Zhang, J.

AbstractBackgroundWe aimed to provide a simple, descriptive health‐status profile for cancer patients with bone metastases, based on the EuroQol EQ‐5D, a tool commonly used to measure health utility scores, and to evaluate its association with the Brief Pain Inventory (BPI), a legacy pain‐assessment tool. Although pain is one of five health‐status dimensions measured by the EQ‐5D, our understanding of how pain relates to the other EQ‐5D dimensions is limited.MethodsWe derived data from 5500 patients with bone metastases who completed the EQ‐5D and BPI. Regression analyses examined how BPI severity and interference scores correlated with EQ‐5D utility scores and how BPI items associated with EQ‐5D items, for the entire sample and by disease‐type subgroup.ResultsRegardless of cancer site, the percentage of patients reporting moderate/severe problems in each of the five EQ‐5D dimensions were pain/discomfort, 78%; usual activities, 58%; mobility, 55%; anxiety/depression, 57%; and self‐care, 26%. BPI pain interference explained more of the variability in the EQ‐5D utility scores than did pain severity (R2 = 41% vs. 34%). BPI worst pain, average pain, pain now, interference with general activity, and interference with work significantly predicted EQ‐5D pain/discomfort, with odds ratio estimates <1.ConclusionsPain/discomfort was the worst‐rated dimension of the EQ‐5D in this population, but the relationship of this item to BPI pain severity was modest, suggesting that the single pain item of the EQ‐5D may be of limited utility in studies for which pain is an endpoint.SignificanceHealth‐status dimensions include more than pain. We examine the contribution of pain severity and pain‐related functional interference in determining the health status of cancer patients with bone metastases. The pain dimension from a health‐status measure may be an inadequate metric in clinical trials/clinical practice when pain is an important outcome.