Health State Descriptions for Canadians

Health State Descriptions for Canadians
82-619-MIE

Cancers

Subsequent health states

References

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How to read the classification

Health states are classified using eleven attributes, each with 4 or 5 levels. Level 1 indicates no limitations, while level 4 or 5 are the most severe limitations. Please note that these levels are a shorthand for the classification: they are not measurements on an interval scale.* A complete list of the attributes and levels appears as Table 1.

As an example, we can look at two health states, the first describing the health state at diagnosis for cancers with very good prognosis and the second describing the health state for a more advanced cancer during the last month of life, during terminal care.

Individuals with early stage breast cancer (a very good prognosis) could be described by the following:

Description	This description applies to the health state at diagnosis of local or regional disease, prior to the commencement of treatment. It describes patients diagnosed with breast, prostate and bladder cancer, but also applies to cancer of the uterus, thyroid, cervix and testis, melanoma and Hodgkin’s disease. Patients report depression, impotence, urinary difficulties (for bladder and prostate cancers) and impaired sexual functioning as well as decreases in self esteem and self-image. Duration of this phase is estimated to be 37 days.6
Classification	Core	Supplementary
	1 1 3 1 1 2	3 1 1 1 1

Click on each number to see which attribute and level of severity it represents. For example, the third number under "Core" corresponds to the attribute Emotional State. Level 3 of this attribute is "Somewhat unhappy".

By contrast, the following describes terminal care:

Description	The health state of patients in the last month of life is similar to that in the palliative care state, except for the severity of the functional limitations experienced. For example, many patients experience severe pain or discomfort during this phase. Generalized weakness and fatigue can make even simple acts, such as feeding oneself, difficult. “The last weeks of life are especially dramatic, with increased dependency, weakness, confusion, and inability to manage simple functional and personal tasks such as bathing, walking and continence.”7
Classification	Core	Supplementary
	4 4 4 4 4 4	3 1 1 1 4

Classification of the major health states in the progression and treatment of cancer are provided in the Summary table.

* For instance, the difference between level 1 and level 2 is not the same as between level 3 and level 4. In addition, attributes are not equally important in terms of health state preferences. For more information on health state preferences developed from these scores, please see http://www.phac-aspc.gc.ca/phi-isp/index.html.

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Date modified: 2005-08-16	Important Notices

Health State Descriptions for Canadians 82-619-MIE

Cancers

How to read the classification

1 1 3 1 1 2

3 1 1 1 1

4 4 4 4 4 4

3 1 1 1 4

Health State Descriptions for Canadians
82-619-MIE