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Stein RC, Dunn JA, Bartlett JMS, et al.; on behalf of the OPTIMA Trial Management Group. OPTIMA prelim: a randomised feasibility study of personalised care in the treatment of women with early breast cancer. Southampton (UK): NIHR Journals Library; 2016 Feb. (Health Technology Assessment, No. 20.10.)

Cover of OPTIMA prelim: a randomised feasibility study of personalised care in the treatment of women with early breast cancer

OPTIMA prelim: a randomised feasibility study of personalised care in the treatment of women with early breast cancer.

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Appendix 7Health utility literature review

Aim

An extensive literature review was carried out to identify the relevant health-utility values for the OPTIMA study. This search was aimed to update the search performed for Health-state utility values in breast cancer by Peasgood et al. in 2010172 as the information provided in this paper was used primarily as a source of information for health states. The main focus was to update health utility information for breast cancer patients in the following stages:

  • disease free (no chemotherapy) (DFnC)
  • disease free (after chemotherapy) (DFC)
  • local recurrence (LR)
  • distant recurrence (DR).

Methodology

To achieve the aim, the following sources were used.

The Cochrane Library databases (Wiley)

Date range searched: 1992 to July 2013.

Date of search: July 2013.

EconLit (EBSCOhost)

Date range searched: 1886 to July 2013.

Date of search: July 2013.

Cost-Effectiveness Analysis Registry (Tufts)

Date range searched: 2009 to present.

Date of search: July 2013.

EMBASE (Ovid)

Date range searched: 1947 to 10 July 2013.

Date of search: July 2013.

Google Scholar

Date range searched: 2009 to present (July 2013).

Date of search: July 2013.

MEDLINE (Ovid)

Date range searched: 1946 to July 2013.

Date of search: July 2013.

MEDLINE In Process & Other Non-Indexed Citations (Ovid)

Date range searched: inception to 19 July 2013.

Date of search: July 2013.

Web of Science (Science Citation Index Expanded, Conference Proceedings Citation Index)

Date range searched: inception to July 2013.

Date of search: July 2013.

The search strategy main concepts were breast cancer and health utilities. A series of search filters were constructed for each of the electronic databases used in the search. (Full details on this search can be found in Search strategy.) An initial search was run in December 2012, and later updated in July 2013. After removing the duplicates, a first selection was made based on published title. Articles not making any reference to health utility and breast cancer were eliminated. A second sift based on the published abstract and a set of predefined of inclusion and exclusion criteria was performed. Table 40 shows the inclusion and exclusion criteria followed.

TABLE 40

TABLE 40

Inclusion and exclusion criteria for health utility literature review

After the second sift, a more detailed third selection was made by reviewing both the published abstract and the full text. Only those articles following both the inclusion and the exclusion criteria were selected. Articles in which the estimation of the quality of life was based on clinical trials, systematic reviews or via recollection of patient information through questioners were considered. These were subject to a more thorough review. Only those articles with information that most closely resembled the disease stages of interest were selected and the parameters retrieved.

Results

Figure 20 shows the flow diagram of the article retrieval and selection process. The full search results can be found in Results tables.

FIGURE 20. Flow diagram of the search and selection process.

FIGURE 20

Flow diagram of the search and selection process.

The search and selection process identified 10 relevant articles.172,174,198–205 Table 41 shows the author, year, title, country, quality of life or QALY estimation method and published journal. Relevant data were extracted from each of the relevant articles. Based on the information retrieved, two articles were selected as a potential source of health utility data.172,174 Table 42 describes the outcome and the reasons for the selection status.

TABLE 41

TABLE 41

Details of the relevant articles identified from the health utility literature search

TABLE 42

TABLE 42

Data extraction, selected and not selected articles

The two selected articles were chosen because of the type of information provided.172,174 Campbell et al.174 was selected as the primary source of information as its data came from clinical trials performed in the UK and it was published more recently than Peasgood et al.172 The values reported are shown as decrements of a baseline HRQoL quality of life based estimates on the EQ-5D outcome measure (Table 43). A detailed description of each of the 10 selected articles can be found in Tables 47–55.

TABLE 43. Health utility parameters extracted from Campbell et al.

TABLE 43

Health utility parameters extracted from Campbell et al., 2011

Search strategy

Health state utilities for breast cancer: update on previous search done at the School of Health and Related Research in 2009

The Cochrane Library: Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects and NHS Economic Evaluation Database

Search strategy

#1 MeSH descriptor: [Breast Neoplasms] explode all trees

#2 MeSH descriptor: [Neoplasms] explode all trees

#3 MeSH descriptor: [Carcinoma] explode all trees

#4 MeSH descriptor: [Adenocarcinoma] explode all trees

#5 MeSH descriptor: [Breast] explode all trees

#6 #2 or #3 or #4

#7 #5 and #6

#8 (carcinoma near/3 breast*):ti,ab,kw

#9 (neoplas* near/3 breast*):ti,ab,kw

#10 (adenocarcinoma near/3 breast*):ti,ab,kw

#11 (cancer* near/3 breast*):ti,ab,kw

#12 (tumour* near/3 breast*):ti,ab,kw

#13 (tumor* near/3 breast*):ti,ab,kw

#14 (malignan* near/3 breast*):ti,ab,kw

#15 #8 or #9 or #10 or #11 or #12 or #13 or #14

#16 #1 or #7 or #15

#17 (HALex):ti,ab,kw

#18 (euroqol or “euro qol*” or eq5d or “eq 5d*”):ti,ab,kw

#19 qaly*:ti,ab,kw

#20 “quality adjusted life year*”:ti,ab,kw

#21 hye*:ti,ab,kw

#22 “health* year* equivalent*”:ti,ab,kw

#23 “health utilit*”:ti,ab,kw

#24 “hui”:ti,ab,kw

#25 “quality of well being”:ti,ab,kw

#26 “quality of wellbeing”:ti,ab,kw

#27 “qwb”:ti,ab,kw

#28 (qald* or qale* or qtimes*):ti,ab,kw

#29 (“quality adjusted life day*” or “quality adjusted life expectanc*” or “quality adjusted survival*”):ti,ab,kw

