Visualization and dynamics of multidimensional health-related quality-of-life-adjusted overall survival: A new analytic approach

Adin-Cristian Andrei*, Kathleen L Grady

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: Vesnarinone Trial (VesT) was a three-armed, placebo-controlled, randomized clinical trial designed to study the effects of 30 mg or 60 mg/day vesnarinone. Certain contradictory results involving patient health-related quality-of-life (HRQOL) and overall survival (OS) have made a definitive and unified conclusion difficult. Methods: To reconcile these findings, we have focused on the HRQOL-adjusted OS, commonly known as quality-adjusted life years (QALYs). Currently, analyses of QALYs incorporate a single HRQOL subscale. However, the VesT HRQOL instrument had two subscales: physical (PHYS) and emotional (EMOT). We have developed new ways to visualize and compare EMOT- and PHYS-adjusted OS. Results: In each VesT arm, there was an increased probability of superior EMOT-adjusted OS, compared to PHYS-adjusted OS. The magnitude of these findings was comparable across trial arms. Despite inferior survival and superior EMOT and PHYS scores, the 60-mg/day arm presents similar EMOT- and PHYS-adjusted OS compared to the placebo arm. Conclusions: We have provided a fresh perspective on the complex interactions between multiple HRQOL dimensions and OS. These novel methods address the burgeoning need for robust information on the interplay between OS and HRQOL from a patient, clinical care and public policy perspective.

Original languageEnglish (US)
Pages (from-to)1411-1419
Number of pages9
JournalQuality of Life Research
Volume23
Issue number5
DOIs
StatePublished - Jan 1 2014

Keywords

  • Cardiac disease
  • Data visualization
  • HRQOL
  • Overall survival
  • Trade-off function
  • Vesnarinone Trial

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Medicine(all)

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