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Given the rising costs of new drugs in the palliative setting, proof of benefit requires health technology assessments (HTA) in public-payer systems such as Canada. This is especially the case for molecular targeted drugs and immunotherapies. The overarching hypothesis is that there will be an increasing need for real-world observational data on health utilities and quality of life assessments from Canadian patients, for HTA within Canada and in other jurisdictions.

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Research question:

How can we efficiently collect real-world patient-reported outcomes suitable for HTAs and for clinical research?



The primary focus is in upper aerodigestive tract cancers, and in particular, metastatic lung cancer, which has now developed into a large number of subtypes, each with its own clinic-demographic features and therapies that can lead to differences in health utilities and quality of life assessments. CHUQoLS and CARMA share many common goals, except CHUQoLS is more developmental in nature at Princess Margaret, and CARMA has used the experience of CHUQoLS to develop an expansion nationally in Canada.


Representative past, current, and future projects include:

(1)    The Impact of Brain Metastases and Associated Neurocognitive Aspects on Health Utility Scores in EGFR Mutated and ALK Rearranged NSCLC: A Real World Evidence Analysis.

(2)    Favourable health-related quality of life reported in survivors of thymic malignancies


(3)    Real-World EQ5D Health Utility Scores for Patients With Metastatic Lung Cancer by Molecular Alteration and Response to Therapy.


(4)    Cancer Patients’ Willingness to Routinely Complete the EQ-5D Instrument at Clinic Visits.

(5)    EQ-5D Health Utility Scores: Data from a Comprehensive Canadian Cancer Centre.

(6)    ALK, EGFR, and Small Cell Lung Cancer Health Utilities Validation with Toxicity Assessments

(7)    Health utility scores from EQ-5D and health-related quality of life in patients with esophageal cancer : a real-world cross-sectional study.

(8)    Health utilities, symptoms across a real-world assessment in head and neck cancer subgroups by treatment


Scientific Goals:

(1)    To identify innovative methods for collecting health utility and quality of life data in the real-world, routine practice setting. 

(2)    To study the effects of the rapidly changing landscape of treatments on cancer patients’ quality of life and health utilities. 

(3)    To demonstrate the usefulness of our methods in generating real world utility data for HTA. 


Funding Sources:Cancer Care Ontario, Princess Margaret Cancer Foundation and the Lung Cancer Fellowship program, Department of Medicine and Division of Medical Oncology, University of Toronto through its Comprehensive Research Experiment for Medical Students (CREMS) program, Chinese government graduate student scholarship.

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