#30 MeSH descriptor: [Quality-Adjusted Life Years] explode all trees

#31 “standard gamble*”:ti,ab,kw

#32 “time trade off”:ti,ab,kw

#33 “time tradeoff”:ti,ab,kw

#34 “tto”:ti,ab,kw

#35 “visual analog* scale*”:ti,ab,kw

#36 “discrete choice experiment*”:ti,ab,kw

#37 (sf6 or “sf 6” or “short form 6” or “shortform 6” or “sf six” or “sfsix” or “short form six”):ti,ab,kw

#38 (sf12 or “sf 12” or “short form 12” or “shortform 12” or “sf twelve” or sftwelve or “short form twelve”):ti,ab,kw

#39 (sf6d or “sf 6d” or “short form 6d” or “shortform 6d” or “sf 6 d”):ti,ab,kw

#40 “health state* utilit*”:ti,ab,kw

#41 “health state* value*”:ti,ab,kw

#42 “health state* preference*”:ti,ab,kw

#43 #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 or #39 or #40 or #41 or #42

#44 #16 and #43 from 2009 to 2012 (Word variations have been searched)

Cost-Effectiveness Analysis Registry

Only simple search allowed: used Breast Cancer – c. 50 hits since 2009, test showed hits already found via other searches.

EconLit: via EBSCOhost

Search strategy

S1 AB ( cancer* or neoplasm* or carcinoma* or adenocarcinoma* or malignan* or tumour* or tumor*) OR TI ( cancer* or neoplasm* or carcinoma* or adenocarcinoma* or malignan* or tumour* or tumor* )

S2 AB ( breast or breasts ) OR TI ( breast or breasts )

S3 TI (HALex or euroqol or “euro qol” or eq5d or “eq 5d”) OR AB ( HALex or euroqol or “euro qol” or eq5d or “eq 5d”)

S4 TI (qaly* or “quality adjusted life year*”) OR AB ( qaly* or “quality adjusted life year*”)

S5 TI ( hye* or “health* year* equivalent*”) OR AB ( hye* or “health* year* equivalent*”)

S6 TI (health utilit* or hui) OR AB (health utilit* or hui)

S7 TI ( “quality of well being” or “quality of wellbeing” or qwb ) OR AB ( “quality of well being” or “quality of wellbeing” or qwb )

S8 AB ( “Standard gamble*” or “time trade off” or “time tradeoff” or tto or “visual analog* scale*” or “discrete choice experiment*”) OR TI ( “Standard gamble*” or “time trade off” or “time tradeoff” or tto or “visual analog* scale*” or “discrete choice experiment*”)

S9 AB ( sf6 or “sf 6” or “short form 6” or “shortform 6” or “sf six” or sfsix or “short form six” or “shortform six”) OR TI ( sf6 or “sf 6” or “short form 6” or “shortform 6” or “sf six” or sfsix or “short form six” or “shortform six”)

S10 AB ( sf12 or “sf 12” or “short form 12” or “shortform 12” or “sf twelve” or sftwelve or “short form twelve” or “shortform twelve”) OR TI ( sf12 or “sf 12” or “short form 12” or “shortform 12” or “sf twelve” or sftwelve or “short form twelve” or “shortform twelve”)

S11 AB ( sf6d or “sf 6d” or “short form 6d” or “shortform 6d” or “sf 6 d”) OR TI ( sf6d or “sf 6d” or “short form 6d” or “shortform 6d” or “sf 6 d”)

S12 AB “health state*” OR TI “health state*"

S13 AB ( “health state* utilit*” or “health state* value*” or “health state* preference*”) OR TI ( “health state* utilit*” or “health state* value*” or “health state* preference*”)

S14 S8 OR S9 OR S10 OR S11 OR S12 OR S13

S15 S3 OR S4 OR S5

S16 S6 OR S7

S17 S14 OR S15 OR S16

S18 S1 AND S2 AND S17

EMBASE Classic and EMBASE

Date range searched: 1947 to 10 December 2012.

