The EORTC QLU-C10D distinguished better between cancer patients and the general population than PROPr and EQ-5D-5L in a cross-sectional study

Health state utility (HSU) instruments for calculating quality-adjusted life years, such as the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Utility - Core 10 Dimensions (QLU-C10D), derived from the EORTC QLQ-30 questionnaire, the Patient-Reported Outcome Measurement Information System (PROMIS) preference score (PROPr), and the EuroQoL-5-Dimensions-5-Levels (EQ-5D-5L), yield different HSU values due to different modeling and different underlying descriptive scales. For example the QLU-C10D includes cancer-relevant dimensions such as nausea. This study aimed to investigate how these differences in descriptive scales contribute to differences in HSU scores by comparing scores of cancer patients receiving chemotherapy to those of the general population. EORTC QLU-C10D, PROPr, and EQ-5D-5L scores were obtained for a convenience sample of 484 outpatients of the Department of Oncology, Charité – Universitätsmedizin Berlin, Germany. Convergent and known group’s validity were assessed using Pearson's correlation and intraclass correlation coefficients (ICC). We assessed each descriptive dimension score's discriminatory power and compared them to those of the general population (n > 1000) using effect size (ES; Cohen's d) and area under the curve (AUC). The mean scores of QLU-C10D (0.64; 95% CI 0.62-0.67), PROPr (0.38; 95% CI 0.36-0.40), and EQ-5D-5L (0.72; 95% CI 0.70-0.75) differed significantly, irrespective of sociodemographic factors, condition, or treatment. Conceptually similar descriptive scores as obtained from the HSU instruments showed varying degrees of discrimination in terms of ES and AUC between patients and the general population. The QLU-C10D and its dimensions showed the largest ES and AUC. The QLU-C10D and its domains distinguished best between health states of the two populations, compared to the PROPr and EQ-5D-5L. As the EORTC Core Quality of Life Questionnaire (QLQ-C30) is widely used in clinical practice, its data are available for economic evaluation. The assessment of dimensions of health-related quality of life (HRQoL), such as physical functioning or depression, is important to cancer patients and physicians for treatment and side effect monitoring. Descriptive HRQoL is measured by patient-reported outcomes measures (PROM). The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire and the Patient-Reported Outcome Measurement Information System (PROMIS) are the most