Construct Validity of the EuroQoL-5 Dimension and the Health Utilities Index in Head and Neck Cancer

Overview

Journal Otolaryngol Head Neck Surg

Publisher Wiley

Specialties General Surgery
Otorhinolaryngology

Date 2021 Jul 27

PMID 34311628

Citations 1

Authors

Christopher W Noel

Sareh Keshavarzi

David Forner

Robert F Stephens

Erin Watson

Eric Monteiro

Ali Hosni

Aaron Hansen

David P Goldstein

John R de Almeida

Affiliations

Soon will be listed here.

Abstract

Objective: The objective of this study was to evaluate the construct validity of 2 health utility instruments-the EuroQoL-5 Dimension (EQ-5D) and the Health Utilities Index-Mark 3 (HUI-3)-and to compare them with disease-specific measures in patients with head and neck cancer.

Study Design: Prospective cross-sectional analysis.

Setting: Princess Margaret Cancer Centre.

Methods: Patients were administered the EQ-5D, HUI-3, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its head and neck cancer module (EORTC QLQ-H&N35), and the University of Washington Quality of Life Questionnaire (UWQoL). Several a priori expected relations were examined. The correlative and discriminative properties of the various instruments were examined.

Results: A total of 209 patients completed the 4 questionnaires. A significant ceiling effect was observed among EQ-5D responses (23% reported a maximum score of 1). The EQ-5D (rho = 0.79) and HUI-3 (rho = 0.60) had a strong correlation with the social-emotional domain of the UWQoL. The EQ-5D had a moderate correlation with the physical domain of the UWQoL (rho = 0.42), whereas the HUI-3 had a weak correlation (rho = 0.29). The EQ-5D and HUI-3 were able to distinguish among levels of health severity measured on the EORTC QLQ-C30 though not the QLQ-H&N35. Comparatively, the UWQoL was able to distinguish levels of disease severity on the EORTC QLQ-C30 and QLQ-H&N35.

Conclusion: The results of this study demonstrate that disease-specific domains from head and neck quality-of-life instruments are not strongly correlated with the EQ-5D and HUI-3. Consideration should be put toward development of a disease-specific preference-based measure for health economic evaluation.

Level Of Evidence: 4.

Citing Articles

Association of Household Income at Diagnosis With Financial Toxicity, Health Utility, and Survival in Patients With Head and Neck Cancer.

Noel C, Hueniken K, Forner D, Liu G, Eng L, Hosni A JAMA Otolaryngol Head Neck Surg. 2022; 149(1):63-70.

PMID: 36416855 PMC: 9685545. DOI: 10.1001/jamaoto.2022.3755.

References

Kvam A, Fayers P, Wisloff F . Responsiveness and minimal important score differences in quality-of-life questionnaires: a comparison of the EORTC QLQ-C30 cancer-specific questionnaire to the generic utility questionnaires EQ-5D and 15D in patients with multiple myeloma. Eur J Haematol. 2011; 87(4):330-7. DOI: 10.1111/j.1600-0609.2011.01665.x. View

Noel C, Sutradhar R, Zhao H, Delibasic V, Forner D, Irish J . Patient-Reported Symptom Burden as a Predictor of Emergency Department Use and Unplanned Hospitalization in Head and Neck Cancer: A Longitudinal Population-Based Study. J Clin Oncol. 2021; 39(6):675-684. DOI: 10.1200/JCO.20.01845. View

Mokkink L, Terwee C, Patrick D, Alonso J, Stratford P, Knol D . The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res. 2010; 19(4):539-49. PMC: 2852520. DOI: 10.1007/s11136-010-9606-8. View

Naunheim M, Wittenberg E, Shrime M . Patient Preference Research in Otolaryngology: What Do Patients Want?. JAMA Otolaryngol Head Neck Surg. 2017; 143(10):971-972. DOI: 10.1001/jamaoto.2017.1086. View

Noel C, de Almeida J . Quality of life considerations for patients with anterior and central skull base malignancies. J Neurooncol. 2020; 150(3):501-508. DOI: 10.1007/s11060-019-03367-w. View

