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    Mapping expanded prostate cancer index composite to EQ5D utilities to inform economic evaluations in prostate cancer: Secondary analysis of NRG/RTOG 0415

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    Author
    Khairnar, Rahul cc
    Pugh, Stephanie L
    Sandler, Howard M
    Lee, W Robert
    Villalonga Olives, Ester
    Mullins, C Daniel
    Palumbo, Francis B
    Bruner, Deborah W
    Shaya, Fadia T
    Bentzen, Soren M
    Shah, Amit B
    Malone, Shawn C
    Michalski, Jeff M
    Dayes, Ian S
    Seaward, Samantha A
    Albert, Michele
    Currey, Adam D
    Pisansky, Thomas M
    Chen, Yuhchyau
    Horwitz, Eric M
    DeNittis, Albert S
    Feng, Felix Y
    Mishra, Mark V
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    Date
    2021-04-14
    Journal
    PLoS ONE
    Publisher
    Public Library of Science
    Type
    Article
    
    Metadata
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    See at
    https://doi.org/10.1371/journal.pone.0249123
    Abstract
    PURPOSE: The Expanded Prostate Cancer Index Composite (EPIC) is the most commonly used patient reported outcome (PRO) tool in prostate cancer (PC) clinical trials, but health utilities associated with the different health states assessed with this tool are unknown, limiting our ability to perform cost-utility analyses. This study aimed to map EPIC tool to EuroQoL-5D-3L (EQ5D) to generate EQ5D health utilities. METHODS AND MATERIALS: This is a secondary analysis of a prospective, randomized non-inferiority clinical trial, conducted between 04/2006 and 12/2009 at cancer centers across the United States, Canada, and Switzerland. Eligible patients included men >18 years with a known diagnosis of low-risk PC. Patient HRQoL data were collected using EPIC and health utilities were obtained using EQ5D. Data were divided into an estimation sample (n = 765, 70%) and a validation sample (n = 327, 30%). The mapping algorithms that capture the relationship between the instruments were estimated using ordinary least squares (OLS), Tobit, and two-part models. Five-fold cross-validation (in-sample) was used to compare the predictive performance of the estimated models. Final models were selected based on root mean square error (RMSE). RESULTS: A total of 565 patients in the estimation sample had complete information on both EPIC and EQ5D questionnaires at baseline. Mean observed EQ5D utility was 0.90±0.13 (range: 0.28-1) with 55% of patients in full health. OLS models outperformed their counterpart Tobit and two-part models for all pre-determined model specifications. The best model fit was: "EQ5D utility = 0.248541 + 0.000748*(Urinary Function) + 0.001134*(Urinary Bother) + 0.000968*(Hormonal Function) + 0.004404*(Hormonal Bother)- 0.376487*(Zubrod) + 0.003562*(Urinary Function*Zubrod)"; RMSE was 0.10462. CONCLUSIONS: This is the first study to identify a comprehensive set of mapping algorithms to generate EQ5D utilities from EPIC domain/ sub-domain scores. The study results will help estimate quality-adjusted life-years in PC economic evaluations.
    Keyword
    Expanded Prostate Cancer Index Composite (EPIC)
    EuroQol-5D-3L (EQ5D)
    mapping algorithm
    Prostate--Cancer
    Cost-Benefit Analysis
    Quality of Life
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/15461
    ae974a485f413a2113503eed53cd6c53
    10.1371/journal.pone.0249123
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