Search strategy

  1. exp breast tumor/ (332,292)
  2. exp neoplasm/ (3,374,500)
  3. exp breast/ (92,709)
  4. 2 and 3 (57,167)
  5. 1 or 4 (344,576)
  6. (carcinoma adj3 breast$).tw. (34,630)
  7. (neoplas$ adj3 breast$).tw. (2667)
  8. (adenocarcinoma adj3 breast$).tw. (2312)
  9. (cancer$ adj3 breast$).tw. (220,550)
  10. (tumour$ adj3 breast$).tw. (5856)
  11. (tumor$ adj3 breast$).tw. (23,736)
  12. (malignan$ adj3 breast$).tw. (7722)
  13. or/5-12 (372,624)
  14. HALex.mp. [mp=title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, word] (27)
  15. (euroqol or euro qol or eq5d or eq 5d).tw. (5077)
  16. qaly$.tw. (6910)
  17. quality adjusted life year$.tw. (6789)
  18. hye$.tw. (1031)
  19. health$ year$ equivalent$.tw. (41)
  20. health utilit$.tw. (1315)
  21. hui.tw. (799)
  22. quality of well being.tw. (344)
  23. quality of wellbeing.tw. (18)
  24. qwb.tw. (174)
  25. (qald$ or qale$ or qtimes$).tw. (140)
  26. (quality adjusted life day$ or quality adjusted life expectanc$ or quality adjusted survival$).tw. (937)
  27. exp quality adjusted life year/ or short form 12/ (10,976)
  28. standard gamble$.tw. (726)
  29. time trade off.tw. (863)
  30. time tradeoff.tw. (213)
  31. tto.tw. (765)
  32. visual analog$ scale$.tw. (32,527)
  33. discrete choice experiment$.tw. (443)
  34. (sf6 or sf 6 or short form 6 or shortform 6 or sf six or sfsix or short form six).tw. (1457)
  35. (sf12 or sf 12 or short form 12 or shortform 12 or sf twelve or sftwelve or short form twelve).mp. [mp=title, abstract, subject headings, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword] (3523)
  36. (sf6d or sf 6d or short form 6d or shortform 6d or sf 6 d).tw. (528)
  37. health state$ utilit$.tw. (391)
  38. health state$ value$.tw. (144)
  39. health state$ preference$.tw. (95)
  40. or/14-39 (57,626)
  41. letter*.pt,ti. (845,685)
  42. editorial*.pt,ti. (445,924)
  43. comment*.pt,ti. (92,999)
  44. or/41-43 (1,358,961)
  45. 40 and 13 (1249)
  46. 45 not 44 (1213)
  47. (2009* or 2010* or 2011* or 2012*).em. (4,696,303)
  48. 46 and 47 (675)

Google Scholar (advanced screen)

At least one of the following: HUI OR TTO OR SG OR EQ-5D OR SF-6D OR SF-12 OR VAS OR QWB OR HALex OR Euroqol

Exact phrases “breast cancer” AND “health state utilities”

Limits Material since 2009 and in subject areas: Medicine, Pharmacology, and Veterinary Science OR Social Sciences, Arts, and Humanities

Note: special interface used: http://scholar.google.co.uk/advanced_scholar_search?hl=en&as_sdt=0,5

Ovid MEDLINE(R)

Date range searched: 1946 to week 3, November 2012.

Search strategy

  1. exp breast neoplasms/ (202,474)
  2. exp neoplasms/ (2,414,772)
  3. exp carcinoma/ (457,980)
  4. exp adenocarcinoma/ (265,518)
  5. exp breast/ (30,049)
  6. or/2-4 (2,414,772)
  7. 5 and 6 (16472)
  8. (carcinoma adj3 breast$).tw. (25,132)
  9. (neoplas$ adj3 breast$).tw. (2066)
  10. (adenocarcinoma adj3 breast$).tw. (1673)
  11. (cancer$ adj3 breast$).tw. (158,629)
  12. (tumour$ adj3 breast$).tw. (3909)
  13. (tumor$ adj3 breast$).tw. (17,709)
  14. (malignan$ adj3 breast$).tw. (5633)
  15. or/8-14 (184,068)
  16. 1 or 7 or 15 (238,389)
  17. HALex.mp. [mp=title, abstract, original title, name of substance word, subject heading word, protocol supplementary concept, rare disease supplementary concept, unique identifier] (14)
  18. (euroqol or euro qol or eq5d or eq 5d).tw. (2952)
  19. qaly$.tw. (4186)
  20. quality adjusted life year$.tw. (4825)
  21. hye$.tw. (587)
  22. health$ year$ equivalent$.tw. (36)
  23. health utilit$.tw. (873)
  24. hui.tw. (556)
  25. quality of well being.tw. (307)
  26. quality of wellbeing.tw. (5)
  27. qwb.tw. (154)
  28. (qald$ or qale$ or qtimes$).tw. (91)
  29. (quality adjusted life day$ or quality adjusted life expectanc$ or quality adjusted survival$).tw. (707)
  30. quality-adjusted life years/ (6160)
  31. standard gamble$.tw. (595)
  32. time trade off.tw. (640)
  33. 34 tto.tw. (490)
  34. visual analog$ scale$.tw. (22,860)
  35. discrete choice experiment$.tw. (284)
  36. (sf6 or sf 6 or short form 6 or shortform 6 or sf six or sfsix or short form six).tw. (924)
  37. time tradeoff.tw. (192)
  38. (sf12 or sf 12 or short form 12 or shortform 12 or sf twelve or sftwelve or short form twelve).mp. [mp=title, abstract, original title, name of substance word, subject heading word, protocol supplementary concept, rare disease supplementary concept, unique identifier] (2085)
  39. (sf6d or sf 6d or short form 6d or shortform 6d or sf 6 d).tw. (318)
  40. health state$ utilit$.tw. (215)
  41. health state$ value$.tw. (105)
  42. health state$ preference$.tw. (72)
  43. or/17-42 (38,587)
  44. letter.pt. (766,872)
  45. editorial.pt. (310,993)
  46. comment.pt. (493,546)
  47. or/44-46 (1,166,749)
  48. 43 not 47 (37,884)
  49. 16 and 48 (660)
  50. (200903* or 200904* or 200905* or 200906* or 200907*or 200908* or 200909* or 200910* or 200911* or 200912* or 2010* or 2011* or 2012*).ed. (2,851,442)
  51. 49 and 50 (230)

Ovid MEDLINE(R) In-Process and Other Non-Indexed Citations

Date searched: 6 December 2012.

Same as OVID MEDLINE. Eleven results.

