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Measurement and Variation in Estimation of Quality of Life Effects of Patients Undergoing Treatment for Papillary Thyroid Carcinoma.

Publication ,  Journal Article
Lubitz, CC; De Gregorio, L; Fingeret, AL; Economopoulos, KP; Termezawi, D; Hassan, M; Parangi, S; Stephen, AE; Halpern, EF; Donelan, K; Swan, JS
Published in: Thyroid : official journal of the American Thyroid Association
February 2017

Thyroid cancer incidence is increasing. The effect of diagnosis and treatment on health-related quality of life (HRQoL) is an essential variable in the absence of a change in life span for the majority of patients. HRQoL instruments, with data useful for between-disease comparisons, are being increasingly used for health policy and outcomes evaluation. Variation exits among the instruments based on the impact of a specific disease. We assessed which of four well-validated, preference-based surveys detect changes in health and clinical intervention in patients diagnosed with papillary thyroid cancer (PTC).Four commonly used HRQoL questionnaires (Short Form-12v2® [SF6D], EuroQol-5D [EQ5D], and Health Utilities Index Mark 2 and 3 [HUI2, HUI3]) were administered to patients with the diagnosis of PTC at three perioperative time points during the first year of treatment. Clinicopathological and treatment course data were assessed for HRQoL impact including complications from surgery, re-operation for persistence/early recurrence, and adjuvant radioactive iodine treatment. We compared standard metrics, including ceiling effect, intraclass correlation coefficient, effect sizes, and quality-adjusted life-years between the four instruments.Of 117 patients, 27% had a preoperative diagnosis of anxiety or depression, 41% had regional lymph node metastases, three had distant metastases and 49% underwent adjuvant radioactive iodine treatment. The ceiling effect (i.e., proportion with a perfect score) was greatest with EQ5D and least with SF6D. Index scores ranged from 0.77 (SF6D) to 0.90 (EQ5D). All scores declined at two weeks postoperatively and returned to pretreatment levels at six months. The SF6D was the only instrument to exceed the conventional minimally important difference between all three time points. Quality-adjusted life-years were as follows: SF6D, 0.79; EQ5D, 0.90; HUI2, 0.88; and HUI3, 0.86.Our results reflect the general good health of PTC patients. The effect on quality of life is primarily related to emotional and social impacts of treatment. The results support the measurement of a similar underlying construct, although variation in detecting changes in health exists between the instruments. Of the instruments assessed, the SF6D is the most responsive to treatment effects and should be utilized in future economic analyses in this patient population.

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Published In

Thyroid : official journal of the American Thyroid Association

DOI

EISSN

1557-9077

ISSN

1050-7256

Publication Date

February 2017

Volume

27

Issue

2

Start / End Page

197 / 206

Related Subject Headings

  • Young Adult
  • Thyroidectomy
  • Thyroid Neoplasms
  • Thyroid Cancer, Papillary
  • Radiotherapy, Adjuvant
  • Quality of Life
  • Patient Reported Outcome Measures
  • Neoplasm Staging
  • Middle Aged
  • Male
 

Citation

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Lubitz, C. C., De Gregorio, L., Fingeret, A. L., Economopoulos, K. P., Termezawi, D., Hassan, M., … Swan, J. S. (2017). Measurement and Variation in Estimation of Quality of Life Effects of Patients Undergoing Treatment for Papillary Thyroid Carcinoma. Thyroid : Official Journal of the American Thyroid Association, 27(2), 197–206. https://doi.org/10.1089/thy.2016.0260
Lubitz, Carrie C., Lucia De Gregorio, Abbey L. Fingeret, Konstantinos P. Economopoulos, Diana Termezawi, Mursal Hassan, Sareh Parangi, et al. “Measurement and Variation in Estimation of Quality of Life Effects of Patients Undergoing Treatment for Papillary Thyroid Carcinoma.Thyroid : Official Journal of the American Thyroid Association 27, no. 2 (February 2017): 197–206. https://doi.org/10.1089/thy.2016.0260.
Lubitz CC, De Gregorio L, Fingeret AL, Economopoulos KP, Termezawi D, Hassan M, et al. Measurement and Variation in Estimation of Quality of Life Effects of Patients Undergoing Treatment for Papillary Thyroid Carcinoma. Thyroid : official journal of the American Thyroid Association. 2017 Feb;27(2):197–206.
Lubitz, Carrie C., et al. “Measurement and Variation in Estimation of Quality of Life Effects of Patients Undergoing Treatment for Papillary Thyroid Carcinoma.Thyroid : Official Journal of the American Thyroid Association, vol. 27, no. 2, Feb. 2017, pp. 197–206. Epmc, doi:10.1089/thy.2016.0260.
Lubitz CC, De Gregorio L, Fingeret AL, Economopoulos KP, Termezawi D, Hassan M, Parangi S, Stephen AE, Halpern EF, Donelan K, Swan JS. Measurement and Variation in Estimation of Quality of Life Effects of Patients Undergoing Treatment for Papillary Thyroid Carcinoma. Thyroid : official journal of the American Thyroid Association. 2017 Feb;27(2):197–206.
Journal cover image

Published In

Thyroid : official journal of the American Thyroid Association

DOI

EISSN

1557-9077

ISSN

1050-7256

Publication Date

February 2017

Volume

27

Issue

2

Start / End Page

197 / 206

Related Subject Headings

  • Young Adult
  • Thyroidectomy
  • Thyroid Neoplasms
  • Thyroid Cancer, Papillary
  • Radiotherapy, Adjuvant
  • Quality of Life
  • Patient Reported Outcome Measures
  • Neoplasm Staging
  • Middle Aged
  • Male