Peasgood, T and Ward, S and Brazier, J (2010): A review and meta-analysis of health state utility values in breast cancer.
Download (641kB) | Preview
Background and purpose Health-related quality of life is an important issue in the treatment of breast cancer, and health-state utilities are essential for cost-utility analysis. This paper identifies and summarises published utilities for common health-related quality of life outcomes for breast cancer, considers the impact of variation in study designs used, and pools utilities for some breast cancer health states.
Data sources and study selection Thirteen databases were searched using key words relating to breast cancer and utility measurement. Articles were included if specified empirical methods for deriving utility values were used and details of the method, including number of respondents, were given. Articles were excluded if values were based on expert opinion or were not unique.
Data extraction and synthesis The authors identified 49 articles which met their inclusion criteria, providing 476 unique utilities for breast cancer health states. Where possible, mean utility estimates were pooled using ordinary least squares, with utilities clustered within study group and weighted by both number of respondents and inverse of the variance of each utility. Regressions included controls for disease state, utility assessment method and other features of study design.
Results Utility values found in the review are summarised for six categories: 1) screening related states, 2) preventative states, 3) adverse events in breast cancer and its treatment, 4) non-specific breast cancer, 5) metastatic breast cancer states and 6) early breast cancer states. Pooled utility values for the latter two categories are estimated, showing base state utility values of between 0.668 and 0.782 for early breast cancer and 0.721 and 0.806 metastatic breast cancer depending upon which model is used. Utilities were found to vary significantly by valuation method, and who conducted the valuation.
Conclusions A large number of utility values for breast cancer is available in the literature; the states which these refer to are often complex, making pooling of values problematic.
The impacts upon quality of life and length of life are both important to the assessment of treatments for breast cancer. These outcomes can be combined using the health-related quality of life measure of a QALY (quality adjusted life year). QALYs may be thought of as a "utility" score, since they represent people’s preferences towards a particular health state, where 0 represents dead and 1 represents full health. Being able to locate any health state on a 0 to 1 scale allows an estimation of the number of QALYs a treatment brings, and, subsequently, a comparison of the cost per QALY benefit across different treatments. The cost per QALY of competing treatments can be a useful input into medical decision making and priority setting.
Cost per QALY for breast cancer treatments may be derived from primary research, or from modelling interventions at different disease stages. Where modelling is conducted, modellers require a "utility" value for each possible health state: e.g. newly diagnosed breast cancer, currently undergoing chemotherapy, and experiencing some toxicity from treatment. This allows them to map the profile of hypothetical patients as they pass through different scenarios and understand the QALYs gained from alternative treatments.
There are numerous studies which have investigated the utility values associated with breast cancer; unfortunately, they show considerable variation in results. For example, values for metastatic breast cancer (MBC) range from -0.52 to 0.882. What explains this variation? First, there are a number of different health states which an individual with MBC may experience relating to different treatment regimes, different responses to treatment and different possible side-effects of treatment. Secondly, there are different methods for generating utility scores, which can generate different values for the exact same health state.
This study aims to systematically review health state utility values (HSUVs) for breast cancer (early and metastatic) in order to identify all breast cancer HSUVs in the current literature. It then seeks to provide a pooled estimate of HSUVs for each identifiable health state within breast cancer. It also seeks to understand the impact of different methodological techniques on the estimates of utility scores for breast cancer. This will generate a list of HSUVs that can be used in future economic evaluations, and offer greater understanding of how representative individual utility estimates are for breast cancer states.
|Item Type:||MPRA Paper|
|Original Title:||A review and meta-analysis of health state utility values in breast cancer|
|Keywords:||breast cancer; utility assessment; health-state utility; systematic review; quality of life; meta-analysis; preferences|
|Subjects:||I - Health, Education, and Welfare > I3 - Welfare and Poverty > I31 - General Welfare
I - Health, Education, and Welfare > I1 - Health > I19 - Other
|Depositing User:||Sarah McEvoy|
|Date Deposited:||30. Mar 2011 19:07|
|Last Modified:||13. Feb 2013 17:21|
National Institute for Health and Clinical Excellence (2004). Guide to the Methods of Technology Appraisal. London: NICE.
