患者对局部晚期或转移性尿路上皮癌一线治疗的偏好:多维阈值法的应用。

IF 3.4 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Andrea B Apolo, Christine Michaels-Igbokwe, Nicholas I Simon, David J Benjamin, Mallory Farrar, Zsolt Hepp, Lisa Mucha, Sebastian Heidenreich, Katelyn Cutts, Nicolas Krucien, Natasha Ramachandran, John L Gore
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引用次数: 0

摘要

目的:患者的偏好有可能影响局部晚期/转移性尿路上皮癌(la/mUC)新疗法的开发,因此我们探讨了la/mUC患者如何看待一线治疗的不同属性:方法:在有针对性地查阅文献并对医生、la/mUC 患者及其护理人员进行定性访谈后,我们制定了在线偏好调查和多维阈值法(MDT)练习。治疗属性包括两个益处(总体反应率[ORR]、与膀胱癌相关的疼痛[评分为0-100;100为最严重的疼痛])和四个与治疗相关的风险(周围神经病变、严重副作用、轻度至中度恶心、轻度至中度皮肤反应)。采用 Dirichlet 回归估算平均偏好权重。计算了边际效用和患者愿意接受的 ORR 降低幅度,以换取其他属性降低 10 个点或降低 10%:共招募了 100 名患者,他们自行填写了调查问卷和 MDT。患者平均年龄为 64.9 岁(标准差为 7.6),54% 为女性,38% 为白人。所有包含的治疗属性对偏好都有显著的统计学影响。ORR的变化影响最大,其次是癌症相关疼痛和治疗相关风险。患者愿意接受 ORR 下降 8.4% 以减少 10 个点的疼痛程度,或 ORR 下降 7.8% 以减少 10% 的周围神经病变风险。如果严重副作用、轻度至中度恶心或皮肤反应减少 10%,患者愿意接受的 ORR 下降幅度分别为 5.5%、3.7% 或 3.4%:结论:在测试的属性中,ORR 的变化对患者来说最为重要。结论:在测试的属性中,ORR 的变化对患者来说最为重要。患者会在治疗属性之间做出权衡,这表明患者可以接受较低的 ORR 来改善其他属性,如减少癌症相关疼痛或治疗相关不良事件的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Patient Preferences for First-Line Treatment of Locally Advanced or Metastatic Urothelial Carcinoma: An Application of Multidimensional Thresholding.

Patient Preferences for First-Line Treatment of Locally Advanced or Metastatic Urothelial Carcinoma: An Application of Multidimensional Thresholding.

Objectives: Patient preferences have the potential to influence the development of new treatments for locally advanced/metastatic urothelial carcinoma (la/mUC), and therefore we explored how patients with la/mUC value different attributes of first-line treatments.

Methods: An online preference survey and multidimensional thresholding (MDT) exercise were developed following a targeted literature review and qualitative interviews with physicians, patients with la/mUC, and their caregivers. Treatment attributes included two benefits (overall response rate [ORR], pain related to bladder cancer [scored 0-100; 100 being the worst pain possible]) and four treatment-related risks (peripheral neuropathy, severe side effects, mild to moderate nausea, mild to moderate skin reactions). A Dirichlet regression was used to estimate average preference weights. Marginal utility and the reduction in ORR that patients would accept in exchange for a 10-point decrease or a 10% decrease in other attributes were calculated.

Results: A total of 100 patients were recruited and self-completed the survey and MDT. Mean patient age was 64.9 years (standard deviation, 7.6), 54% were female, and 38% identified as white. All included treatment attributes had a statistically significant impact on preferences. Changes in ORR had the largest impact, followed by cancer-related pain and treatment-related risks. Patients were willing to accept an 8.4% decrease in ORR to reduce their pain level by 10 points or a 7.8% decrease in ORR to reduce the risk of peripheral neuropathy by 10%. For a 10% decrease in severe side effects, mild to moderate nausea, or skin reaction, patients would accept decreases in ORR of 5.5%, 3.7%, or 3.4%, respectively.

Conclusions: Of the attributes tested, changes in ORR were most important to patients. Patients made tradeoffs between treatment attributes indicating that a lower ORR may be acceptable for an improvement in other attributes such as reduced cancer-related pain or the risk of treatment-related adverse events.

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来源期刊
Patient-Patient Centered Outcomes Research
Patient-Patient Centered Outcomes Research HEALTH CARE SCIENCES & SERVICES-
CiteScore
6.60
自引率
8.30%
发文量
44
审稿时长
>12 weeks
期刊介绍: The Patient provides a venue for scientifically rigorous, timely, and relevant research to promote the development, evaluation and implementation of therapies, technologies, and innovations that will enhance the patient experience. It is an international forum for research that advances and/or applies qualitative or quantitative methods to promote the generation, synthesis, or interpretation of evidence. The journal has specific interest in receiving original research, reviews and commentaries related to qualitative and mixed methods research, stated-preference methods, patient reported outcomes, and shared decision making. Advances in regulatory science, patient-focused drug development, patient-centered benefit-risk and health technology assessment will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in The Patient may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances. All manuscripts are subject to peer review by international experts.
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