A scoping review of utilisation of the EQ-5D questionnaire to evaluate health-related quality of life following a diagnosis of head and neck cancer

The importance of health-related quality of life (QOL) following diagnosis and treatment of head and neck cancer (HNC) is increasingly recognised. Among the QOL questionnaires available for use the EuroQol 5 Dimensions (EQ-5D) generic QOL index is widely accepted in the literature, but the format, extent of use and reporting of the EQ-5D varies substantially, limiting comparisons across studies and patient cohorts. This scoping review aimed to establish how EQ-5D has been utilised within HNC research and suggest standards for reporting the results of this QOL index. The electronic databases Medline via Ovid, Embase, PsycINFO, CINAHL and HANDLE-on-QOL were searched using MESH terms and keywords (last updated 27/12/21). Studies must have been published in English language and included participants who completed an EQ-5D questionnaire to assess QOL or calculate health utility values following diagnosis of HNC. A comparison to reference populations or sequential EQ-5D questionnaires administered over time was not required for study inclusion but has been explored. Outcomes of included studies may have included EQ-5D or derivative data such as health utility values, although studies which did not report EQ-5D data have been included to aid exploration of current utilisation in research. Case reports, case series and review articles were excluded. Abstract screening and data extraction was undertaken independently by two authors. Results were synthesised by tabulation using a pre-formulated data report form. Fifty-four articles met inclusion criteria and were analysed. Nine studies were randomised controlled trials and 26 were cross-sectional studies. EQ-5D data was frequently utilised to calculate utility/index values. Nineteen studies published EQ-5D results at domain level, while 23 published EQ-5D visual analogue scores (VAS). Nine studies included EORTC QLQ-C30 data. There was large variation in reporting of EQ-5D results. Standardised reporting criteria should be developed. We suggest as a minimum that both VAS and utility values are presented, as these reflect complementary but distinct outcomes. Researchers should consider the feasibility of including HRQOL as an outcome in intervention research in HNC as its importance to holistic patient care is increasingly supported by clinical research.