Web of Science

Search strategy

# 1 1737 Topic=(HALex or euroqol or “euro qol” or eq5d or “eq 5d”) OR Title=(HALex or euroqol or “euro qol” or eq5d or “eq 5d”)

  Databases = SCI-EXPANDED, SSCI, CPCI-S Timespan =  1 January 2009 – 18 December 2012

  Lemmatization = Off 

# 2 2304 Topic=(qaly* or “quality adjusted life year*”) OR Title=(qaly* or “quality adjusted life year*”)

  Databases = SCI-EXPANDED, SSCI, CPCI-S Timespan =  1 January 2009 – 18 December 2012

  Lemmatization = Off

# 3 893 Topic=(hye* or “health* year* equivalent*”) OR Title=(hye* or “health* year* equivalent*”)

  Databases = SCI-EXPANDED, SSCI, CPCI-S Timespan =  1 January 2009 – 18 December 2012

  Lemmatization = Off

# 4 5853 Topic=(health utilit* or hui) OR Title=(health utilit* or hui)

  Databases = SCI-EXPANDED, SSCI, CPCI-S Timespan =  1 January 2009 – 18 December 2012

  Lemmatization = Off

# 5 57 Topic=(“quality of well being” or “quality of wellbeing” or qwb) OR Title=(“quality of well being” or “quality of wellbeing” or qwb)

  Databases = SCI-EXPANDED, SSCI, CPCI-S Timespan =  1 January 2009 – 18 December 2012

  Lemmatization = Off

# 6 8435 Topic=(“Standard gamble*” or “time trade off” or “time tradeoff” or tto or “visual analog* scale*” or “discrete choice experiment*”) OR Title=(“Standard gamble*” or “time trade off” or “time tradeoff” or tto or “visual analog* scale*” or “discrete choice experiment*”)

Databases = SCI-EXPANDED, SSCI, CPCI-S Timespan =  1 January 2009 – 18 December 2012

  Lemmatization = Off

# 7 1388 Topic=((sf6 or “sf 6” or “short form 6” or “shortform 6” or “sf six” or sfsix or “short form six” or “shortform six”)) OR Title=((sf6 or “sf 6” or “short form 6” or “shortform 6” or “sf six” or sfsix or “short form six” or “shortform six”))

  Databases = SCI-EXPANDED, SSCI, CPCI-S Timespan =  1 January 2009 – 18 December 2012

  Lemmatization = Off

# 8 1009𠀃Topic=((sf12 or “sf 12” or “short form 12” or “shortform 12” or “sf twelve” or sftwelve or “short form twelve” or “shortform twelve”)) OR Title=((sf12 or “sf 12” or “short form 12” or “shortform 12” or “sf twelve” or sftwelve or “short form twelve” or “shortform twelve”))

  Databases = SCI-EXPANDED, SSCI, CPCI-S Timespan =  1 January 2009 – 18 December 2012

  Lemmatization = Off

# 9 235 Topic=((sf6d or “sf 6d” or “short form 6d” or “shortform 6d” or “sf 6 d”)) OR Title=((sf6d or “sf 6d” or “short form 6d” or “shortform 6d” or “sf 6 d”))

  Databases = SCI-EXPANDED, SSCI, CPCI-S Timespan =  1 January 2009 – 18 December 2012

  Lemmatization = Off

# 10 1238 Topic=(“health state*”) OR Title=(“health state*”)

  Databases = SCI-EXPANDED, SSCI, CPCI-S Timespan =  1 January 2009 – 18 December 2012

  Lemmatization = Off

# 11 19,991 #10 OR #9 OR #8 OR #7 OR #6 OR #5 OR #4 OR #3 OR #2 OR #1

  Databases = SCI-EXPANDED, SSCI, CPCI-S Timespan =  1 January 2009 – 18 December 2012

  Lemmatization = Off

# 12 40,529 TI=((cancer* or neoplasm* or carcinoma* or adenocarcinoma* or malignan* or tumour* or tumor* or oncol*) AND (breast or breasts or mammary))

  Databases = SCI-EXPANDED, SSCI, CPCI-S Timespan =  1 January 2009 – 18 December 2012

  Lemmatization = Off

# 13 206 #12 AND #11

  Databases = SCI-EXPANDED, SSCI, CPCI-S Timespan =  1 January 2009 – 18 December 2012

  Lemmatization = Off

Results tables

TABLE 44

Results from first search (date: 19 December 2012)

Database and dates coveredDate searchedConcept search strategyHitsNotes
The Cochrane Library: CENTRAL (Wiley)12 December 2012Breast cancer + health utilities41Three databases searched at once on the same interface (Wiley): but results are exported from each individual database
The Cochrane Library: DARE (Wiley)12 December 2012Breast cancer + health utilities1
The Cochrane Library: NHS Economic Evaluations Database (Wiley)12 December 2012Breast cancer + health utilities59
Cost-Effectiveness Analysis Registry19 December 2012Breast cancer0
EconLit (EBSCOhost)18 December 201213
EMBASE Classic + EMBASE: searched from 1947 to 10 December 201212 December 2012Breast cancer + health utilities
Since 2009		675
Google Scholar19 December 2012153
Ovid MEDLINE(R): searched from 1946 to week 3 November 201211 December 2012Breast cancer + health utilities
Since April 2009		230
Ovid MEDLINE(R) In-Process and Other Non-Indexed Citations: searched 6 December 201211 December 2012Same as above11
Web of Science18 December 2012206

CENTRAL, Cochrane Central Register of Controlled Trials; DARE, Database of Abstracts of Reviews of Effects.

Total hits = 1389.

Deduplicated EndNote (Thomson Reuters, CA, USA) library contains: 901 hits.