Brazier J, Ratcliffe J, Salomon J, Tsuchiya A (2007). Measuring and valuing health benefits for economic valuation. Oxford: Oxford University Press.
Dolan P (1997). Modelling valuations for EuroQol health states. Med Care 35(11):1095-108.
Brazier JE, Roberts J, Deverill M (2002). The estimation of a preference-based measure of health from the SF-36. Journal of Health Economics 21:271-92.
Feeny D, Furlong W, Boyle M, Torrance GW (1995). Multi-attribute health status classification systems: Health Utilities Index. Pharmacoeconomics 7(8):490-502.
Gold MR, Franks P, McCoy KI, Fryback DG (1998). Toward consistency in cost-utility analyses: using national measures to create condition-specific values. Med Care 36(6):778-92.
Feeny D, Furlong W, Torrance GW, Goldsmith CH, DePauw S, et al (2002). Multi-attribute and single-attribute utility functions for the Health Utilities Index Mark 3 System. Medical Care 40(2):113-28.
Erickson P (1998). Evaluation of a population-based measure of quality of life: the Health and Activity Limitation Index (HALex). Qual Life Res 7:101-14.
Stevenson MD, Oakley J, Chilcott JB (2004). Gaussian process modeling in conjunction with individual patient simulation modeling: a case study describing the calculation of cost-effectiveness ratios for the treatment of established osteoporosis. Med Decis Making 24(1):89.
Sonnenberg FA, Burkman RT, Hagerty CG, Speroff L, Speroff T (2004). Costs and net health effects of contraceptive methods. Contraception 69(6):447-59.
Hind D, Ward S, De Nigris E, Simpson E, Carroll C, Wyld L (2007). Hormonal therapies for early breast cancer: systematic review and economic evaluation. Health Technology Assessment 26(11).
McLernon DJ, Dillon J, Donnan PT (2008). Health-state utilities in liver disease: a systematic review. Med Decis Making 28(4):582.
Bremner KE, Chong CAKY, Tomlinson G, Alibhai SMH, Krahn MD (2007). A review and meta-analysis of prostate cancer utilities. Med Decis Making 27(3):288.
Tengs TO, Lin TH (2002). A meta-analysis of utility estimates for HIV/AIDS. Medical Decision Making 22:475-81.
Tengs TO, Lin TH (2003). A meta-analysis of quality-of-life estimates for stroke. Pharmacoeconomics 21(3):191-200.
Bonomi AE, Boudreau DM, Fishman PA, Ludman E, Mohelnitzky A, Cannon EA, et al (2008). Quality of life valuations of mammography screening. Qual Life Res 17(5):801-14.
de Haes JC, De Koning HJ, van Oortmarssen GJ, van Agt HM, de Bruyn AE, van der Maas PJ (1991). The impact of a breast cancer screening programme on quality-adjusted life-years. Int J Cancer 21;49(4):538-44.
De Koning HJ, Vanineveld BM, van Oortmarssen GJ, Dehaes JCJM, Collette HJA, Hendriks JHCL, et al (1991). Breast cancer screening and cost-effectiveness - policy alternatives, quality-of-life considerations and the possible impact of uncertain factors. Int J Cancer 49(4):531-7.
Gerard K, Johnston K, Brown J (1999). The role of a pre-scored multi-attribute health classification measure in validating condition-specific health state descriptions. Health Econ 8(8):685-99.
Johnston K, Brown J, Gerard K, O'Hanlon M, Morton A (1998). Valuing temporary and chronic health states associated with breast screening. Soc Sci Med 47(2):213-22.
Rijnsburger AJ, Essink-Bot ML, van DS, Borsboom GJ, Seynaeve C, Bartels CC, et al (2004). Impact of screening for breast cancer in high-risk women on health-related quality of life. Br J Cancer 91(1):69-76.
