Predicting cancer patients’ quality of life: an analysis of the relationship between utility, treatment regimes and time
Paula Lorgelly, Deputy Director, Office of Health Economics
Monday, 14 March 2016, 12pm to 1pm
RD Lecture Theatre, Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF
Hosted by HERC
Abstract: Many cancer treatments and therapies are considered to be detrimental to a patient's quality of life. This paper seeks to quantify the disutility of specific cancer treatments, including surgery, radiotherapy, chemotherapy and newer targeted treatments, within a large cancer cohort study. Cancer 2015 is a large-scale prospective longitudinal population-based molecular study. It enrols cancer patients who are treatment naïve. All cancer tumour sites, except leukaemia, and all grades of cancer from localised through to metastatic are included. Patients are followed up at three or six month intervals depending on the severity of disease. Patients complete the EORTC-QLQ-C30 and the EQ-5D-3L at baseline and each follow-up. In addition to quality of life measures the cohort database includes clinical and genomic information, patient demographics and treatment intentions. The cohort data have been linked to administrative reimbursement data, which provides detailed information on specific health care resource use (including pharmaceuticals; medical services, which includes general practice visits, pathology tests and radiology; emergency presentations; hospital admissions and day case visits). The analysis utilises date-specific information to make inferences regarding the effect of treatment regimes on quality of life outcomes. Events (that is treatments) that pre-date the quality of life assessment are hypothesised to have an effect on patient reported outcomes. Regression analyses will explore this relationship and understand the importance of different treatments at different proximities in time, while controlling for a range of confounding factors. Preliminary analysis of 1678 patient quality of life assessments (for whom we have 1115 with follow-up responses) suggests that there is an effect of treatment, which varies with both treatment type and proximity, but importantly also patient experience.
Biography: Paula Lorgelly is the Deputy Director at OHE. Prior to joining OHE she was an Associate Professor at Monash University, where she worked on public health / policy related research and supervised PhD students including being CHE PhD Program Director. She was a standing member of the Economic Sub-Committee of the Pharmaceutical Benefits Advisory Committee, and in this capacity provided advice on the effectiveness and cost effectiveness of treatments seeking reimbursement on the Pharmaceutical Benefits Scheme in Australia.
Paula has over 15 years’ experience working in academia in Australia and the United Kingdom. Her research spans three key areas of health economics: the determinants of health, economic evaluation and outcome measurement. Much of her recent work has utilised Cancer 2015, a large genomic cancer cohort study from Victoria, Australia.