Fayers P, Bottomley A . Quality of life research within the EORTC-the EORTC QLQ-C30. European Organisation for Research and Treatment of Cancer. Eur J Cancer. 2002; 38 Suppl 4:S125-33. DOI: 10.1016/s0959-8049(01)00448-8. View

Stephens R, Noel C, Su J, Xu W, Krahn M, Monteiro E . Mapping the University of Washington Quality of life questionnaire onto EQ-5D and HUI-3 indices in patients with head and neck cancer. Head Neck. 2019; 42(3):513-521. DOI: 10.1002/hed.26031. View

Rogers S, Alvear A, Anesi A, Babin E, Balik A, Batstone M . Variations in concerns reported on the patient concerns inventory in patients with head and neck cancer from different health settings across the world. Head Neck. 2019; 42(3):498-512. PMC: 7079080. DOI: 10.1002/hed.26027. View

Noel C, Stephens R, Su J, Xu W, Krahn M, Monteiro E . Mapping the EORTC QLQ-C30 and QLQ-H&N35, onto EQ-5D-5L and HUI-3 indices in patients with head and neck cancer. Head Neck. 2020; 42(9):2277-2286. DOI: 10.1002/hed.26181. View

10.

Rogers S, Gwanne S, Lowe D, Humphris G, Yueh B, Weymuller Jr E . The addition of mood and anxiety domains to the University of Washington quality of life scale. Head Neck. 2002; 24(6):521-9. DOI: 10.1002/hed.10106. View

11.

Weymuller Jr E, Alsarraf R, Yueh B, Deleyiannis F, Coltrera M . Analysis of the performance characteristics of the University of Washington Quality of Life instrument and its modification (UW-QOL-R). Arch Otolaryngol Head Neck Surg. 2001; 127(5):489-93. DOI: 10.1001/archotol.127.5.489. View

12.

Rogers S, Lowe D . Screening for dysfunction to promote multidisciplinary intervention by using the University of Washington Quality of Life Questionnaire. Arch Otolaryngol Head Neck Surg. 2009; 135(4):369-75. DOI: 10.1001/archoto.2009.7. View

13.

Bjordal K, Hammerlid E, Ahlner-Elmqvist M, de Graeff A, Boysen M, Evensen J . Quality of life in head and neck cancer patients: validation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35. J Clin Oncol. 1999; 17(3):1008-19. DOI: 10.1200/JCO.1999.17.3.1008. View

14.

Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D . Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011; 20(10):1727-36. PMC: 3220807. DOI: 10.1007/s11136-011-9903-x. View

15.

Gritz E, Carmack C, de Moor C, Coscarelli A, Schacherer C, MEYERS E . First year after head and neck cancer: quality of life. J Clin Oncol. 1999; 17(1):352-60. DOI: 10.1200/JCO.1999.17.1.352. View

16.

van Dongen-Leunis A, Redekop W, Uyl-de Groot C . Which Questionnaire Should Be Used to Measure Quality-of-Life Utilities in Patients with Acute Leukemia? An Evaluation of the Validity and Interpretability of the EQ-5D-5L and Preference-Based Questionnaires Derived from the EORTC QLQ-C30. Value Health. 2016; 19(6):834-843. DOI: 10.1016/j.jval.2016.05.008. View

17.

Noel C, Lee D, Kong Q, Xu W, Simpson C, Brown D . Comparison of Health State Utility Measures in Patients With Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg. 2015; 141(8):696-703. DOI: 10.1001/jamaoto.2015.1314. View

18.

Argiris A, Karamouzis M, Raben D, Ferris R . Head and neck cancer. Lancet. 2008; 371(9625):1695-709. PMC: 7720415. DOI: 10.1016/S0140-6736(08)60728-X. View

19.

Singer S, Amdal C, Hammerlid E, Tomaszewska I, Castro Silva J, Mehanna H . International validation of the revised European Organisation for Research and Treatment of Cancer Head and Neck Cancer Module, the EORTC QLQ-HN43: Phase IV. Head Neck. 2019; 41(6):1725-1737. DOI: 10.1002/hed.25609. View

20.

Teckle P, Peacock S, McTaggart-Cowan H, van der Hoek K, Chia S, Melosky B . 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. PMC: 3236471. DOI: 10.1186/1477-7525-9-106. View