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Jones C, Venable JR. Theory-Based Problem Formulation and Ideation in mHealth. J ORGAN END USER COM 2022. [DOI: 10.4018/joeuc.289434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This article reports on an investigation into how to improve problem formulation and ideation in Design Science Research (DSR) within the mHealth domain. A Systematic Literature Review of problem formulation in published mHealth DSR papers found that problem formulation is often only weakly performed, with shortcomings in stakeholder analysis, patient-centricity, clinical input, use of kernel theory, and problem analysis. The study proposes using Coloured Cognitive Mapping for DSR (CCM4DSR) as a tool to improve problem formulation in mHealth DSR. A case study using CCM4DSR found that using CCM4DSR provided a more comprehensive problem formulation and analysis, highlighting aspects that, until CCM4DSR was used, weren’t apparent to the research team and which served as a better basis for mHealth feature ideation.
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Bhurosy T, Heckman CJ, Riley M. Prevalence and correlates of skin self-examination behaviors among melanoma survivors: a systematic review. Transl Behav Med 2020; 10:1120-1133. [PMID: 33044529 DOI: 10.1093/tbm/ibaa003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Melanoma is the most common cause of skin cancer deaths, and individuals who have had melanoma have an increased risk of developing new melanomas. Doing regular self-examinations of skin enables one to detect thinner melanomas earlier when the disease is more treatable. The aim of this systematic review is to characterize and evaluate the existing literature on the prevalence and correlates of skin self-examination (SSE) behaviors among adult melanoma survivors in the USA and Canada. A computerized literature search was performed using PubMed, Google Scholar, and ScienceDirect. The inclusion criteria for the studies were: (a) reported results for adult melanoma survivors in the USA or Canada, (b) papers described empirical research, (c) assessed SSE and related behaviors, and (d) papers were published in a peer-reviewed journal in the past 20 years. Key phrases such as "skin self-examination/SSE in melanoma survivors in the United States" and "correlates of skin self-examination/SSE" were used. Based on the inclusion criteria, 30 studies were included in the systematic review. SSE prevalence varied depending on how SSE was defined. Demographics and factors (gender, education level, patient characteristics, partner assistance, and physician support) associated with SSE were identified. Findings of this review show evidence for the need to have a consistent way to assess SSE and suggest different types of correlates on which to focus in order to promote SSE and reduce the risk of melanoma recurrence in survivors. This systematic review and its protocol have been registered in the international database of prospectively registered systematic reviews in health and social care (PROSPERO; ID: 148878).
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Affiliation(s)
- Trishnee Bhurosy
- Division of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Carolyn J Heckman
- Division of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Mary Riley
- Division of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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Parsons BG, Hay JL, Aspinwall LG, Zaugg K, Zhu A, Mooney RH, Klein SZ, Grossman D, Leachman SA, Wu YP. Understanding Skin Screening Practices Among Children at Elevated Risk for Melanoma to Inform Interventions for Melanoma Prevention and Control. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:509-514. [PMID: 30771212 PMCID: PMC6697232 DOI: 10.1007/s13187-019-01489-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Melanoma is the deadliest form of skin cancer. Screening can aid in early disease detection, when treatment is more effective. Although there are currently no consensus guidelines regarding skin screening for pediatric populations with elevated familial risk for melanoma, at-risk children with the help of their parents and healthcare providers may implement skin self-exams. Healthcare providers may also recommend screening practices for these children. The goal of the current study was to describe current screening behaviors and provider recommendation for screening among children of melanoma survivors. Parents of children with a family history of melanoma completed a questionnaire that included items on children's screening frequency, thoroughness, and who performed the screening. Seventy-four percent of parents reported that their children (mean age = 9.0 years, SD = 4.8) had engaged in parent-assisted skin self-exams (SSEs) in the past 6 months. Only 12% of parents reported that children received SSEs once per month (the recommended frequency for adult melanoma survivors). In open-ended responses, parents reported that healthcare providers had provided recommendations around how to conduct SSEs, but most parents did not report receiving information on recommended SSE frequency. Twenty-six percent of parents (n = 18) reported that children had received a skin exam by a healthcare provider in the past 6 months. The majority of children with a family history of melanoma are reportedly engaging in skin exams despite the lack of guidelines on screening in this population. Future melanoma preventive interventions should consider providing families guidance about implementing screening with their children.
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Affiliation(s)
- Bridget G Parsons
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Lisa G Aspinwall
- Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84112, USA
| | - Kelsey Zaugg
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA
| | - Angela Zhu
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA
| | - Ryan H Mooney
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA
| | - Stephanie Z Klein
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT, 84132, USA
| | - Douglas Grossman
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT, 84132, USA
| | - Sancy A Leachman
- Department of Dermatology & Knight Cancer Institute, Oregon Health & Science University, 3303 SW Bond Avenue, Portland, OR, 97239, USA
| | - Yelena P Wu
- Huntsman Cancer Institute, 2000 Circle of Hope, Rm 4509, Salt Lake City, UT, 84112, USA.
- Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT, 84132, USA.
