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Quality of Life Research
Gepubliceerd in: Quality of Life Research 4/2015

01-04-2015

Joint modeling of longitudinal health-related quality of life data and survival

Auteurs: Divine E. Ediebah, Francisca Galindo-Garre, Bernard M. J. Uitdehaag, Jolie Ringash, Jaap C. Reijneveld, Linda Dirven, Efstathios Zikos, Corneel Coens, Martin J. van den Bent, Andrew Bottomley, Martin J. B. Taphoorn

Gepubliceerd in: Quality of Life Research | Uitgave 4/2015

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Abstract

Purpose

In cancer research, outcome measures may co-vary. Treatment and treatment related impairment of health-related quality of life (HRQoL) may affect survival. When these effects are analyzed separately, bias may arise. Therefore, we investigated the combined effect of treatment and longitudinally measured HRQoL on survival.

Methods

Patients with anaplastic oligodendrogliomas (n = 288) who were randomized (EORTC 26951) to radiotherapy (RT) alone or RT plus procarbazine, lomustine, and vincristine (PCV) chemotherapy were analyzed. HRQoL [appetite loss (AP)] was assessed with the EORTC QLQ-C30. We compared survival results from different analysis strategies: Cox model with treatment only [model 1 (M1)] or with treatment and time-dependent AP score [model 2 (M2)] and the joint model combining longitudinal AP score and survival [model 3 (M3)].

Results

The estimated hazard ratio (HR) for RT plus PCV was 0.76 (95 % CI 0.58–1.00) for M1, 0.72 (0.55–0.96) for M2, and 0.69 (0.52–0.92) for M3. This corresponds to a lower risk of death of 24 % in M1, 28 % in M2, and 31 % in M3, for patients treated with RT plus PCV chemotherapy. AP resulted in an increased risk of death, with estimated HR of 1.06 (1.01–1.12) for M2 and 1.13 (1.03–1.23) for M3: Every 10-point increase of AP resulted in a 13 % increased risk of death in M3 as compared to 6 % in M2.

Conclusion

Part of the survival benefit of treatment with RT plus PCV chemotherapy can be masked by the negative effect that this treatment has on patients’ HRQoL. In our study, up to 7 % of the theoretical treatment efficacy was lost when AP was not adjusted through joint modeling.
vorige artikel Factor analyses of a social support scale using two methods
volgende artikel Multiple imputation to deal with missing EQ-5D-3L data: Should we impute individual domains or the actual index?
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Metagegevens
Titel
Joint modeling of longitudinal health-related quality of life data and survival
Auteurs
Divine E. Ediebah
Francisca Galindo-Garre
Bernard M. J. Uitdehaag
Jolie Ringash
Jaap C. Reijneveld
Linda Dirven
Efstathios Zikos
Corneel Coens
Martin J. van den Bent
Andrew Bottomley
Martin J. B. Taphoorn
Publicatiedatum
01-04-2015
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 4/2015
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-014-0821-6

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