Determination of quality of life-related utilities for health states relevant to ovarian cancer diagnosis and treatment.
OBJECTIVE
(1) To define a set of health state descriptions related to screening, diagnosis, prognosis, and toxicities relevant to ovarian cancer; (2) To derive a set of quality of life-related utilities to be used for cost-effectiveness analyses.


METHODS
A comprehensive list of health states was developed to represent the experiences of diagnostic testing for ovarian cancer, natural history of ovarian cancer (e.g., newly diagnosed early stage ovarian cancer, recurrent progressive ovarian cancer) and the most common chemotherapy-related toxicities (e.g. alopecia, peripheral neuropathy, pain, neutropenia, fatigue). Valuation of each health state was obtained through individual interviews of 13 ovarian cancer patients and 37 female members of the general public. Interviews employed visual analog score (VAS) and time trade off (TTO) methods of health state valuation.


RESULTS
Mean TTO-derived utilities were higher than VAS-derived utilities by 0.118 U (p<0.0001). Mean VAS-derived utilities for screening tests were 0.83 and 0.81 for true negative blood test and ultrasound; 0.79 and 0.78 for false negative blood test and ultrasound, respectively. Patients and volunteers generally agreed in their preference ranking of chemotherapy-associated states, with lowest rankings being given to febrile neutropenia, grades 3-4 fatigue, and grades 3-4 nausea/vomiting. For 55% of chemotherapy-associated health states, the average utility assigned was higher for patients than for volunteers.


CONCLUSIONS
This study establishes societal preferences for a number of health states related to screening, diagnosis and treatment of ovarian cancer that can be used for assessing the cost-effectiveness of different ovarian cancer screening and treatment regimens.
Havrilesky
Laura J
LJ
Division of Gynecologic Oncology, Duke University Medical Center, Durham NC 27710, USA. havri001@mc.duke.edu
Broadwater
Gloria
G
Davis
Debra M
DM
Nolte
Kimberly C
KC
Barnett
J Cory
JC
Myers
Evan R
ER
Kulasingam
Shalini
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005260:Female; D017144:Focus Groups; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics / Q000473:pathology; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000191:economics / Q000473:pathology; D011788:Quality of Life; D012720:Severity of Illness Index