A Prospective Cohort Study Defining Utilities Using Time Trade-Offs and the Euroqol-5D to Assess the Impact of Cancer-Related Lymphedema
Identifieur interne : 005E98 ( Main/Exploration ); précédent : 005E97; suivant : 005E99A Prospective Cohort Study Defining Utilities Using Time Trade-Offs and the Euroqol-5D to Assess the Impact of Cancer-Related Lymphedema
Auteurs : Andrea L. Cheville [États-Unis] ; Mously Almoza [États-Unis] ; Janice N. Courmier [États-Unis] ; Jeffrey R. Basford [États-Unis]Source :
- Cancer [ 0008-543X ] ; 2010.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Analyse coût-bénéfice, Années de vie ajustées sur la qualité, Femelle, Humains, Indice de masse corporelle, Lymphoedème (), Lymphoedème (diagnostic), Lymphoedème (psychologie), Mâle, Profil d'impact de la maladie, Qualité de vie, Sujet âgé, Tumeurs (), Études prospectives, Évaluation de résultat (soins).
- MESH :
- diagnostic : Lymphoedème.
- psychologie : Lymphoedème.
- Pascal (Inist)
- Adulte, Adulte d'âge moyen, Analyse coût-bénéfice, Années de vie ajustées sur la qualité, Cancer, Femelle, Humains, Indice de masse corporelle, Lymphoedème, Mâle, Profil d'impact de la maladie, Prospective, Etude cohorte, Qualité de vie, Sujet âgé, Tumeur maligne, Santé, Qualité de vie, Lymphoedème, Coût, Economie santé, Indice masse corporelle, Aspect économique, Cancérologie, Tumeurs, Études prospectives, Évaluation de résultat (soins).
- Wicri :
- topic : Cancer, Prospective.
English descriptors
- KwdEn :
- Adult, Aged, Body Mass Index, Body mass index, Cancer, Cancerology, Cohort study, Cost-Benefit Analysis, Costs, Economic aspect, Female, Health, Health economy, Humans, Lymphedema, Lymphedema (complications), Lymphedema (diagnosis), Lymphedema (psychology), Male, Malignant tumor, Middle Aged, Neoplasms (complications), Outcome Assessment (Health Care), Prospective, Prospective Studies, Quality of Life, Quality of life, Quality-Adjusted Life Years, Sickness Impact Profile.
- MESH :
- complications : Lymphedema, Neoplasms.
- diagnosis : Lymphedema.
- psychology : Lymphedema.
- Adult, Aged, Body Mass Index, Cost-Benefit Analysis, Female, Humans, Male, Middle Aged, Outcome Assessment (Health Care), Prospective Studies, Quality of Life, Quality-Adjusted Life Years, Sickness Impact Profile.
Abstract
BACKGROUND: The devastating impact of lymphedema on cancer survivors' quality of life has prompted consideration of several changes in medical and surgical care. Unfortunately, our understanding of the benefits gained from these approaches relative to their cost remains limited. This study was designed to estimate utilities for lymphedema and characterize how utilities differ between subgroups defined by lymphedema etiology and distribution. METHODS: A consecutive sample of 236 subjects with lymphedema seen at a lymphedema clinic completed both a time trade-off (TTO) exercise and the Euroqol 5D. Responses were adjusted in multivariate regression models for demographic factors, comorbidities, and lymphedema severity/location. RESULTS: Most participants (167 of 236, 71%) had lymphedema as a consequence of cancer treatment; 123 with breast cancer and upper extremity involvement. Mean TTO utility estimates were consistently higher than Euroqol 5D estimates. Unadjusted TTO (0.85; standard deviation [SD], 0.21) and Euroqol 5D (0.76; SD, 0.18) scores diminished with increasing lymphedema stage and patient body mass index (BMI). Adjusted utility scores were lowest in patients with cancer-related lower extremity lymphedema (TTO=0.82; SD, 0.04 and Euroqol 5D=0.80; SD, 0.03). Breast cancer patients also had lower adjusted Euroqol 5D scores (0.80; SD, 0.02). CONCLUSIONS: Lymphedema-associated utilities are in the range of 0.80. Lower utilities are observed for patients with higher lymphedema stages, elevated BMI, and cancer-related lymphedema. Greater expenditures for the prevention and treatment of cancer-related lymphedema are warranted.
