Quality of life in cancer
Effects of cancer treatment on quality of life (ETCQoL).
The main aim of the ECTQoL study is to assess the feasibility of collecting data from patients to determine the effects of cancer treatments on patients’ quality of life. This report contains the findings from breast cancer clinics at the two sites: Weston Park Hospital in Sheffield and The Clatterbridge Cancer Centre in the Wirral.
It took five months to recruit 40 patients at one site. Across the two sites, Sheffield and Clatterbridge, 79 breast cancer patients were recruited and were asked to complete the EQ-5D. Oncology consultants filled in a brief questionnaire that provided additional details about the stage of the disease, the therapy and the response.
The mean EQ-5D score for the 79 patients was 0.718 (standard error = 0.027). EQ-5D scores have been calculated by disease stage, line of therapy, response and patient groups.
In most cases the scores have a logical ordering, but the complexity of the disease and treatment means that numerous combinations of therapy, stage, line and response are possible. Consequently the finding is that a large sample size is needed to allow any conclusions to be drawn.
In addition, the study reveals that adverse events and disease response are difficult to classify without additional testing (and funding).
However, whilst the study has identified some difficulties and the need for much larger sample sizes, it was successful in demonstrating the feasibility of collecting utility data from routine practice. The value of any future work, therefore, needs to be considered in the context of alternative sources of utility values.
Whilst a scaled-up version of this study would be complex, it would provide data with considerable advantages; EQ-5D estimates in an England and Wales population of patients in routine care precisely matches NICE’s needs.
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