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Grant Details

Grant Number: 7R01CA089503-02 Interpret this number
Primary Investigator: Dobrez, Deborah
Organization: Northshore University Healthsystem
Project Title: Measurement & Use of Utilities in Ovarian Cancer Cea
Fiscal Year: 2001


Abstract

Utilities play a key role in the evaluation of treatments that, in addition to cost and survival, have quality of life implications (Gold 96). However, considerable dissatisfaction exists regarding the quality of utility instruments available (Froberg-III, 89, Gold 96), and how utility scores are used in cost-effectiveness analyses (CEA; Neumann 1997 MDM, Fryback). The extent to which utility assessment, and method for incorporating utilities in to the cost-effectiveness (CE) models, actually affects the CE model results in a significant and meaningful way is largely unstudied. In the proposed study, we will use a model for ovarian cancer screening to address these issues. Our specific aims are: (1) Compare six utility questionnaires: (2) Determine the impact of frame of reference on current health and hypothetical health state utilities; and (3) Determine the sensitivity of cost- effectiveness models to assessment method, sample characteristics, including experience with the disease, age, race/ethnicity and gender, and to techniques for incorporating the utility scores in to the cost-effectiveness model. We will conduct simulations to determine both the range of screening parameters for which any screen for ovarian cancer might be considered cost-effective, and to fit our ovarian cancer screening model to screening for other cancer diagnoses, to determine whether cost-effectiveness models for screening for other cancer diagnoses are also sensitive to choice of utility score. We will specifically administer six different utility questionnaires for current health and multiple hypothetical health states in ovarian cancer and primary care patients, and in women enrolled in the Northwestern Ovarian Cancer Early Detection Program (n=1800). A sampling strategy will be used where each patient responds to four of the six utility questionnaires for three health states to minimize respondent burden. This methodological study will focus on the improvement of cost- effectiveness methods through both the better measurement and use of utilities in CFAs, providing information that is generalizable across all cancers and chronic illnesses, and will also provide the framework for future studies of the CE of ovarian cancer screening.



Publications

LPA receptor 2 mediates LPA-induced endometrial cancer invasion.
Authors: Hope J.M. , Wang F.Q. , Whyte J.S. , Ariztia E.V. , Abdalla W. , Long K. , Fishman D.A. .
Source: Gynecologic oncology, 2009 Jan; 112(1), p. 215-23.
EPub date: 2008-11-18.
PMID: 19019417
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S1P induced changes in epithelial ovarian cancer proteolysis, invasion, and attachment are mediated by Gi and Rac.
Authors: Devine K.M. , Smicun Y. , Hope J.M. , Fishman D.A. .
Source: Gynecologic oncology, 2008 Aug; 110(2), p. 237-45.
EPub date: 2008-05-29.
PMID: 18513786
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S1P and LPA have an attachment-dependent regulatory effect on invasion of epithelial ovarian cancer cells.
Authors: Smicun Y. , Gil O. , Devine K. , Fishman D.A. .
Source: Gynecologic oncology, 2007 Nov; 107(2), p. 298-309.
EPub date: 2007-08-22.
PMID: 17716713
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Lysophosphatidic acid down-regulates stress fibers and up-regulates pro-matrix metalloproteinase-2 activation in ovarian cancer cells.
Authors: Do T.V. , Symowicz J.C. , Berman D.M. , Liotta L.A. , Petricoin E.F. , Stack M.S. , Fishman D.A. .
Source: Molecular cancer research : MCR, 2007 Feb; 5(2), p. 121-31.
PMID: 17314270
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S1P regulation of ovarian carcinoma invasiveness.
Authors: Smicun Y. , Reierstad S. , Wang F.Q. , Lee C. , Fishman D.A. .
Source: Gynecologic oncology, 2006 Dec; 103(3), p. 952-9.
EPub date: 2006-09-07.
PMID: 16956652
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Inhibition of matrilysin expression by antisense or RNA interference decreases lysophosphatidic acid-induced epithelial ovarian cancer invasion.
Authors: Wang F.Q. , Smicun Y. , Calluzzo N. , Fishman D.A. .
Source: Molecular cancer research : MCR, 2006 Nov; 4(11), p. 831-41.
PMID: 17114341
Related Citations

Matrilysin over-expression in MCF-7 cells enhances cellular invasiveness and pro-gelatinase activation.
Authors: Wang F. , Reierstad S. , Fishman D.A. .
Source: Cancer letters, 2006-05-18; 236(2), p. 292-301.
EPub date: 2005-07-12.
PMID: 16019136
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Vascular endothelial growth factor-regulated ovarian cancer invasion and migration involves expression and activation of matrix metalloproteinases.
Authors: Wang F.Q. , So J. , Reierstad S. , Fishman D.A. .
Source: International journal of cancer, 2006-02-15; 118(4), p. 879-88.
PMID: 16152587
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Lysophosphatidic acid stimulates fas ligand microvesicle release from ovarian cancer cells.
Authors: Meng Y. , Kang S. , Fishman D.A. .
Source: Cancer immunology, immunotherapy : CII, 2005 Aug; 54(8), p. 807-14.
EPub date: 2005-01-21.
PMID: 15662527
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LPA-induced epithelial ovarian cancer (EOC) in vitro invasion and migration are mediated by VEGF receptor-2 (VEGF-R2).
Authors: So J. , Wang F.Q. , Navari J. , Schreher J. , Fishman D.A. .
Source: Gynecologic oncology, 2005 Jun; 97(3), p. 870-8.
PMID: 15919106
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The role of ultrasound evaluation in the detection of early-stage epithelial ovarian cancer.
Authors: Fishman D.A. , Cohen L. , Blank S.V. , Shulman L. , Singh D. , Bozorgi K. , Tamura R. , Timor-Tritsch I. , Schwartz P.E. .
Source: American journal of obstetrics and gynecology, 2005 Apr; 192(4), p. 1214-21; discussion 1221-2.
PMID: 15846205
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Estradiol-induced ezrin overexpression in ovarian cancer: a new signaling domain for estrogen.
Authors: Song J. , Fadiel A. , Edusa V. , Chen Z. , So J. , Sakamoto H. , Fishman D.A. , Naftolin F. .
Source: Cancer letters, 2005-03-18; 220(1), p. 57-65.
PMID: 15737688
Related Citations

Matrilysin (MMP-7) promotes invasion of ovarian cancer cells by activation of progelatinase.
Authors: Wang F.Q. , So J. , Reierstad S. , Fishman D.A. .
Source: International journal of cancer, 2005-03-10; 114(1), p. 19-31.
PMID: 15523695
Related Citations

Translocation of Fas by LPA prevents ovarian cancer cells from anti-Fas-induced apoptosis.
Authors: Meng Y. , Kang S. , So J. , Reierstad S. , Fishman D.A. .
Source: Gynecologic oncology, 2005 Feb; 96(2), p. 462-9.
PMID: 15661236
Related Citations

Upregulation of FasL by LPA on ovarian cancer cell surface leads to apoptosis of activated lymphocytes.
Authors: Meng Y. , Graves L. , Do T.V. , So J. , Fishman D.A. .
Source: Gynecologic oncology, 2004 Dec; 95(3), p. 488-95.
PMID: 15581951
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