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Cheville</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Physical Medicine and Rehabilitation, Mayo Clinic</s1><s2>Rochester, Minnesota</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Almoza, Mously" sort="Almoza, Mously" uniqKey="Almoza M" first="Mously" last="Almoza">Mously Almoza</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Physical Medicine and Rehabilitation, New York Presbyterian Hospital Columbia and Cornell</s1><s2>New York, New York</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Courmier, Janice N" sort="Courmier, Janice N" uniqKey="Courmier J" first="Janice N." last="Courmier">Janice N. Courmier</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Basford, Jeffrey R" sort="Basford, Jeffrey R" uniqKey="Basford J" first="Jeffrey R." last="Basford">Jeffrey R. Basford</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Physical Medicine and Rehabilitation, Mayo Clinic</s1><s2>Rochester, Minnesota</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Minnesota</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Cancer</title><title level="j" type="abbreviated">Cancer</title><idno type="ISSN">0008-543X</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Cancer</title><title level="j" type="abbreviated">Cancer</title><idno type="ISSN">0008-543X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Body Mass Index</term><term>Body mass index</term><term>Cancer</term><term>Cancerology</term><term>Cohort study</term><term>Cost-Benefit Analysis</term><term>Costs</term><term>Economic aspect</term><term>Female</term><term>Health</term><term>Health economy</term><term>Humans</term><term>Lymphedema</term><term>Lymphedema (complications)</term><term>Lymphedema (diagnosis)</term><term>Lymphedema (psychology)</term><term>Male</term><term>Malignant tumor</term><term>Middle Aged</term><term>Neoplasms (complications)</term><term>Outcome Assessment (Health Care)</term><term>Prospective</term><term>Prospective Studies</term><term>Quality of Life</term><term>Quality of life</term><term>Quality-Adjusted Life Years</term><term>Sickness Impact Profile</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse coût-bénéfice</term><term>Années de vie ajustées sur la qualité</term><term>Femelle</term><term>Humains</term><term>Indice de masse corporelle</term><term>Lymphoedème ()</term><term>Lymphoedème (diagnostic)</term><term>Lymphoedème (psychologie)</term><term>Mâle</term><term>Profil d'impact de la maladie</term><term>Qualité de vie</term><term>Sujet âgé</term><term>Tumeurs ()</term><term>Études prospectives</term><term>Évaluation de résultat (soins)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Lymphedema</term><term>Neoplasms</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Body Mass Index</term><term>Cost-Benefit Analysis</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Outcome Assessment (Health Care)</term><term>Prospective Studies</term><term>Quality of Life</term><term>Quality-Adjusted Life Years</term><term>Sickness Impact Profile</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse coût-bénéfice</term><term>Années de vie ajustées sur la qualité</term><term>Cancer</term><term>Femelle</term><term>Humains</term><term>Indice de masse corporelle</term><term>Lymphoedème</term><term>Mâle</term><term>Profil d'impact de la maladie</term><term>Prospective</term><term>Etude cohorte</term><term>Qualité de vie</term><term>Sujet âgé</term><term>Tumeur maligne</term><term>Santé</term><term>Qualité de vie</term><term>Lymphoedème</term><term>Coût</term><term>Economie santé</term><term>Indice masse corporelle</term><term>Aspect économique</term><term>Cancérologie</term><term>Tumeurs</term><term>Études prospectives</term><term>Évaluation de résultat (soins)</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Cancer</term><term>Prospective</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">BACKGROUND: The devastating impact of lymphedema on cancer survivors' quality of life has prompted consideration of several changes in medical and surgical care. Unfortunately, our understanding of the benefits gained from these approaches relative to their cost remains limited. This study was designed to estimate utilities for lymphedema and characterize how utilities differ between subgroups defined by lymphedema etiology and distribution. METHODS: A consecutive sample of 236 subjects with lymphedema seen at a lymphedema clinic completed both a time trade-off (TTO) exercise and the Euroqol 5D. Responses were adjusted in multivariate regression models for demographic factors, comorbidities, and lymphedema severity/location. RESULTS: Most participants (167 of 236, 71%) had lymphedema as a consequence of cancer treatment; 123 with breast cancer and upper extremity involvement. Mean TTO utility estimates were consistently higher than Euroqol 5D estimates. Unadjusted TTO (0.85; standard deviation [SD], 0.21) and Euroqol 5D (0.76; SD, 0.18) scores diminished with increasing lymphedema stage and patient body mass index (BMI). Adjusted utility scores were lowest in patients with cancer-related lower extremity lymphedema (TTO=0.82; SD, 0.04 and Euroqol 5D=0.80; SD, 0.03). Breast cancer patients also had lower adjusted Euroqol 5D scores (0.80; SD, 0.02). CONCLUSIONS: Lymphedema-associated utilities are in the range of 0.80. Lower utilities are observed for patients with higher lymphedema stages, elevated BMI, and cancer-related lymphedema. Greater expenditures for the prevention and treatment of cancer-related lymphedema are warranted.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Minnesota</li><li>Texas</li><li>État de New York</li></region></list><tree><country name="États-Unis"><region name="Minnesota"><name sortKey="Cheville, Andrea L" sort="Cheville, Andrea L" uniqKey="Cheville A" first="Andrea L." last="Cheville">Andrea L. Cheville</name></region><name sortKey="Almoza, Mously" sort="Almoza, Mously" uniqKey="Almoza M" first="Mously" last="Almoza">Mously Almoza</name><name sortKey="Basford, Jeffrey R" sort="Basford, Jeffrey R" uniqKey="Basford J" first="Jeffrey R." last="Basford">Jeffrey R. Basford</name><name sortKey="Courmier, Janice N" sort="Courmier, Janice N" uniqKey="Courmier J" first="Janice N." last="Courmier">Janice N. Courmier</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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