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Development, Validation, and Valuation of a Head and Neck Cancer-Specific Health Utility Instrument (HNC-8D): A Head
John R de Almeida1,2, Jie Su3, Abdullah AlShenaiber4
1Department of Otolaryngology-Head and Neck Surgery, University Health Network, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
JAMA Otolaryngology-- Head & Neck Surgery
|April 10, 2025
Summary
A new head and neck cancer utility measure, the HNC-8D, was developed and validated. This tool accurately measures health utility and differentiates health states in head and neck cancer patients.
Area of Science:
- Oncology
- Psychometrics
- Health Economics
Background:
- Generic health utility instruments lack specificity for head and neck cancer patients.
- There is a need for a validated, cancer-specific measure to assess health utility.
Purpose of the Study:
- To develop and validate a head and neck cancer-specific health utility instrument.
- To evaluate the discriminative ability and predictive accuracy of the new measure.
Main Methods:
- A two-phase psychometric study involving instrument development, validation, and valuation.
- Exploratory factor analysis and Rasch modeling were used for item selection and dimension establishment.
- Time-trade-off exercises with healthy participants were conducted to value health states.
Main Results:
- The Head and Neck Cancer-8 Dimensions (HNC-8D) instrument was developed with 8 dimensions.
- The HNC-8D demonstrated discriminative validity, distinguishing between different disease severities.
- The scoring algorithm achieved low mean absolute differences between predicted and observed utilities (0.041 in discovery, 0.082 in validation sets).
Conclusions:
- The HNC-8D is a novel, validated health utility measure for head and neck cancer patients.
- The instrument shows predictive accuracy and can differentiate health utility states post-treatment.
- This measure can improve the assessment of quality of life in head and neck cancer survivorship.
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