Health-related quality of life in the treatment and survivorship phases of breast cancer.
Bibliographic record
Abstract
e18621 Background: Understanding the health-related quality of life (HRQOL) of breast cancer during treatment and survivorship is important; however, little data are available - particularly for long-term ( > 5 year) survivors. Health utility scores anchored between 0 (death) and 1 (perfect/best possible health) have been shown to be a good proxy index score of the overall HRQOL. The aim of this study was to estimate the utilities in the treatment and survivorship of breast cancer using validated preference-based measures(PBMs). Methods: Women (18 years or older) with history of breast cancer (on/off treatment) were recruited via Love Research Army (LRA), an online community of women engaged in breast cancer research. Members of the LRA were invited to participate via email and women who self-selected to be eligible were asked to complete clinical and demographics form and two generic PBMs - EQ-5D and Short Form-12 (SF-12), and one cancer-specific PBM-European Organization for Research and Treatment of Cancer-8D (EORTC-8D). Descriptive statistics and non-parametric analysis of variance tests were used to examine differences between the survivorship groups. Results: 1,636 women aged 46 ± 10 years were included in the analysis. Mean age at primary diagnosis was 35 ± 10 years and most patients were diagnosed with breast cancer stage 0-2 (n = 1362, 83.25%). For women currently on treatments, mean utility values were: chemotherapy (EQ-5D = 0.61, SF-6D = 0.67,EORTC-8D = 0.69), radiation(EQ-5D = 0.71, SF-6D = 0.67, EORTC-8D = 0.66), hormone replacement therapy (EQ-5D = 0.82,SF-6D = 0.76,EORTC-8D = 0.85), targeted therapy (EQ-5D = 0.77, SF-6D = 0.74, EORTC-8D = 0.82), and surgery (EQ-5D = 0.81,SF-6D = 0.69, EORTC-8D = 0.78). For women diagnosed with arm lymphedema (n = 182,11%), utility values were EQ-5D = 0.79,SF-6D = 0.74, EORTC-8D = 0.82. Women who were ≤ 5 years post-primary diagnosis reported slightly lower utility values (EQ-5D = 0.82,SF-6D = 0.76,EORTC-8D = 0.84) than women who were 6-10 years (EQ-5D = 0.83,SF-6D = 0.76,EORTC-8D = 0.85; p = 0.117) post-primary diagnosis. However, when utilities for women who were ≤ 5 years post-primary diagnosis were compared to women who were 11 to 15 years (EQ-5D = 0.86,SF-6D = 0.79,EORTC-8D = 0.88) and over 15 years (EQ-5D = 0.86,SF-6D = 0.81,EORTC-8D = 0.89) post-primary diagnosis, the difference was statistically significant (p = 0.000). Women who belonged to non-White ethnic groups, had lower levels of education (Bachelors or less) and reported less than USD 50,000 annual income in the previous year reported lower utility values across all time points, after adjusting for age and cancer stage. Conclusions: This study shows that the HRQOL decline in the first five years post-primary breast cancer diagnosis persists for several years into survivorship. Further, women from ethnic minority groups and lower socioeconomic background have lower HRQOL, irrespective of their age and cancer stage.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".