The Association Between Health-Related Quality of Life Scores and Clinical Outcomes for People Living With Lung Cancer: An Australian Registry Cohort Study Using Patient-Reported Outcomes to Drive Value-Based Healthcare

Harden, SV; King, MT; Li, JJ; Tissera, S; Lloyd, M; Briggs, L; Wood, T; Billah, B; Samankula, D; Smith, S; Brand, M; Lang, T; Parente, P; McGrath, S; Langton, D; Dumnall, T; Jennings, B; Nicholls, S; Stirling, RG; Richardson, G; Zalcberg, J

Author(s): Harden, SV; King, MT; Li, JJ; Tissera, S; Lloyd, M; Briggs, L; Wood, T; Billah, B; Samankula, D; Smith, S; Brand, M; Lang, T; Parente, P; McGrath, S; Langton, D; Dumnall, T; Jennings, B; Nicholls, S; Stirling, RG; Richardson, G; Zalcberg, J;
Details: Publication Year 2026-02,Volume 17,Issue #4,Page e70245
Journal Title: Thoracic Cancer
Publication Type: Research article
Abstract: INTRODUCTION: Improving patient-centered outcomes is a core aim of value-based healthcare (VBHC). Integrating patient-reported outcome and experience measures (PROMs/PREMs) into clinical quality registries may provide insight into health-related quality of life (HRQL) and variation in care. We piloted PROMs/PREMs collection in an Australian Lung Cancer Registry to evaluate associations between HRQL, clinical outcomes and treatment value. METHODS: Individuals newly diagnosed with lung cancer across five metropolitan health services were invited to complete electronic PROMs (EORTC QLQ-C30 and QLQ-LC29) and PREMs at baseline and follow-up. Preference-based utilities (QLU-C10D) and quality-adjusted life-years (QALYs) were derived and linked with registry clinical data. Stage-specific Australian health system cost estimates for guideline concordant treatment (GCT) provided context for value-based reporting. Multivariable regression examined associations between HRQL and clinical variables. RESULTS: Baseline PROMs/PREMs were completed by 241/490 (49%) participants. HRQL was associated with cancer stage, ECOG performance status ≥ 2, comorbidities, weight loss, and receipt of GCT (p = 0.041). HRQL remained stable among ongoing respondents over time. Estimated health system costs increased with advancing stage, while earlier stage disease was associated with better HRQL and survival. A registry-level VBHC dashboard integrating HRQL, patient experience, clinical quality indicators and cost context was developed to support health service performance review. CONCLUSIONS: PROMs/PREMs linked with clinical and cost data provided meaningful insight into patient-centered outcomes and drivers of value in lung cancer care. This VBHC framework highlights the importance of early diagnosis and access to evidence-based treatment and offers a scalable approach to support patient-centered quality improvement at the health system level.
Publisher: Wiley
Keywords: Humans; *Lung Neoplasms/therapy/epidemiology/pathology/economics; Male; Female; *Quality of Life; *Patient Reported Outcome Measures; Registries; Australia/epidemiology; Aged; Middle Aged; Cohort Studies; Aged, 80 and over; Value-Based Health Care; guideline concordant treatment; health‐related quality of life; lung cancer; patient reported experience measures; patient reported outcome measures; value based healthcare
Department(s): Radiation Oncology
Publisher's Version: https://doi.org/10.1111/1759-7714.70245
Open Access at Publisher's Site: https://doi.org/10.1111/1759-7714.70245
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2026-03-10 04:07:02

Last Modified: 2026-03-10 04:07:14