Mapping EORTC QLQ-C30 and QLQ-MY20 to EQ-5D in patients with multiple myeloma

Irina Proskorovsky, Philip Lewis, Cathy D Williams, Karin Jordan, Charalampia Kyriakou, Jack Ishak, Faith E Davies, Irina Proskorovsky, Philip Lewis, Cathy D Williams, Karin Jordan, Charalampia Kyriakou, Jack Ishak, Faith E Davies

Abstract

Background: In oncology, health-related quality of life (HRQoL) data are often collected using disease-specific patient questionnaires while generic, patient-level utility data required for health economic modeling are often not collected.

Methods: We developed a mapping algorithm for multiple myeloma that relates HRQoL scores from the European Organization for Research and Treatment of Cancer (EORTC) questionnaires QLQ-C30 and QLQ-MY20 to a utility value from the European QoL-5 Dimensions (EQ-5D) questionnaire. Data were obtained from 154 multiple myeloma patients who had participated in a multicenter cohort study in the UK or Germany. All three questionnaires were administered at a single time point. Scores from all 19 domains of the QLQ-C30 and QLQ-MY20 instruments were univariately tested against EQ-5D values and retained in a multivariate regression model if statistically significant. A 10-fold cross-validation model selection method was also used as an alternative testing means. Two models were developed: one based on QLQ-C30 plus QLQ-MY20 scores and one based on QLQ-C30 scores alone. Adjusted R-squared, correlation coefficients, and plots of observed versus predicted EQ-5D values were presented for both models.

Results: Mapping revealed that Global Health Status/QoL, Physical Functioning, Pain, and Insomnia were significant predictors of EQ-5D utility values. Similar results were observed when QLQ-MY20 scores were excluded from the model, except that Emotional Functioning and became a significant predictor and Insomnia was no longer a significant predictor. Adjusted R-squared values were of similar magnitude with or without inclusion of QLQ-MY20 scores (0.70 and 0.69, respectively), suggesting that the EORTC QLQ-MY20 adds little in terms of predicting utility values in multiple myeloma.

Conclusions: This algorithm successfully mapped EORTC HRQoL data onto EQ-5D utility in patients with multiple myeloma. Current mapping will aid in the analysis of cost-effectiveness of novel therapies for this indication.

Figures

Figure 1
Figure 1
Observed and predicted EQ-5D utility from trimmed model with EORTC QLQ-C30 and QLQ-MY20.
Figure 2
Figure 2
Observed and predicted EQ-5D utility from trimmed model with EORTC QLQ-C30 only.

