The University of Wisconsin Breast Cancer Epidemiology Simulation Model: An Update.

The University of Wisconsin Breast Cancer Epidemiology Simulation Model (UWBCS), also referred to as Model W, is a discrete-event microsimulation model that uses a systems engineering approach to replicate breast cancer epidemiology in the US over time. This population-based model simulates the lifetimes of individual women through 4 main model components: breast cancer natural history, detection, treatment, and mortality. A key feature of the UWBCS is that, in addition to specifying a population distribution in tumor growth rates, the model allows for heterogeneity in tumor behavior, with some tumors having limited malignant potential (i.

Health Condition Impacts in a Nationally Representative Cross-Sectional Survey Vary Substantially by Preference-Based Health Index.

Importance: Many cost-utility analyses rely on generic utility measures for estimates of disease impact. Commonly used generic preference-based indexes may generate different absolute estimates of disease burden despite sharing anchors of dead at 0 and full health at 1.0.

Responding to vaccine safety signals during pandemic influenza: a modeling study.

Background: Managing emerging vaccine safety signals during an influenza pandemic is challenging. Federal regulators must balance vaccine risks against benefits while maintaining public confidence in the public health system.

Methods: We developed a multi-criteria decision analysis model to explore regulatory decision-making in the context of emerging vaccine safety signals during a pandemic.

Impact of lung cancer screening results on participant health-related quality of life and state anxiety in the National Lung Screening Trial.

Background: Low-dose computed tomography (LDCT) lung screening has been associated with a 20% reduction in lung cancer mortality. A major barrier to the adoption of lung screening is the potential negative psychological impact of a false-positive (FP) screen, occurring in 20% to 50% of those screened. The objective of this study was to assess the impact of abnormal findings on health-related quality of life (HRQoL) and anxiety in the American College of Radiology (ACRIN)/National Lung Screening Trial (NLST).

Consequences of false-positive screening mammograms.

Importance: False-positive mammograms, a common occurrence in breast cancer screening programs, represent a potential screening harm that is currently being evaluated by the US Preventive Services Task Force.

Objective: To measure the effect of false-positive mammograms on quality of life by measuring personal anxiety, health utility, and attitudes toward future screening.

Design, Setting, And Participants: The Digital Mammographic Imaging Screening Trial (DMIST) quality-of-life substudy telephone survey was performed shortly after screening and 1 year later at 22 DMIST sites and included randomly selected DMIST participants with positive and negative mammograms.

Variation in tumor natural history contributes to racial disparities in breast cancer stage at diagnosis.

Black women tend to be diagnosed with breast cancer at a more advanced stage than whites and subsequently experience elevated breast cancer mortality. We sought to determine whether there are racial differences in tumor natural history that contribute to these disparities. We used the University of Wisconsin Breast Cancer Simulation Model, a validated member of the National Cancer Institute's Cancer Intervention and Surveillance Modeling Network, to evaluate the contribution of racial differences in tumor natural history to observed disparities in breast cancer incidence.

Erratum to: Interpersonal discrimination and health-related quality of life among black and white men and women in the United States.

Objective: We assessed associations between discrimination and health-related quality of life among black and white men and women in the United States.

Methods: We examined data from the National Health Measurement Study, a nationally representative sample of 3,648 adults aged 35-89 in the non-institutionalized US population. These data include self-reported lifetime and everyday discrimination as well as several health utility indexes (EQ-5D, HUI3, and SF-6D).

Interpersonal discrimination and health-related quality of life among black and white men and women in the United States.

Objective: We assessed associations between discrimination and health-related quality of life among black and white men and women in the United States.

Methods: We examined data from the National Health Measurement Study, a nationally representative sample of 3,648 adults aged 35-89 in the non-institutionalized US population. These data include self-reported lifetime and everyday discrimination as well as several health utility indexes (EQ-5D, HUI3, and SF-6D).

Agreement about identifying patients who change over time: cautionary results in cataract and heart failure patients.

Background: Preference-based measures of health-related quality of life all use the same dead = 0.00 to perfect health = 1.00 scale, but there are substantial differences among measures.

Race and gender associations between obesity and nine health-related quality-of-life measures.

Purpose: To assess how health-related quality of life (HRQoL) varies by body mass index (BMI) category among gender and racial subgroups using nine HRQoL measures.

Methods: Among 3,710 US adults, we evaluated self-reported height, weight, and HRQoL that was measured by six indexes (EQ-5D; HUI2; HUI3; SF-6D; QWB-SA; HALex) and three summary measures (theta; PCS; MCS). Mean HRQoL was estimated by weighted regression for normal, overweight, and obese subgroups (BMI: 18.

Health-related quality of life in adults reporting arthritis: analysis from the National Health Measurement Study.

Background: Arthritis is the leading cause of disability in the United States. We assess the generic health-related quality-of-life (HRQOL) among a nationally representative sample of U.S.

Race and preference-based health-related quality of life measures in the United States.

Background: Health-related quality of life instruments (HRQoL) are widely used to produce measures that summarize population health and to inform decision-making and health policy. Although the literature about the relationship between health and race in the United States is quite extensive, there is a lack of studies that comprehensively examine the relationship between race and preference-based HRQoL. Given the widespread use of these measures, it becomes important to understand the extent of the race differences in HRQoL scores and factors associated with any such differences.

