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정창욱
정창욱 (Chang Wook Jeong) 저자 이메일 보기
서울대학교병원, University of California, San Francisco
 
조회 352  인쇄하기 주소복사 트위터 공유 페이스북 공유 
Robust Health Utility Assessment Among Long-term Survivors of Prostate Cancer: Results from the Cancer of the Prostate Strategic Urologic Research Endeavor Registry
열기 Authors and Affiliations

Abstract

Background
Valid health utility values are essential for comparative effectiveness analyses. However, subjective utilities in long-term survivors of prostate cancer (PCa) with various oncological and functional outcomes have not been well described.

Objective
To quantify utilities in long-term survivors of PCa using the standard gamble method, generally regarded as the approach best grounded in economic theory.

Design, setting, and participants
We performed a cross-sectional study nested within a prospective cohort—Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE). Overall, 1884 (59.7%) of 3155 active participants across all disease states returned the questionnaire.

Intervention
Various primary treatments for PCa.

Outcome measurements and statistical analysis
Utility values for PCa health, sexual function, urinary function, bowel function, and overall health were measured, based on patients’ conditions at the time of the survey. Bias correction methods were employed.

Results and limitations
After exclusion of incomplete or disqualified data, 1740 (92.3% of responding) patients were included in the final analysis. The mean age was 73.1 ± 8.2 yr at a median of 9 yr (interquartile range: 6–11) since diagnosis. Mean utilities for PCa health and overall health were 0.934 ± 0.120 and 0.960 ± 0.100, respectively. After bias correction by probability weighting function, utilities were 0.866 ± 0.154 and 0.897 ± 0.142, and by mixed model correction, 0.845 ± 0.186 and 0.884 ± 0.176, respectively. Measured utilities were similarly high for specific functional outcomes, even with bias corrections. Survivorship bias and skewed proportion of disease status due to natural history of PCa were potential limitations.

Conclusions
Standard gamble-based utilities in long-term survivors of PCa were much higher than those determined previously. The results indicate substantial human resilience: most PCa patients adapt to their health status over time even if they experience incomplete functional recovery and would not take risk in pursuit of better quality of life.

Patient summary
We elicited health utilities (measures of quality of life) among long-term survivors of prostate cancer using the most robust method. These were much higher than previously reported values that were based on theoretical scenarios or indirect methods. Long-term survivors of prostate cancer may adapt well to their health conditions over time even if they experience disease-specific or functional problems.

Keywords : Prostate cancer; Utility; Quality of life; Cohort study; Cancer survivors

논문정보
- 형식: Research article
- 게재일: 2019년 07월 (BRIC 등록일 2019-08-01)
- 연구진: 국내(교신)+국외 연구진태극기
- 분야: Medicine
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김동원
발표: 김동원 (Dongseo University)
일자: 2019년 9월 27일 (금) 오전 10시 (한국시간)
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