Cappelli M, Surh L, Humphreys L, Verma S, Logan D, Hunter A, et al (2001). Measuring women's preferences for breast cancer treatments and BRCA1/BRCA2 testing. Qual Life Res 10(7):595-607.
Grann VR, Jacobson JS, Sundararajan V, Albert SM, Troxel AB, Neugut AI (1999). The quality of life associated with prophylactic treatments for women with BRCA1/2 mutations... including commentary by Matloff ET. Cancer J Sci Am 5(5):283-92.
Sackett DL, Torrance GW (1978). The utility of different health states as perceived by the general public. Journal of Chronic Diseases 31(697):704.
Jansen SJ, Stiggelbout AM, Wakker PP, Nooij MA, Noordijk EM, Kievit J (2000). Unstable preferences: a shift in valuation or an effect of the elicitation procedure? Med Decis Making 20(1):62-71.
Jansen SJT, Stiggelbout AM, Wakker PP, Vlieland TPMV, Leer JWH, Nooy MA, et al (1998). Patients' utilities for cancer treatments: A study of the chained procedure for the standard gamble and time tradeoff. Med Decis Making 18(4):391-9.
Cykert S, Phifer N, Hansen C (2004). Tamoxifen for breast cancer prevention: A framework for clinical decisions. Obstet Gynecol 104(3):433-42.
Mansel R, Locker G, Fallowfield L, Benedict A, Jones D (2007). Cost-effectiveness analysis of anastrozole vs tamoxifen in adjuvant therapy for early stage breast cancer in the United Kingdom: the 5-year completed treatment analysis of the ATAC ("Arimidex", Tamoxifen alone or in combination) trial. Br J Cancer 16;97(2):152-61.
Sorensen SV, Brown RB, et al (2004). Patient-rated utilities in postmenopausal early breast cancer (EBC):a cross-country comparison. Value in Health 7(6):641.
Peasgood T, Herrmann K, Kanis JA, Brazier JE (2009). An updated systematic review of health state utility values for osteoporosis related conditions. Osteoporosis International 20(6).
Yabroff KR, Lawrence WF, Clauser S, Davis WW, Brown ML (2004). Burden of illness in cancer survivors: Findings from a population-based national sample. J Natl Cancer Inst 96(17):1322-30.
Sullivan PW, Lawrence WF, Ghushchyan V (2005). A national catalog of preference-based scores for chronic conditions in the United States. Med Care 43(7):736-40.
Ko CY, Maggard M, Livingston EH (2003). Evaluating health utility in patients with melanoma, breast cancer, colon cancer, and lung cancer: a nationwide, population-based assessment. J Surg Res 114(1):1-5.
Yabroff KR, McNeel TS, Waldron WR, Davis WW, Brown ML, Clauser S, et al (2007). Health limitations and quality of life associated With cancer and other chronic diseases by phase of care. Med Care 45(7):629.
Stratmann-Schoene D (2006). A preference-based index for the SF-12. Health Econ 15(6).
Isogai PK, Mittmann N, Bordeleau LJ (2008). Health preference instruments in a breast cancer population: Is there a ceiling effect when compared to the quality-of-life instruments? [journal not named] 6597.
Shih YCT, Wang XS, Cantor SB, Cleeland CS (2006). The association between symptom burdens and utility in Chinese cancer patients. Qual Life Res 15(8):1427-38.
Grann VR, Panageas KS, Whang W, Antman KH, Neugut AI (1998). Decision analysis of prophylactic mastectomy and oophorectomy in BRCA1-positive or BRCA2-positive patients. J Clin Oncol 16(3):979-85.
Hauser R, Theriault R, Cantor S, Shepherd M, Wilson J, Lawson K, et al (2001). Utilities of metastatic breast cancer patients (pt) treated with taxanes compared to utilities of oncology nurses (nur). Proc Am Soc Clin Oncol 20 abstr 164.