TABLE 45

Results from update search (date: 23 July 2013)

Database and dates coveredDate searchedConcept search strategyHitsNotes
The Cochrane Library: CENTRAL (Wiley)23 July 2013Breast cancer + health utilities6Limit of 2012 to 2013 applied
The Cochrane Library: DARE (Wiley)23 July 2013Breast cancer + health utilities0
The Cochrane Library: NHS Economic Evaluations Database (Wiley)23 July 2013Breast cancer + health utilities14
Cost-Effectiveness Analysis Registry23 July 2013Breast cancer0All from 2012 already in library
EconLit – EBSCOhost23 July 2013Breast cancer + health utilities15No date limit applied as EBSCOhost interface working only intermittingly
EMBASE Classic + EMBASE searched from 1947 to 19 July 201322 July 2013Breast cancer + health utilities since 2009143Limit 2012 to 2013 applied
Google Scholar23 December 2012Breast cancer + health utilities2012–201325About 100 results. Chose those where “health state utilities” and “Breast cancer” were prominent
Ovid MEDLINE(R): searched from 1946 to week 2 July 201322 July 2013Breast cancer + health utilities since April 200939
Ovid MEDLINE(R) In-Process and Other Non-Indexed Citations. Date searched 19 July 201322 July 2013Same as above39
Web of Science23 July 201378Limit 2012 to 2013 applied
RePEc23 July 2013Breast cancer3Imported via Google Scholar

CENTRAL, Cochrane Central Register of Controlled Trials; DARE, Database of Abstracts of Reviews of Effects; RePEc, Research Papers in Economics.

Total hits = 362.

Deduplicated EndNote library contains: 169 hits.

Detailed descriptions of the relevant articles

TABLE 46

Detailed description of Campbell et al., 2011174

Authors (year)TitleCountryPopulation
Campbell et al., 2011174The cost-effectiveness of adjuvant chemotherapy for early breast cancer: a comparison of no chemotherapy and first, second, and third generation regimens for patients with differing prognosesUKWomen diagnosed with early breast cancer. Women were divided into those under and those over 50 years of age
QALY estimation methodWomen entering the model were assumed to have HRQoL on average equivalent to women in age-matched UK general population. During chemotherapy, the decrements in HRQoL (using the EQ-5D) were estimated for each regimen based on trial data: ABC, NEAT and TACT. Some estimations were made based on a literature review
Relevant QALY measuresValueSource
Baseline HRQoL based on EQ-5DAge and sex adjusted. UK population norms(Department of Health, 1998)
Decrements in HRQoL from underlying levels (early breast cancer)
Patients not receiving chemotherapy–0.003ABC trial
Patients receiving CMF–0.057NEAT, TACT
Patients receiving E-CMF/FEC60–0.067TACT
Patients receiving FEC-D–0.099ABC trial, NEAT, TACT
Decrements in HRQoL from underlying levels (metastatic breast cancer)
With CMF year 1–0.057ABC trial
With E-CMF/FEC60 year 1–0.038ABC trial
With FEC-D year 1–0.035NEAT, TACT
With local recurrence–0.108 (SE 0.04)TACT trial
With metastatic recurrence–0.303 (SE 0.16)(Hayman et al. 1997;207 Sorensen et al. 2004;208 Stalmeier 2002;209 Suh et al. 2005210)
With contralateral/second primary breast tumour–0.108 (SE 0.04)(Chie et al. 2000;211 Cykert et al. 2004;212 Grann et al. 1999;213 Stalmeier 2002209)
HRQoL final 3 months of life0.159 (SE 0.04)(Sorensen et al. 2004;208 Stalmeier 2002;209 Suh et al. 2005210)
StatusSelected

ABC, Adjuvant Breast Cancer; FEC-D, fluorouracil, epirubicin, cyclophosphamide and docetaxel; HRQoL, health-related quality of life; NEAT, National Epirubicin Adjuvant Trial; TACT, Taxotere as Adjuvant Chemotherapy Trial.

TABLE 47

Detailed description of Shabaruddin et al., 2013198

Authors (year)TitleCountryPopulation
Shabaruddin et al. 2013198A systematic review of utility values for chemotherapy-related adverse eventsNot country-specificArticles that assess chemotherapy treatments that value utility of chemotherapy-related AEs. No discrimination on the type of cancer being treated
QALY estimation methodThe review aim was to identify published articles that have reported utility values for chemotherapy based on different instruments such as standard gamble, visual analogue scale and time trade-off
Relevant QALY measuresValueSource/comments
Nausea and/or vomiting32 values measuring different degrees of nausea and/or vomiting. Expressed in utility decrements or means in comparison with a base stateSeveral. Details can be found in the online appendix 3 of the published paper198
Neuropathy21 values measuring different degrees/types of neuropathy. Expressed in utility decrements or means in comparison with a base state
Neutropenia12 values measuring different degrees/types of neutropenia. Expressed in utility decrements or means in comparison with a base state
Anaemia34 values measuring different degrees of anaemia. Expressed in utility decrements or means in comparison with a base state
AlopeciaSeven values measuring different degrees/types of alopecia. Expressed in utility decrements or means in comparison with a base state
Skin reactionFive values measuring different degrees of skin reactions. Expressed in utility decrements or means in comparison with a base state
Hand–foot syndromeFive values measuring different degrees of hand–foot syndrome. Expressed in utility decrements or means in comparison with a base state
FatigueEight values measuring different degrees of fatigue. Expressed in utility decrements or means in comparison with a base state
Diarrhoea12 values measuring different degrees of diarrhoea. Expressed in utility decrements or means in comparison with a base state
Stomatitis10 values measuring different degrees of stomatitis. Expressed in utility decrements or means in comparison with a base state
Secondary cancersTwo utility measures of secondary malignant neoplasms. Expressed in means in comparison with a base state
PyrexiaThree values measuring different degrees of pyrexia. Expressed in utility decrements or means in comparison with a base state
Cardiovascular diseaseThree values measuring different degrees of cardiovascular disease. Expressed in utility decrements or means in comparison with a base state
OtotoxicityTwo values measuring different degrees of ototoxicity disease. Expressed in utility decrements or means in comparison with a base state
Flu-like syndromeThree values measuring different degrees of flu-like syndrome. Expressed in terms decrements or means in comparison with a base state
OedemaTwo values measuring different degrees of oedema. Expressed in decrements or means in comparison with a base state
Infection-related eventsFive utility measures of infection-related events: pneumonia, infection without hospitalisation and sepsis. Expressed in terms of means in comparison with a base state
Myalgia painTwo values measuring different degrees of myalgia pain. Expressed in means in comparison with a base state
Common adverse events specific to chemotherapy drugSix utility measures of common AEs: toxicity from paclitaxel, docetaxel, and vinorelbine. Expressed in means utility values
Adverse events leading to hospital staySix utility measures of AEs leading to hospitalisation: 1-day inpatient or outpatient stay; hospitalisation from 2 to 5 days. Expressed in utility decrements in comparison with a base state
Non-specific event relating to AEs37 utility measures of non-specific AE related to AEs: low, moderate, high or extremely high AE, low, moderate or high treatment efficacy and poor or positive well-being. Expressed in terms of means utility values
StatusNot selected. Potentially useful for some toxicity adverse events

