Are preference-weighted cancer-specific measures more sensitive than generic measures? A comparison of EQ-5D-5L, SF-6Dv2, FACT-8D and QLU-C10D in gastrointestinal cancers.

Authors

Xin Zhang, Mengting Ji, Luying Wang, Nan Luo

Published in

Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research. Jul 04, 2026. Epub Jul 04, 2026.

Abstract

To compare psychometric performance of generic EQ-5D-5L, SF-6Dv2 and cancer-specific FACT-8D and QLU-C10D in gastric, pancreatic, and colorectal cancers.
Patients recruited from a tertiary hospital in Shanghai, China, assessed their health using preference-weighted measures (PWMs) at two subsequent visits. Clinical data were extracted from medical records. Known-group validity, responsiveness and agreement were assessed. PWMs' index scores were computed using Chinese value sets.
Analysis included 170 gastric, 142 pancreatic, and 207 colorectal cancer patients. ECOG=1 was most common (82-83%), and Stage-IV predominated (60-65%) across three cancers. EQ-5D-5L showed strongest known-group validity for ECOG (Cohen's d: 1.87, 1.01, 1.73 across gastric, pancreatic, colorectal cancers), followed by QLU-C10D (1.33, 1.22, 1.44), SF-6Dv2 (1.37, 1.00, 1.11), and FACT-8D (0.71, 0.72, 1.25). All PWMs discriminated between early (0-III) and advanced (IV) stages; effect sizes were small or negligible, but SF-6Dv2 and FACT-8D failed for colorectal cancer. PWMs showed similar responsiveness to improvement across cancers, with standardized response means (SRMs) larger in pancreatic (range: 0.32-0.81) than colorectal (-0.07-0.45) or gastric cancers (0.00-0.51). Their relative responsiveness to deterioration varied by cancer type: in colorectal cancer, FACT-8D produced larger SRMs (-0.53--0.83) and QLU-C10D the greatest variation (-0.34--0.92); in gastric cancer, SF-6Dv2 had higher SRMs (-0.45--1.22) than others (-0.29--0.74); in pancreatic cancer, SRMs were comparable across PWMs. Agreement between PWMs was poor to moderate (ICC: 0.42-0.75).
This study suggests that cancer-specific PWMs are not necessarily more sensitive than generic PWMs. Psychometric performance of these PWMs varies by cancer type. Their suboptimal agreement limits the interchangeability.

PMID:
42401314
Bibliographic data and abstract were imported from PubMed on 05 Jul 2026.

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