Hurny C, van Wegberg B, Bacchi M, Bernhard J, Thurlimann B, Real O, et al (1998). Subjective health estimations (SHE) in patients with advanced breast cancer: an adapted utility concept for clinical trials. Br J Cancer 77(6):985-91.
Hutton J, Brown R, Borowitz M, Abrams K, Rothman M, Shakespeare A (1996). A new decision model for cost-utility comparisons of chemotherapy in recurrent metastatic breast cancer. Pharmacoeconomics 9:8-22.
Launois R, Reboul Marty J, Henry B, Bonneterre J (1996). A cost-utility analysis of second-line chemotherapy in metastatic breast cancer - Docetaxel versus paclitaxel versus vinorelbine. Pharmacoeconomics 10(5):504-21.
Lidgren M, Wilking N, Jonsson B, Rehnberg C (2007). Health related quality of life in different states of breast cancer. Qual Life Res 16:1073-81.
Lloyd A, Nafees B, Narewska J, Dewilde S, Watkins J (2006). Health state utilities for metastatic breast cancer. Br J Cancer 18;95(6):683-90.
McLachlan SA, Pintilie M, Tannock IF (1999). Third line chemotherapy in patients with metastatic breast cancer: an evaluation of quality of life and cost. Breast Cancer Res Treat 54(3):213-23.
Milne RJ, Heaton-Brown KH, Hansen P, Thomas D, Harvey V, Cubitt A, et al (2006). Quality-of-life valuations of advanced breast cancer by New Zealand women. Pharmacoeconomics 24(3):281-92.
Schleinitz MD, DePalo D, Blume J, Stein M (2006). Can differences in breast cancer utilities explain disparities in breast cancer care? J Gen Intern Med 21(12):1253-60.
Simons WR (2007). Standard gamble techniques for the measurement of treatment related toxicity in oncology: Application to breast cancer. Value in Health 10(3):A5.
Walker M, de Jonge PV, Doyle S, Farina C (2006). Elicitation of UK health utilities in primary, recurrent and metastatic breast cancer. Ann Oncol 17:81-2.
Brown RE, Hutton J, Burrell A (2001). Cost effectiveness of treatment options in advanced breast cancer in the UK. Pharmacoeconomics 19(11):1091-102.
Brown RE, Hutton J (1998). Cost-utility model comparing docetaxel and paclitaxel in advanced breast cancer patients. Anticancer Drugs 9(10):899-907.
Kearney N, Brown R, Rothman M (1999). Utility measures in cancer care. Eur J Oncol Nurs 3(3):192-6.
Dranitsaris G, Hsu T (1999). Cost utility analysis of prophylactic pamidronate for the prevention of skeletal related events in patients with advanced breast cancer. Support Care Cancer 7(4):271-9.
Dranitsaris G, Leung P, Mather J, Oza A, Dranitsaris G, Leung P, et al (2000). Cost-utility analysis of second-line hormonal therapy in advanced breast cancer: a comparison of two aromatase inhibitors to megestrol acetate. Anticancer Drugs 11(7):591-601.
Leung PP, Tannock IF, Oza AM, Puodziunas A, Dranitsaris G (1999). Cost-utility analysis of chemotherapy using paclitaxel, docetaxel, or vinorelbine for patients with anthracycline-resistant breast cancer. J Clin Oncol 17(10):3082-90.
Bernhard J, Zahrieh D, Coates AS, Gelber RD, Castiglione-Gertsch M, Murray E, et al (2004). Quantifying trade-offs: quality of life and quality-adjusted survival in a randomised trial of chemotherapy in postmenopausal patients with lymph node-negative breast cancer. Br J Cancer 29;91(11):1893-901.
Bernhard J, Zahrieh D, Zhang JJ, Martinelli G, Basser R, Hurny C, et al (2008). Quality of life and quality-adjusted survival (Q-TWiST) in patients receiving dose-intensive or standard dose chemotherapy for high-risk primary breast cancer. Br J Cancer 98:25-33.
