1. Utility Scores for Risk-Reducing Mastectomy and Risk-Reducing Salpingo-Oophorectomy: Mapping to EQ-5D.
- Author
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Oxley, Samuel G., Wei, Xia, Sideris, Michail, Blyuss, Oleg, Kalra, Ashwin, Sia, Jacqueline J. Y., Ganesan, Subhasheenee, Fierheller, Caitlin T., Sun, Li, Sadique, Zia, Jin, Haomiao, Manchanda, Ranjit, and Legood, Rosa
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SALPINGO-oophorectomy , *HEALTH status indicators , *DATA analysis , *BIBLIOGRAPHIC databases , *RESEARCH funding , *OVARIAN tumors , *QUESTIONNAIRES , *QUALITY of life , *MASTECTOMY , *CONFIDENCE intervals , *ALGORITHMS ,BREAST tumor prevention - Abstract
Simple Summary: Surgery to prevent breast and ovarian cancer is very effective, but there is limited research into the quality of life afterwards, particularly with reference to quality-of-life scores known as utility scores. These are important for patients at increased cancer risk who are considering surgery and are essential for health-economic evaluations. This article used data from a systematic review of different quality-of-life questionnaires given to patients following these surgeries. We converted these data into utility scores, as recommended by the national guidelines. This shows that surgery to prevent breast cancer is associated with a long-term utility score of 0.92 and surgery to prevent ovarian cancer has a score of 0.97, indicating a mild–moderate impact. These are the first utility scores sourced from patients who have undergone these procedures, and they are important to doctors counselling patients about cancer prevention options and to researchers. Higher-quality studies are still needed, using the recommended quality-of-life questionnaire (EQ-5D). Background: Risk-reducing mastectomy (RRM) and risk-reducing salpingo-oophorectomy (RRSO) are the most effective breast and ovarian cancer preventive interventions. EQ-5D is the recommended tool to assess the quality of life and determine health-related utility scores (HRUSs), yet there are no published EQ-5D HRUSs after these procedures. These are essential for clinicians counselling patients and for health-economic evaluations. Methods: We used aggregate data from our published systematic review and converted SF-36/SF-12 summary scores to EQ-5D HRUSs using a published mapping algorithm. Study control arm or age-matched country-specific reference values provided comparison. Random-effects meta-analysis provided adjusted disutilities and utility scores. Subgroup analyses included long-term vs. short-term follow-up. Results: Four studies (209 patients) reported RRM outcomes using SF-36, and five studies (742 patients) reported RRSO outcomes using SF-12/SF-36. RRM is associated with a long-term (>2 years) disutility of −0.08 (95% CI −0.11, −0.04) (I2 31.4%) and a utility of 0.92 (95% CI 0.88, 0.95) (I2 31.4%). RRSO is associated with a long-term (>1 year) disutility of −0.03 (95% CI −0.05, 0.00) (I2 17.2%) and a utility of 0.97 (95% CI 0.94, 0.99) (I2 34.0%). Conclusions: We present the first HRUSs sourced from patients following RRM and RRSO. There is a need for high-quality prospective studies to characterise quality of life at different timepoints. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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