Utilities of metastatic breast cancer patients treated with taxanes compared to utilities of oncology nurses

Access full-text files

Date

2001-08

Authors

Hauser, Robert Sean, 1972-

Journal Title

Journal ISSN

Volume Title

Publisher

Abstract

Utility analyses are rapidly becoming a standard measure for many oncology studies. A recent publication in JCO reported utility scores obtained from 40 published studies and presented the results in a league table format (Earl et al. J Clin Oncl, 2000;18(18): 3302- 2217). The majority of the studies utilized healthcare professionals (nurses and physicians) as proxies for the patients with the disease state studied. The main objective of this study was to determine if there is a significant difference between utility scores obtained from metastatic breast cancer patients and oncology nurses. Using eight Markov modeled health states describing metastatic breast cancer; the standard gamble procedure was utilized to obtain utility scores from 45 patients and 57 oncology nurses. Utility values are measured on a scale between 0.0 and 1.0. Independent t-tests were used to test for differences between groups using an alpha level of 0.05. Significant differences (all p values <0.001) were found on all eight modeled health states. Patients reported a utility score of 0.84 (sd=0.11) compared to 0.71 (sd=0.22) reported by nurses on the “Partial Response (PR)” health state. Patients reported a utility score of 0.78 (sd=0.17) compared to 0.63 (sd=0.24) reported by nurses on the “PR with Severe Peripheral Edema” health state. Patients reported a utility score of 0.76 (sd=0.13) compared to 0.56 (sd=0.24) reported by nurses on the “PR with Severe Peripheral Neuropathy” health state. Patients reported a utility score of 0.73 (sd=0.16) compared to 0.59 (sd=0.22) reported by nurses on the “Before Second Line Treatment Begins” health state. Patients reported a utility score of 0.72 (sd=0.15) compared to 0.54 (sd=0.22) reported by nurses on the “Stable Disease” health state. Patients reported a utility score of 0.63 (sd=0.18) compared to 0.45 (sd=0.25) reported by nurses on the “Late Progressive Disease” health state. Patients reported a utility score of 0.40 (sd=0.26) compared to 0.19 (sd=0.21) reported by nurses on the “Terminal Disease” health state. Patients reported a utility score of 0.39 (sd=0.25) compared to 0.20 (sd=0.23) reported by nurses on the “Sepsis” health state. These results suggest that patients have a higher utility for health than nurses perceive the patients as having. Furthermore, these results may show that when performing cost-utility analysis, that a patient utility measure should be incorporated into the decision model rather than a proxy score obtained by a healthcare professional. Further studies should compare patients in other disease states with healthcare professionals to see if these results hold true for other disease states. These results also lead to the question of who’s utility values should we use for cost-utility analysis in oncology.

Description

text

LCSH Subject Headings

Citation