obtained between observed and calculated utilities and the low RMSE scores lead us towards a favourable conclusion Introduction : Cancer clinical trials frequently incorporate quality of life ( QoL ) measures but rarely patient utility . Utility information is required for cost utility evaluations of novel cancer therapies . We assessed the feasibility of converting QoL data into utility scores using the European Organization for Research and Treatment of Cancer Quality of Life-Core  30 question naire ( EORTC QLQ-C30 ) and the EQ-5D in patients with non-small cell lung cancer ( NSCLC ) . Methods : Out patients with all different disease states of NSCLC attending a major Canadian cancer center completed the QLQ-C30 and EQ5D on a single visit . Results of the QLQ-C30 summary scores were mapped to predict EQ-5D utility scores using linear regression . Backward variable elimination using the Akaike Information Criterion was used to reduce the full model that included all QLQ-C30 summary scores to examine which QLQ-C30 dimensions best predict a patient 's utility score . To test the predictive power of the model , 10-fold cross-validation was used . Results : A total of 172 patients participated in the study . Median age of the sample was 66 years ( range , 32–85 years ) ; 46.5 % were men . The cross-validation estimate of mean utility score was 0.76 ( SD : 0.20 ) , which was the same as the actual mean utility score . Of the 15 QLQ-C30 dimensions , 4 functional dimensions ( physical , role , emotional , and social ) and the pain symptom dimension were predictive of patient utility scores . Conclusions : Our study demonstrates the feasibility of deriving utility scores from prospect i ve QoL data . Validation of the QLQ-C30 predictors found in this study could further the ability to estimate cost utility of therapies for economic evaluations
Conclusion Various methods have been used at all stages of CSPBM development .
The choice between developing a classification system de novo or from an existing instrument may depend on the availability of a suitable existing measure , while the choice between a decomposed or composite approach appears to be determined primarily by the purpose for which the instrument is design ed .
Background Health state utility values ( HSUVs ) are required to calculate quality -adjusted life-years ( QALYs ) .
They are frequently derived from generic preference-based measures of health .
However , such generic measures may not capture health attributes of relevance to specific conditions .
In such cases , a condition-specific preference-based measure ( CSPBM ) may be more appropriate .
Objective This systematic review aim ed to identify all published accounts of developing CSPBMs to describe and appraise the methods used .