AE, adverse event.

TABLE 48

Detailed description of Moro-Valdezate et al. 2013199

Authors (year)TitleCountryPopulation
Moro-Valdezate et al., 2013199Evolution of health-related quality of life in breast cancer patients during the first year of follow-upSpainTotal of 364 women after surgery followed for 1 year. Patients on Stage IV were excluded. Participants‘ age ranged from < 50 years to > 70 years, with a mean age of 59 years (most frequent 60–69 years age group). Most of respondents had breast-conserving surgery 61%, radiotherapy 74% and adjuvant chemotherapy 97%
QALY estimation methodObservational, multicentre and prospective study of a cohort of breast cancer patients, assessing HRQoL at 1, 6 and 12 months after surgery using three questionnaires: EuroQol-5D-3L, EORTC QLQ-C30 and EORTC QLQ-BR23
Relevant QALY measuresValueSource/comments
EQ-5D-3L
VAS1 month: 70; 6 months: 70; 1 year: 80321 respondents
Score1 month: 0.81; 6 months: 0.83; 1 year: 0.83336 respondents
EORTC QLQ-C30
Global health status1 month: 66.67; 6 months: 83.33; 1 year: 100
Specific utilities values were also estimated such as physical, role, emotional, cognitive, social functioning, fatigue, pain, nausea/vomiting, dyspnoea, insomnia, appetite loss, constipation, diarrhoea and financial difficulties. Values can be found in the published article197		335 respondents
EORTC QLQ-C30
Body image1 month: 83.33; 6 months: 91.67; 1 year: 100316 respondents
Sexual functioning1 month: 100; 6 months: 86.67; 1 year: 86.67268 respondents
Sexual enjoyment1 month: 66.67; 6 months: 66.67; 1 year: 66.67116 respondents
Future perspective1 month: 33.33; 6 months: 66.67; 1 year: 66.67334 respondents
Systematic therapy side effects1 month: 19.05; 6 months: 14.29; 1 year: 9.52263 respondents
Breast symptoms1 month: 25.00; 6 months: 16.67; 1 year: 16.67326 respondents
Arms symptoms1 month: 22.22; 6 months: 11.11; 1 year: 11.11330 respondents
Upset by hair loss1 month: 33.33; 6 months: 33.33; 1 year: 0.0077 respondents
StatusNot selected. Potentially useful for patients in the disease-free stage

EORTC, European Organization for Research and Treatment of Cancer; EQ-5D-3L, European Quality of Life–5 Dimensions-3 Levels; QLQ-BR23, Quality of Life Questionnaire for Breast Cancer Patients; QLQ-C30, Quality of Life Questionnaire for Cancer Patients for use in International Clinical Trials; VAS, visual analogue scale.

TABLE 49

Detailed description of Shih et al., 2012200

Authors (year)TitleCountryPopulation
Shih et al., 2012200Health state utility assessment for breast cancerSingaporeMen or women over the age of 21 years with at least 2 years’ experience in the oncology department
QALY estimation methodHealth states utilities were obtained from using the VAS and SG methods
Relevant QALY measuresValue
VAS score, RAWaVAS score adjustedaSG score, RAWaSG score, adjustedbSource/comments
No recurrence with no side effect0.8700.8600.6780.673Medical personal survey in an oncology department hospital in Singapore
No recurrence with hip fracture0.5140.4820.5040.353
No recurrence with wrist fracture0.5080.4750.5330.386
No recurrence with spine fracture0.5080.3720.4580.383
No recurrence with vaginal bleeding0.7250.7040.5540.473
No recurrence with deep-vein thrombosis0.5820.5540.5150.357
No recurrence with pulmonary embolism0.3680.3290.4630.395
No recurrence with cataract0.5470.5190.5190.355
No recurrence with ischaemic cerebrovascular events0.2990.2560.4080.289
No recurrence with common side effects musculoskeletal disorder0.6530.6290.5100.371
No recurrence with common side effects hot flushes0.7490.7300.5880.520
No recurrence with endometrial cancer0.5060.4720.5010.365
New contralateral breast cancer0.5000.4680.4430.284
Locoregional recurrence with no side effects0.5250.4910.4730.376
Locoregional recurrence with side effects: general0.5060.4730.4380.336
Distant recurrence with no side effects0.4380.4000.4700.371
Distant recurrence with side effects: chemotherapy0.4040.3650.4580.356
Distant recurrence with side effects: endocrine therapy0.4100.3700.4450.299
Worse health0.033–0.0320.364–0.160
Current health0.9440.9410.9160.973
StatusProbable. Possible problems as values are based on Asian populations

SG, standard gamble; VAS, visual analogue scale.

a

Mean values. Median values can be found in the main text of the article.

b

Median values.

