Quality Of Life In Patients With Thyroid Papillary Carcinoma And Study On Health Utility Mapping Model

Research background and purpose:1.To explore the quality of life of patients with papillary thyroid carcinoma(PTC).2.The Five-level Euro Qol Five-dimensional Questionnaire(EQ-5D-5L)was used to measure the health utility values of patients with PTC and to discuss the factors affecting them.3.Multiple mapping models were developed and the best model was selected from them for obtaining health utility parameters for PTC patients when preference-based health utility measures were not available.Materials and Methods:Using a cross-sectional study method,1100 patients with PTC in a tertiary oncology hospital in Chengdu,Sichuan Province from May to December 2021 were used as the study population and questionnaires were administered to them.The investigation contents mainly included the general demographic data of patients,clinical treatment information,the EQ-5D-5L scale,the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30(EORTC QLQ-C3)and European Organization for Research and Treatment of Cancer head and neck cancer quality questionnaire(EORTC QLQ-H&N35)、Thyroid Cancer-specific Quality of Life Questionnaire,(THYCA-Qo L).The Chinese health utility score system was used to calculate the EQ-5D-5L health utility values and the Tobit model was used to analyse the factors influencing the health utility values.The mapping model was established by direct mapping(Ordinary Least Squares,Tobit model,Beta mixture regression model)and indirect mapping algorithm(Ordered Probit model).The mean absolute error,root mean square error,Akakike information criterion,Bayesian information criterion,absolute error,and Intraclass correlation coefficient were used to evaluate the performance of the model.The stability of the model was tested by fivefold cross-validation and random sample validation,and the optimal model was selected.All data were analyzed using STATA 17.0 statistical software.Result:1.The mean health utility value of the EQ-5D-5L scale is 0.870 ± 0.094.The mean EQ-VAS scale score was 76.5 ± 13.0.The mean EORTC QLQ-C30 scale overall health status score was 73.2381 ± 19.3939.2.Univariate analysis showed statistically significant differences(P < 0.05)between patients with different gender,occupation,marital status,type of health insurance,monthly household income,whether they were accompanied by a family member,whether they were currently hospitalised,their current mode of treatment,and their current disease status.The results of the multifactorial analysis showed that gender,occupation,and whether or not they were currently hospitalised were statistically significant(P < 0.05).4.The correlation coefficients between total score of the EQ-5D-5L and EORTC QLQ-C30 and H&N35 ranged from-0.5706 to 0.5976,and the correlation coefficients between total score of the EQ-5D-5L and THYCA-Qo L ranged from-0.4040 to 0.1065.5.Four econometric methods,namely Ordinary Least Squares,Tobit model,Beta mixture regression model,and Ordered Probit model,were used to build the mapping models,and the optimal model filtered out was Beta mixture regression model(BETAMIX).Among the models with EORTC QLQ-C30,QLQ-H&N35 mapped onto EQ-5D-5L,BETAMIX M3a(with truncation point)was the best model.BETAMIX M2(without truncation point)was the optimal model among the models with THYCA-Qo L mapped to EQ-5D-5L.Conclusion:1.In this study,the quality of life and health utility values of PTC patients were obtained by the EQ-5D-5L,EORTC QLQ-C30,QLQ-H&N35 and THYCA-Qo L scales,and the overall quality of life of PTC patients was better.2.Gender,occupation,marital status,type of health insurance,family monthly income,whether accompanied by family members,whether currently hospitalized,current treatment,and current disease status are the main factors affecting the quality of life and health utility value of PTC patients.3.The mapping algorithm reported(BETAMIX)in this study can be used to map the EORTC QLQ-C30,QLQ-H&N35 and THYCA-Qo L scales into EQ-5D-5L,which can provide reference value for future medical and health decisions.