AUTHOR=Sun Yue , Zhou Hui-Jun , Shen Anle , Wu Bin , Wang Wei , Luo Nan , Wang Pei 

TITLE=A cross-sectional study evaluating health-related quality of life of Chinese pediatric patients with hematological malignancies using EQ-5D-Y

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.1050835

DOI=10.3389/fpubh.2022.1050835

ISSN=2296-2565

ABSTRACT=Background 
The study aimed to assess health-related quality of life (HRQoL) and to estimate health utility of pediatric patients with hematological malignancies (HMs) in China. 

Method
A cross-sectional study recruited a series of pediatric inpatients diagnosed with HM from November 2018 to May 2019 in the Shanghai Children Medical Centre. Subjects were interviewed to collect socio-demographic information about themselves and their guardians. The EQ-5D-Y was completed by each patient to rate their own HRQoL which later derived the health utility. The health status was also assessed by clinicians following the Eastern Cooperative Oncology Group (ECOG) system. Upon the descriptive analyses and univariate analyses, multivariate generalized linear models were built to explore the associations of risk factors with HRQoL measures of the utility, Visual Analogue Scale (VAS) score and the five EQ-5D-Y domains. 

Results
The 96 subjects had a mean age of 10.5 years and included 62 (64.4%) boys. There were 46 (47.9%) and 25 (26.0%) children diagnosed with acute lymphoblastic leukaemia and Non-Hodgkin’s lymphoma respectively. The means (SD) of utility and EQ-VAS scores were 0.88 (0.10) and 85.8 (15.1) respectively. Twenty-six (27.1%) patients were graded poor health by ECOG standard (score 2/3). Both uni- and multi-variate analyses found strong correlations between ECOG and HRQoL. After adjusting for covariates, poor ECOG score was significantly associated with an impaired utility and VAS of -0.103 and -8.65 respectively. With regard to individual HRQoL domains, worse ECOG were more likely to report health problems with an increased risk of 2.94 to 12.50; Residence, income, Guardians’ education and disease duration were also found to be significantly related to either utility or certain health domains.
 
Conclusion
The HRQoL of Chinese pediatric patients with HM is considered relatively poor and of great concern to healthcare. With the strong correlations between EQ-5D-Y related HRQoL measures and the traditional clinical index ECOG. the EQ-5D-Y is able to provide valuable evidence for clinical decision making at individual level. At the same time, its health utility can inform resource-allocation at a macro level.