Conner-Spady BL, Cumming C, Nabholtz JM, Jacobs P, Stewart D (2005). A longitudinal prospective study of health-related quality of life in breast cancer patients following high-dose chemotherapy with autologous blood stem cell transplantation. Bone Marrow Transplant 36(3):251-9.
Gordon LG, Scuffham P, Battistutta D, Graves N, Tweeddale M, Newman B, et al (2005). A cost-effectiveness analysis of two rehabilitation support services for women with breast cancer. Breast Cancer Res Treat 94(2):123-33.
Hayman JA, Fairclough DL, Harris JR, Weeks JC (1997). Patient preferences concerning the trade-off between the risks and benefits of routine radiation therapy after conservative surgery for early-stage breast cancer. J Clin Oncol 15(3):1252-60.
Hayman JA, Kabeto MU, Schipper MJ, Bennett JE, Vicini FA, Pierce LJ (2005). Assessing the benefit of radiation therapy after breast-conserving surgery for ductal carcinoma-in-situ. J Clin Oncol 23(22):5171-7.
Jansen SJT, Kievit J, Nooij MA, Stiggelbout AM (2001). Stability of patients' preferences for chemotherapy: the impact of experience. Med Decis Making 21(4):295-306.
Jansen SJ, Otten W, Nortier JW, Stiggelbout AM, et al (2004). The impact of the perception of treatment choice on satisfaction with treatment, experienced chemotherapy burden and current quality of life. Br J Cancer 91(1):56-61.
Kimman ML, Dirksen CD, Lambin P, Boersma LJ (2009). Responsiveness of the EQ-5 D in breast cancer patients in their first year after treatment. Health and Quality of Life Outcomes 7(1):11.
Lovrics PJ, Cornacchi SD, Barnabi F, Whelan T, Goldsmith CH (2008). The feasibility and responsiveness of the health utilities index in patients with early-stage breast cancer: A prospective longitudinal study. Qual Life Res 17(2):333-45.
Namjoshi MA, Taylor TN, Brooks J, Hohl R (1998). Relationship between utility scores and disease-specific quality of life measures in a breast cancer population. Med Decis Making 18(4):470.
Polsky D, Keating NL, Weeks JC, Schulman KA (2002). Patient choice of breast cancer treatment: impact on health state preferences. Med Care 40(11):1068-79.
Prescott RJ, Kunkler IH, Williams LJ, King CC, Jack W, van der Pol M, et al (2007). A randomised controlled trial of postoperative radiotherapy following breast-conserving surgery in a minimum-risk older population. The PRIME trial. Health Technology Assessment 11(31):1.
Wolowacz SE, Cameron DA, Tate HC, Bagust A (2008). Docetaxel in combination with doxorubicin and cyclophosphamide as adjuvant treatment for early node-positive breast cancer: a cost-effectiveness and cost-utility analysis. J Clin Oncol 26(6):925.
Grunberg SM, Boutin N, Ireland A, Miner S, Silveira J, Ashikaga T (1996). Impact of nausea/vomiting on quality of life as a visual analogue scale-derived utility score. Support Care Cancer 4(6):435-9.
Gerard K, Dobson M, Hall J (1993). Framing and labeling effects in health descriptions - quality adjusted life years for treatment of breast cancer. J Clin Epidemiol 46(1):77-84.
Hall J, Gerard K, Salkeld G, Richardson J (1992). A cost utility analysis of mammography screening in Australia. Social Science & Medicine 34(9):993-1004.
Nafees B, Stafford M, Bhalla S (2006). Health utilities in the UK for second line non-small cell lung cancer. Value in Health 9:296.
Gabriel SE, Kneeland TS, Melton LJ, Moncur MM, Ettinger B, Tosteson ANA (1999). Health-related quality of life in economic evaluations for osteoporosis: whose values should we use? Med Decis Making 19(2):141.
Franic DM, Pathak DS (2003). Effect of including (versus excluding) fates worse than death on utility measurement. Int J Technol Assess Health Care 19(2):347-61.