TABLE 50

Detailed description of Matalqah et al., 2011201

Authors (year)TitleCountryPopulation
Matalqah et al., 2011201Health-related quality of life using EQ-5D among breast cancer survivors in comparison with age-matched peers from the general population in the state of Penang, MalaysiaMalaysiaWomen age 20 years or older with confirmed diagnosis of breast cancer compared with a similar group of women without
QALY estimation methodThe EQ-5D instrument in two languages, the English version for Malaysia and the Malay version, was used in face-to-face interviews for valuating and describing the HRQoL
Relevant QALY measuresValueSource/comments
Breast cancer survivorsGeneral population
General EQ–5D0.71 ± 0.250.87 ± 0.16
< 50 years of age0.79 ± 0.220.91 ± 0.13
> 50 years of age0.67 ± 0.260.83 ± 0.17
General EQ VAS72.7 ± 16.974.6 ± 13.2
< 50 years of age75.075.3
> 50 years of age71.174.0
StatusNot selected. Not enough data to populate the model. The values might be used for the disease-free stage

EQ VAS, EuroQol Group instrument visual analogue scale; HRQol, health-related quality of life.

TABLE 51

Detailed description of Farkkila et al., 2011202

Authors (year)TitleCountryPopulation
Farkkila et al., 2011202Health state utilities in breast cancerFinlandPatients diagnosed with breast cancer between the ages of 31 and 90 years in a hospital in Helsinki, Finland
QALY estimation methodA total of 778 BC patients assessed their HRQoL with different quality of life questionnaires. Patients were divided based on disease state
Relevant QALY measuresValueSource/comments
Generic 15DEQ-5D
Baseline before treatment0.896 ± 0.0830.818 ± 0.228
First year remission after diagnosis or recurrence0.901 ± 0.800.860 ± 0.178
Second year or following years after remission0.884 ± 0.1030.843 ± 0.189
Metastatic disease0.825 ± 0.1130.746 ± 0.251
Terminal care0.756 ± 0.1100.514 ± 0.300
StatusProbable. Some health stages might be useful, in particular those after remission, metastatic disease and terminal care

15D, 15-dimensional health-related quality of life measure.

TABLE 52

Detailed description of Delgado-Sanz et al., 2011203

Authors (year)TitleCountryPopulation
Delgado-Sanz et al., 2011203Heath-related quality of life in Spanish breast cancer patients: a systematic reviewSpainSystematic review on existing literature related to health-related quality of life in Spanish population
QALY estimation methodAuthors consulted MEDLINE, PubMed, EMBASE, PsycINFO, Dialnet, and other Spanish and Latin American databases: ‘Índice Bibliográfico Español en ciencias de la Salud’ and ‘Literatura Latinoamericana y del Caribe en ciencias de la Salud’. Two researchers participated in the selection and extraction of the relevant information. Detailed analysis was performed only on those articles reporting Spanish studies
Relevant QALY measuresValueSource/comments
None provided
StatusNot selected. A brief description of the main findings of the selected papers is provided. The authors did not extract utility values from the retrieved articles. It is based only on Spanish population

TABLE 53

Detailed description of Anhoury et al., 2011204

Authors (year)TitleCountryPopulation
Anhoury et al., 2011204Health-related quality of life among women with a history of breast cancer in EuropeUK, Germany, France, Italy and SpainAuthors used data from the 2010 EU (UK, Germany, France, Italy and Spain) National Health and Wellness Survey (NHWS). Data on 579 women reported history of breast cancer. Most were cancer free (76.9%)
QALY estimation methodThe history of women with and without breast cancer was compared and adjusted using demographic characteristics to estimate their utility values
Relevant QALY measuresValueSource/observations
Breast cancer positive (BC+)Breast cancer negative (BC–)
Health states utilities0.690.71Subsequent analyses of just the BC+ group revealed that the primary predictors of health state utilities included age (b = 0.002), employment (b = 0.43), exercise behaviour (b = 0.04), alcohol use (b = 0.04), comorbidity burden (b = –0.01), years diagnosed (b = 0.002), and current cancer stage (b’s = –0.01 to –0.08) (all p values < .05)
StatusNot selected. Only one utility parameter reported. This might be useful if no other information on disease-free patients is found

Note: ‘b’ is the correlation coefficient.