Standard error of measurement of 5 health utility indexes across the range of health for use in estimating reliability and responsiveness.

Background: Standard errors of measurement (SEMs) of health-related quality of life (HRQoL) indexes are not well characterized. SEM is needed to estimate responsiveness statistics, and is a component of reliability.

Purpose: To estimate the SEM of 5 HRQoL indexes.

Five preference-based indexes in cataract and heart failure patients were not equally responsive to change.

Objective: To compare the responsiveness to clinical change of five widely used preference-based health-related quality-of-life indexes in two longitudinal cohorts.

Study Design And Setting: Five generic instruments were simultaneously administered to 376 adults undergoing cataract surgery and 160 adults in heart failure management programs. Patients were assessed at baseline and reevaluated after 1 and 6 months.

Underlying dimensions of the five health-related quality-of-life measures used in utility assessment: evidence from the National Health Measurement Study.

Background: Preference-weighted health-related quality-of-life (HRQoL) indexes produce a summary score from discrete health states determined by questions falling into several attributes, such as pain and mobility. Values of HRQoL are used alongside other health outcomes to monitor the health of populations.

Objective: The purpose of this study was to examine among US adults, the underlying factor structure of HRQoL attribute scores across 5 indexes of HRQoL: EuroQol-5 Dimension, Health Utilities Index Mark 2, Health Utilities Index Mark 3, Short Form-6 Dimension, and Quality of Well-Being Scale Self-Administered form.

Gender differences in health-related quality-of-life are partly explained by sociodemographic and socioeconomic variation between adult men and women in the US: evidence from four US nationally representative data sets.

Purpose: The purpose of this study was to describe gender differences in self-reported health-related quality-of-life (HRQoL) and to examine whether differences are explained by sociodemographic and socioeconomic status (SES) differentials between men and women.

Methods: Data were from four US nationally representative surveys: US Valuation of the EuroQol EQ-5D Health States Survey (USVEQ), Medical Expenditure Panel Survey (MEPS), National Health Measurement Study (NHMS) and Joint Canada/US Survey of Health (JCUSH). Gender differences were estimated with and without adjustment for sociodemographic and SES indicators using regression within and across data sets with SF-6D, EQ-5D, HUI2, HUI3 and QWB-SA scores as outcomes.

Predicting the EuroQol Group's EQ-5D index from CDC's "Healthy Days" in a US sample.

Background: Obtaining reliable preference-based scores from the widely used Healthy Days measures would enable calculation of quality-adjusted life years (QALYs) and cost-utility analyses in many US community populations and over time. Previous studies translating the Healthy Days to the EQ-5D, a preference-based measure, relied on an indirect method because of a lack of population-based survey data that asked both sets of questions of the same respondents.

Method: Data from the 2005-2006 National Health Measurement Study (NHMS; n = 3844 adults 35 years old or older) were used to develop regression-based models to estimate EQ-5D index scores from self-reported age, self-rated general health, and numbers of unhealthy days.

Three methods tested to model SF-6D health utilities for health states involving comorbidity/co-occurring conditions.

Objectives: Compare three commonly used methods to combine the impacts of multiple health conditions on SF-6D health utility scores.

Study Design And Setting: We used data from the 1998-2004 Medicare Health Outcomes Survey to compare three commonly suggested models of multiple health conditions' impacts on health-related quality of life: additive, minimum, and multiplicative. We modeled SF-6D scores using information about 15 health conditions, both unadjusted and adjusted for age, sex, education, and income.

Comparison of 5 health-related quality-of-life indexes using item response theory analysis.

Background: Five health-related quality-of-life (HRQoL) indexes--EQ-5D, HUI2, HUI3, QWB-SA, and SF-6D--are each used to assign community-based utility scores to health states, although these scores differ.

Objective: The authors transform these indexes to a common scale to understand their interrelationships.

Methods: Data were from the National Health Measurement Study, a telephone survey of 3844 US adults.

Measuring health-related quality of life in population-based studies of coronary heart disease: comparing six generic indexes and a disease-specific proxy score.

Purpose: To compare HRQoL differences with CHD in generic indexes and a proxy CVD-specific score in a nationally representative sample of U.S. adults.

Effects of mode and order of administration on generic health-related quality of life scores.

Objective: We evaluate the effects of mode and order of administration on health-related quality of life (HRQOL) scores.

Method: We analyzed HRQOL data from the Clinical Outcomes and Measurement of Health Study (COMHS). In COMHS, we enrolled patients with heart failure or cataracts at three sites (University of California, San Diego, University of California, Los Angeles, and University of Wisconsin).

Socioeconomic status and age variations in health-related quality of life: results from the national health measurement study.

Objectives: We examine whether multiple health-related quality of life (HRQoL) measures are stratified by socioeconomic status (SES) and age in the United States.

Methods: Data are from the 2005/2006 National Health Measurement Study, a telephone survey of a nationally representative sample of U.S.

Cost-effectiveness of digital mammography breast cancer screening.

Background: The DMIST (Digital Mammography Imaging Screening Trial) reported improved breast cancer detection with digital mammography compared with film mammography in selected population subgroups, but it did not assess the economic value of digital relative to film mammography screening.

Objective: To evaluate the cost-effectiveness of digital mammography screening for breast cancer.

Design: Validated, discrete-event simulation model.