Franic DM, Pathak DS, Gafni A (2003). Are health states "timeless"? A case study of an acute condition: post-chemotherapy nausea and vomiting. J Eval Clin Pract 9(1):69-82.
Polsky D, Mandelblatt JS, Weeks JC, Venditti L, Hwang YT, Glick HA, et al (2003). Economic evaluation of breast cancer treatment: considering the value of patient choice. J Clin Oncol 15;21(6):1139-46.
Perez DJ, Williams SM, Christensen EA, McGee RO, Campbell AV (2001). A longitudinal study of health related quality of life and utility measures in patients with advanced breast cancer. Qual Life Res 10(7):587-93.
Post PN, Stiggelbout AM, Wakker PP (2001). The utility of health states after stroke a systematic review of the literature. Stroke 32(6):1425-9.
Wolfson AD, Sinclair AJ, Bombardier C, McGeer A (1982). Preference measurements for functional status in stroke patients: interrater and intertechnique comparisons. In: Kane RL (ed), Values and Long-Term Care. Lexington, MA: Lexington Books.
Torrance GW (1976). Social preferences for health states: an empirical evaluation of three measurement techniques. Socio-Economic Planning Sciences 10(3):129-36.
O'Leary JF, Fairclough DL, Jankowski MK, Weeks JC (1995). Evidence for a possible plateau relationship comparison of time-tradeoff utilities and rating scale values of cancer patients and their relatives. Med Decis Making 15:132-7.
Conner-Spady B, Cumming C, Nabholtz JM, Jacobs P, Stewart D (2001). Responsiveness of the EuroQol in breast cancer patients undergoing high dose chemotherapy. Qual Life Res 10(6):479-86.
Ossa DF, Briggs A, McIntosh E, Cowell W, Littlewood T, Sculpher M (2007). Recombinant erythropoietin for chemotherapy-related anaemia: economic value and health-related quality-of-life assessment using direct utility elicitation and discrete choice experiment methods. Pharmacoeconomics 25(3):223.
Pickard AS, Neary MP, Cella D (2007). Estimation of minimally important differences in EQ-5D utility and VAS scores in cancer. Health and Quality of Life Outcomes 5:70.
Locker GY, Mansel R, Cella D, Dobrez D, Sorensen S, Gandhi SK (2007). Cost-effectiveness analysis of anastrozole versus tamoxifen as primary adjuvant therapy for postmenopausal women with early breast cancer: a US healthcare system perspective. The 5-year completed treatment analysis of the ATAC (æArimidexÆ, Tamoxifen Alone or in Combination) trial. Breast Cancer Research and Treatment 106(2):229-38.
Ashby J, O'Hanlon M, Buxton MJ (1994). The time trade-off technique - how do the valuations of breast cancer patients compare to those of other groups? Qual Life Res 3(4):257-65.
Brown RE, Hutton J, Burrell A (2001). Cost effectiveness of treatment options in advanced breast cancer in the UK. Pharmacoeconomics 19(11):1091-102.
Brown R, Benedict A, Mansel A (2005). Cost-effectiveness of anastrozole over tamoxifen in post menopausal women with early breast cancer from a UK national health service perspective: The 5-year completed treatment analysis of the ATAC trial. Value in Health 8(6):A34.
Brown R, Benedict A, Mansel RE (2004). Cost-utility analysis of anastrozole versus tamoxifen as adjuvant therapy in postmenopausal women with early breast cancer (EBC): A UK National Health Service (NHS) perspective. Value in Health 7(6):670.
Sorensen SV, Brown R, et al (2004). Patient-rated utilities in postmenopausal early breast cancer (EBC):a cross-country comparison. Value in Health 7(6):641.
Buxton M, Ashby J, O'Hanlon M (1987). Alternative methods of valuing health states: A comparative analysis based on a empirical study using the time trade-off approach in relation to health states one year after treatment for breast cancer. Health Economics Research Group Discussion Paper Brunel University, Uxbridge; Number 2.