TABLE 54

Detailed description of Peasgood et al., 2010172

Authors, yearTitleCountryPopulation
Peasgood et al., 2010172Health-state utility values in breast cancerSystematic review of the literatureReview focused on health states utility for conditions relating to breast cancer
QALY estimation methodA total of 13 databases were searched for articles in March 2009 using key terms to identify HSUVs related to breast cancer. Articles included contained at least one original, unique utility value. HSUVs were estimated using an existing multiattribute health state descriptive system such as the generic EQ-5D, SF-6D, HUI3 or condition-specific questionnaires. The preferences of patient populations towards their own current health may be measured directly using VAS, SG or TTO. Health utility was divided into six categories: screening-related states; preventive states; adverse events in breast cancer and its treatment; non-specific breast cancer; early breast cancer states; and metastatic breast cancer states. Meta-regression analysis was performed using different models to weight data
Relevant QALY measuresValue (p-value)Source/comments
Early breast cancerMetastatic breast cancer
VariablesModel 1Model 2Model 3VariablesModel 1Model 2Model 3
Surgery (reference: breast-conserving surgery)Treatment type (reference: chemotherapy)
 Mastectomy and reconstruction–0.020 (0.657)–0.029 (0.468)–0.049 (0.096) Hormonal0.165 (0.023)0.234 (0.000)0.213 (0.213)
 Mastectomy only0.041 (0.124)0.003 (0.914)0.017 (0.564) Radiotherapy0.134 (0.001)0.134 (000)0.140 (0.005)
 Surgery type non-specific0.036 (0.264)0.000 (0.990)0.023 (0.601) Treatment not specified–0.105 (0.014)–0.112 (0.008)–0.153 (0.000)
 Surgery non-specific0.038 (0.165)–0.010 (0.790)0.030 (0.508)
Non-surgical treatments (reference: chemotherapy)Response to treatment (reference: stable)
 Radiotherapy0.078 (0.018)0.090 (0.003)0.104 (0.005) Response–0.085 (0.001)0.094 (0.001)0.088 (0.008)
 Chemotherapy with toxicity–0.026 (0.632) Progression–0.126 (0.159)–0.205 (0.000)–0.197 (0.001)
 Hormonal0.077 (0.017)–0.074 (0.013)0.074 (0.085) Terminal–0.352 (0.000)–0.390 (0.000)–0.461 (0.000)
 Treatment non-specific0.083 (0.030)0.087 (0.007)0.078 (0.048) Response not specified–0.187 (0.013)–0.267 (0.000)–0.244 (0.000)
Time period (reference: under 1 year)Side effects (reference: no side effects)
 Peripheral neuropathy–0.085 (0.063)–0.138 (0.004)–0.142 (0.010)
Over 1 year0.100 (0.004)0.038 (0.096)0.058 (0.019) Oedema–0.017 (0.755)–0.011 (0.664)–0.015 (0.519)
Time non-specific0.053 (0.123)0.006 (0.844)0.045 (0.322) Febrile neuropathy–0.192 (0.000)–0.172 (0.002)
 Sepsis–0.228 (0.009)–0.160 (0.001)–0.192 (0.005)
 Hypercalcaemia–0.628 (0.000)–0.672 (0.000)–0.856 (0.000)
 Other side effect0.172 (0.125)0.194 (0.003)0.176 (0.021)
Whose values (reference: community sample)Whose values (reference: community)
 Clinician0.164 (0.017)0.179 (0.010)0.130 (0.080) Clinician0.033 (0.655)0.000 (0.997)0.016 (0.717)
 Patient’s own health0.171 (0.001)0.209 (0.000)0.162 (0.007) Patient’ own health0.240 (0.000)0.243 (0.000)0.209 (0.000)
 Patient’s scenario0.085 (0.119)0.084 (0.108)0.077 (0.186) Patient’ scenario0.156 (0.000)0.126 (0.001)0.138 (0.003)
Valuation method (SG)Valuation method (reference: SG)
 VAS worst–best–0.194 (0.002)–0.187 (0.000)NA VAS worst–best0.045 (0.436)0.066 (0.107)NA
 VAS dead–full health–0.205 (0.000)–0.181 (0.000)NA VAS dead–full health–0.068 (0.155)–0.060 (0.062)NA
 EQ-5D–0.215 (0.000)–0.168 (0.001)–0.112 (0.026) EQ-5D0.107 (0.105)0.160 (0.062)NA
 TTO top not full health0.074 (0.176)0.099 (0.073)NA TTO top not full health–0.0519 (0.470)0.0173 (0.593)0.0464 (0.337)
 TTO different anchor–0.014 (0.550)0.008 (0.785)0.016 (0.587) TTO different anchor0.205 (0.013)0.257 (0.000)NA
 TTO top full health–0.157 (0.021)–0.133 (0.002)–0.110 (0.023) TTO top full health0.087 (0.233)0.143 (0.000)0.173 (0.003)
 HUI3–0.248 (0.000)–0.188 (0.001)–0.132 (0.023) Constant (base scenario)0.614 (0.000)0.640 (0.000)0.632 (0.000)
 Constant (base scenario)0.725 (0.000)0.663 (0.000)0.648 (0.000)

HSUV, health state utility value; HUI, health utility index; NA, not applicable; SG, standard gamble; TTO, time trade-off; VAS, visual analogue scale.

TABLE 55

Detailed description of Prescott et al., 2007205

Authors (year)TitleCountryPopulation
Prescott et al., 2007205A randomised controlled trial of postoperative radiotherapy following breast-conserving surgery in a minimum-risk older population. The PRIME trialUKPatients ≥ 65 years of age, provided that their cancer was considered to be at low risk of local recurrence, were suitable for breast-conserving surgery, were receiving endocrine therapy and were able and willing to give informed consent
QALY estimation methodThe objective of the PRIME trial was to determine whether or not adjuvant breast irradiation significantly changes the QoL of older women with breast cancer treated with breast-conserving surgery and adjuvant endocrine therapy. The QLC-C30 and QLQ-BR23 were used to complement the EORTC QLQ-C30 scale QoL measures
Relevant QALY measuresValueSource/comments
RadiotherapyNo radiotherapy
EQ-5D
Baseline0.77 (0.73 to 0.80)0.74 (0.70 to 0.77)
 3.5 months0.78 (0.74 to 0.81)0.76 (0.73 to 0.79)
 9 months0.76 (0.71 to 0.81)0.72 (0.68 to 0.76)
 15 months0.74 (0.70 to 0.78)0.73 (0.69 to 0.77)
Unadjusted QALYs0.95 (0.90 to 0.99)0.92 (0.88 to 0.95)

EORTC, European Organization for Research and Treatment of Cancer; QLQ-BR23, Quality of Life Questionnaire for Breast Cancer Patients; QLQ-C30, Quality of Life Questionnaire for Cancer Patients for Use in International Clinical Trials; QoL, quality of life.

Copyright © Queen’s Printer and Controller of HMSO 2016. This work was produced by Stein et al. under the terms of a commissioning contract issued by the Secretary of State for Health. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.

Included under terms of UK Non-commercial Government License.

Bookshelf ID: NBK343769
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