References

    1. Tosh JC, Longworth LJ, George E. Utility values in National Institute for Health and Clinical Excellence (NICE) Technology Appraisals. Value Health. 2011;14:102–109. doi: 10.1016/j.jval.2010.10.015.
    1. Brazier JE, Rowen D, Mavranezouli I, Tsuchiya A, Young T, Yang Y, Barkham M, Ibbotson R. Developing and testing methods for deriving preference-based measures of health from condition-specific measures (and other patient-based measures of outcome) Health Technol Assess. 2012;16:1–114.
    1. The EuroQol Group (EQ-5D) [ ]. Accessed December 23, 2013.
    1. McKenzie L, van der Pol M. Mapping the EORTC QLQ-C-30 onto the EQ-5D instrument: the potential to estimate QALYs without generic preference data. Value Health. 2009;12:167–171. doi: 10.1111/j.1524-4733.2008.00405.x.
    1. Patrick DL, Deyo RA. Generic and disease-specific measures in assessing health status and quality of life. Med Care. 1989;27:S217–S232. doi: 10.1097/00005650-198903001-00018.
    1. Delforge M, Dhawan R, Robinson D Jr, Meunier J, Regnault A, Esseltine DL, Cakana A, van de Velde H, Richardson PG, San Miguel JF. Health-related quality of life in elderly, newly diagnosed multiple myeloma patients treated with VMP vs. MP: results from the VISTA trial. Eur J Haematol. 2012;89:16–27. doi: 10.1111/j.1600-0609.2012.01788.x.
    1. Dimopoulos MA, Delforge M, Hájek R, Kropff M, Pettrucci MT, Lewis P, Nixon A, Zhang J, Mei J, Palumbo A. Lenalidomide, melphalan and prednisone followed by lenalidomide maintenance improves health-related quality of life in newly diagnosed multiple myeloma patients aged 65 years or older: results of a randomized phase III trial. Haematologica. 2013;98(5):784–788. doi: 10.3324/haematol.2012.074534.
    1. Brown RE, Stern S, Dhanasiri S, Schey S. Lenalidomide for multiple myeloma: cost-effectiveness in patients with one prior therapy in England and Wales. Eur J Health Econ. 2012. doi:10.1007/s/10198-012-0395-6.
    1. Teckle P, Peacock S, Mc Taggart-Cowen H, Van der Hoek K, Chia S, Melosky B, Gelmon K. The ability of cancer-specific and generic preference-based instruments to discriminate across clinical and self-reported measures of cancer severities. Health Qual Life Outcomes. 2011;9:106. doi: 10.1186/1477-7525-9-106. doi:10.1186/1477-7525-9-106.
    1. Kim EJ, Ko SK, Kang HY. Mapping the cancer-specific EORTC QLQ-C30 and EORTC QLQ-BR23 to the generic EQ-5D in metastatic breast cancer patients. Qual Life Res. 2012;21(7):1193–1203. doi: 10.1007/s11136-011-0037-y.
    1. Kontodimopoulos N, Aletras VH, Paliouras D, Niakas D. Mapping the cancer-specific EORTC QLQ-C30 to the preference-based EQ-5D, SF-6D, and 15D instruments. Value Health. 2009;12:1151–1157. doi: 10.1111/j.1524-4733.2009.00569.x.
    1. Crott R, Briggs A. Mapping the QLQ-C30 quality of life cancer questionnaire to EQ-5D patient preferences. Eur J Health Econ. 2010;11:427–434. doi: 10.1007/s10198-010-0233-7.
    1. Wu EQ, Mulani P, Farrell MH, Sleep D. Mapping FACT-P and EORTC QLQ-C30 to patient health status measured by EQ-5D in metastatic hormone-refractory prostate cancer patients. Value Health. 2007;10:408–414. doi: 10.1111/j.1524-4733.2007.00195.x.
    1. Rowen D, Brazier J, Young T, Gaugris S, Craig BM, King MT, Velikova G. Deriving a preference-based measure for cancer using the EORTC QLQ-C30. Value Health. 2011;14:721–731. doi: 10.1016/j.jval.2011.01.004.
    1. Versteegh MM, Leunis A, Luime JJ, Boggild M, Uyl-de Groot CA, Stolk EA. Mapping QLQ-C30, HAQ, and MSIS-29 on EQ-5D. Med Decis Making. 2012;32:554–568. doi: 10.1177/0272989X11427761.
    1. Jordan K, Proskorovsky I, Lewis P, Ishak J, Payne K, Lordan N, Kyriakou C, Williams CD, Peters S, Davies FE. Effect of general symptom level, specific adverse events, treatment patterns, and patient characteristics on health-related quality of life in patients with multiple myeloma: results of a European, multicenter cohort study. Support Care Cancer. 2013. epub ahead of print doi:10.1007/s00520-013-1991-4.
    1. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, Kaasa S, Klee M, Osoba D, Razavi D, Rofe PB, Schraub S, Sneeuw K, Sullivan M, Takeda F. for the European Organization for Research and Treatment of Cancer QLQ-C30. A quality-of-life instrument for Use in international clinical trials in oncology. JNCI. 1993;85:365–376. doi: 10.1093/jnci/85.5.365.
    1. Cocks K, Cohen D, Wisløff F, Sezer O, Lee S, Hippe E, Gimsing P, Turesson I, Hajek R, Smith A, Graham L, Phillips A, Stead M, Velikova G, Brown J. EORTC Quality of Life Group. An international field study of the reliability and validity of a disease-specific questionnaire module (the QLQ-MY20) in assessing the quality of life of patients with multiple myeloma. Eur J Cancer. 2007;43:1670–1678. doi: 10.1016/j.ejca.2007.04.022.
    1. Picard RR, Cook RD. Cross-validation of regression models. J Am Stat Assoc. 1984;79:575–583. doi: 10.1080/01621459.1984.10478083.
    1. Dimopoulos MA, Palumbo A, Hajek R, Kropff M, Petrucci MT, Lewis P, Millar S, Zhang J, Mei J, Delforge M. Factors that influence health-related quality of life in newly diagnosed patients with multiple myeloma aged ≥ 65 years treated with melphalan, prednisone and lenalidomide followed by lenalidomide maintenance: results of a randomized trial. Leuk Lymphoma. 2013. epub ahead of print, doi:10.3109/10428194.2013.847933.

Source: PubMed

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