Carter KJ, Ritchey NP, Castro F, Caccamo LP, Kessler E, Erickson BA, et al (1998). Treatment of early-stage breast cancer in the elderly: A health-outcome-based approach. Med Decis Making 18(2):213-9.
Franic DM, Pathak DS, Gafni A (2005). Quality-adjusted life years was a poor predictor of women's willingness to pay in acute and chronic conditions: results of a survey. J Clin Epidemiol 58(3):291-303.
Grimison PS, Simes RJ, Hudson HM, Stockler MR (2009). Preliminary validation of an optimally weighted patient-based utility index by application to randomized trials in breast cancer. Value in Health 9999(9999).
Hillner BE, Smith TJ (1991). Efficacy and cost-effectiveness of adjuvant chemotherapy in women with node-negative breast cancer - a decision-analysis model. N Engl J Med 324(3):160-8.
Hillner BE, Smith TJ, Desch CE (1992). Efficacy and cost-effectiveness of autologous bone marrow transplantation in metastatic breast cancer. Estimates using decision analysis while awaiting clinical trial results. JAMA 15;267(15):2055-61.
Jeruss JS, Hunt KK, Xing Y, Krishnamurthy S, Meric-Bernstam F, Cantor SB, et al (2006). Is intraoperative touch imprint cytology of sentinel lymph nodes in patients with breast cancer cost effective? Cancer 15;107(10):2328-36.
Launois RJ, Reboul-Marty JM, Bonneterre J (1997). A medico-economic evaluation of second line chemotherapy in metastatic breast cancer: comparison between docetaxel, paclitaxel, and vinorelbine. Bulletin du Cancer 84(7):709.
Norum J, Olsen JA, Wist EA (1997). Lumpectomy or mastectomy? Is breast conserving surgery too expensive? Breast Cancer Research and Treatment 45(1):7-14.
Jansen SJT, Stiggelbout AM, Nooij MA, Kievit J (2000). The effect of individually assessed preference weights on the relationship between holistic utilities and nonpreference-based assessment. Qual Life Res 9(5):541-57.
Richardson J, Hall J, Salkeld G (1996). The measurement of utility in multiphase health states. Int J Technol Assess Health Care 12(1):151-62.
Unic I, Stalmeier PFM, Verhoef LCG, van Daal WAJ (1998). Assessment of the time-tradeoff values for prophylactic mastectomy of women with a suspected genetic predisposition to breast cancer. Med Decis Making 18(3):268-77.
Wittenberg E, Winer EP, Weeks JC (2005). Patient utilities for advanced cancer: effect of current health on values. Med Care 43(2):173-81.
Fountzilas G, Dafni U, Dimopoulos MA, Koutras A, Skarlos D, Papakostas P, et al (2009). A randomized phase III study comparing three anthracycline-free taxane-based regimens, as first line chemotherapy, in metastatic breast cancer. Breast Cancer Research and Treatment 115(1):87-99.
Chie WC, Huang CS, Chen JH, Chang KJ (2000). Utility assessment for different clinical phases of breast cancer in Taiwan. Journal of the Formosan Medical Association = Taiwan yi zhi 99(9):677.
Hwang JS, Wang JD (2004). Integrating health profile with survival for quality of life assessment. Qual Life Res 13(1):1-10.
Kestle J, DePauw S, Kelleher L (1989). A time trade-off method for measuring quality of life in stage 2 breast cancer patients. Clinical Res 37:316A.
Stalmeier PFM, Bezembinder TGG, Unic IJ (1996). Proportional heuristics in time tradeoff and conjoint measurement. Med Decis Making 1996;16(1):36.
Suh WW, Hillner BE, Pierce LJ, Hayman JA (2005). Cost-effectiveness of radiation therapy following conservative surgery for ductal carcinoma in situ of the breast. International Journal of Radiation Oncology, Biology, Physics 61(4):1054-61.