{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T15:32:41Z","timestamp":1793287961412,"version":"4.5.0"},"reference-count":63,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"American Cancer Society","award":["RSG-20-024-01-CPHPS"],"award-info":[{"award-number":["RSG-20-024-01-CPHPS"]}],"id":[{"id":"https:\/\/ror.org\/02e463172","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Thyroid cancer survivors experience distinctive, persistent burdens that diminish health-related quality of life (HRQoL). Utilities from patient preference-based measures are needed for quality-adjusted life-year estimation and decision-making. Generic instruments lack thyroid-specific content, limiting applicability in this population. We sought to develop a thyroid-cancer-specific utility measure, Thyroid Cancer Quality of Life Index (TCQOLI) to support clinical research, cost-effectiveness analyses, and policy applications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We conducted a multicenter, multiphase, mixed-method, cross-sectional study. Phase 1 defined the TCQOLI domains and items using input from multidisciplinary experts and patients with thyroid cancer. Phase 2 evaluated the instrument via cognitive interviews (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 50) and a mailed\/phone-assisted psychometric survey in adults with thyroid cancer (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 163), followed by confirmatory factor analysis (CFA) and reliability\/validity analyses. Phase 3 valued health states in a separate sample (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 103) using interviewer-administered visual analog scales (VAS; 0\u2013100) and standard gamble (SG). Levels of morbidity in each health domain with VAS and SG were used for assessing preferences for three clinical marker states. We derived a weighted dead-to-full-health lower VAS anchor, estimated a VAS to SG power mapping solution to apply to the model overall, and constructed additive, multiplicative, and unweighted indices. Agreement of the indices with direct VAS was summarized by Pearson\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      , mean absolute error (MAE), overall standard deviation (OSD) of differences, and intraclass correlation (ICC).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Ten candidate domains were finalized; because one domain, reproduction concern, had the weakest psychometrics and the lowest model weight, the primary instrument uses nine domains (a 10-domain version was also evaluated). CFA supported a general HRQoL factor plus a voice\/swallow factor with acceptable composite reliability and model fit. The instrument-level ceiling effect was low (3.8%) with no floor effect. The 9-domain additive multiattribute utility theory index correlated with direct VAS (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      \u2248 0.74\u20130.75) and showed the best agreement. MAE\/OSD was 0.045\/0.095 after SG mapping and a good to excellent ICC of 0.74.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>TCQOLI is a psychometrically robust, thyroid-cancer-specific, preference-based measure with patient-anchored valuation, suitable for health-economic evaluations. This concise index supports comparative-effectiveness research in thyroid cancer and informs resource allocation across clinical and policy settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10507256261425624","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T04:23:34Z","timestamp":1771993414000},"page":"278-290","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["A Thyroid-Cancer-Specific Utility Index: Development and Valuation of the Thyroid Cancer Quality of Life Index"],"prefix":"10.1177","volume":"36","author":[{"given":"Carrie E.","family":"Cunningham","sequence":"first","affiliation":[{"name":"Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA."},{"name":"MGH Institute for Technology Assessment, Harvard Medical School, Boston, Massachusetts, 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