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Merten JW, Hamadi H, Wheeler M. Cancer risk perception predictors for total body skin examinations: a cross-sectional study using Health Information National Trends Survey (HINTS) 2017 data. Int J Dermatol 2020; 59:829-836. [PMID: 32459047 DOI: 10.1111/ijd.14935] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 04/15/2020] [Accepted: 04/18/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Despite the lack of national skin cancer screening recommendations, a total body skin examination by a healthcare provider may detect skin cancer earlier, allowing for more effective treatment and better outcomes. OBJECTIVE Examine prevalence, demographic, and cancer risk perceptions of adults who have had a skin examination performed by a healthcare provider. METHODS Retrospective, cross-sectional analysis of a nationally representative sample of U.S. adults using the Health Information National Trends Survey (HINTS). Logistic regressions were performed to identify associations between having a skin examination, risk perceptions, and demographic variables. RESULTS Approximately 46% of the sample reported having a skin examination. Females, college graduates, those with a history of skin cancer, people who check their skin for signs of skin cancer, and adults over the age of 45 were more likely to have a skin examination. The people least likely to be screened were those not wanting to know their chances of getting cancer. LIMITATIONS HINTS is a cross-sectional survey which provides only a glimpse of predictors. CONCLUSIONS The findings are consistent with other studies that people sometimes avoid cancer risk information. An educational intervention focused on the benefits of early cancer detection would benefit people who report not wanting to know their chances of getting cancer.
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Affiliation(s)
- Julie W Merten
- Department of Public Health, University of North Florida, Jacksonville, FL, USA
| | - Hanadi Hamadi
- Department of Health Administration, University of North Florida, Jacksonville, FL, USA
| | - Meghann Wheeler
- Department of Public Health, University of North Florida, Jacksonville, FL, USA
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Coroiu A, Moran C, Bergeron C, Drapeau M, Wang B, Kezouh A, Ernst J, Batist G, Körner A. Short and long-term barriers and facilitators of skin self-examination among individuals diagnosed with melanoma. BMC Cancer 2020; 20:123. [PMID: 32059700 PMCID: PMC7023754 DOI: 10.1186/s12885-019-6476-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 12/17/2019] [Indexed: 12/21/2022] Open
Abstract
Background Melanoma can be lethal if not detected early and treated. Early detection can be facilitated via skin self-examination (SSE) and as such, SSE is part of melanoma follow-up care for individuals with a prior history, who face a life-long risk of reoccurrence. The objective of the current study was to identify short- and long-term predictors of SSE among melanoma survivors to inform future prevention interventions in high-risk groups. Method This is an observational study with longitudinal assessments conducted with adult melanoma patients in active follow-up care. Primary outcome measures Behavioral outcomes, comprehensive SSE (checking up to 5 body areas in the last 3 months) and optimal SSE (checking the entire body at least monthly in the last 3 months) were assessed at 3, 12, and 24 months post a dermatological educational session on skin cancer prevention. T tests and chi square analyses were used to examine changes in outcomes from 3 to 12 and 24 months. Linear and logistic regression models were used to examine the association between predictors and the primary outcomes. Results Comprehensive SSE did not decrease significantly from 3 (M = 2.7, SD = 1.1) to 12 (M = 2.6, SD = 1.2) and 24 months (M = 2.4, SD = 1.2) post the education session, with the stronger predictor at all timepoints being intentions to perform SSE. Optimal SSE was higher at 3 months (59%) compared to 12 (46%) and 24 months (34%), with key predictors including self-efficacy and intentions to perform SSE and male sex at 3 months post; self-efficacy and reliance on medical advice at 12 months; and (lower) education and self-efficacy at 24 months. Conclusions The key findings of this study are that 1) survivors maintain SSE behaviour over time, but rates of SSE performed in agreement with medical recommendations are higher immediately post standard dermatological education (i.e. usual care) and decrease somewhat over a 24-month period; and 2) the strongest psycho-social predictors of SSE are intentions and self-efficacy to perform the behavior, which are highly modifiable, for example via motivational interviewing and goal setting health interventions.
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Affiliation(s)
- Adina Coroiu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Educational and Counselling Psychology, McGill University, Montréal, Quebec, Canada
| | - Chelsea Moran
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Catherine Bergeron
- Department of Educational and Counselling Psychology, McGill University, Montréal, Quebec, Canada
| | - Martin Drapeau
- Department of Educational and Counselling Psychology, McGill University, Montréal, Quebec, Canada.,Department of Psychiatry, McGill University, Montréal, Canada
| | - Beatrice Wang
- Gerald Bronfman Department of Oncology, McGill University Health Center, Montréal, Canada
| | - Abbas Kezouh
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Canada
| | - Jochen Ernst
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
| | - Gerald Batist
- Department of Medicine, McGill University, Montréal, Canada.,Department of Oncology, Sir Mortimer B. Davis-Jewish General Hospital, Montréal, Canada.,Department of Oncology, McGill University, Montréal, Canada.,Segal Cancer Centre, Montréal, Canada.,Centre for Translational Research in Cancer, McGill University, Montréal, Canada
| | - Annett Körner
- Department of Educational and Counselling Psychology, McGill University, Montréal, Quebec, Canada.,Department of Oncology, McGill University, Montréal, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Canada.,Louise Granofsky Psychosocial Oncology Program, Segal Cancer Center, Montreal, Canada.,Psychosocial Oncology Program, McGill University Health Centre, Montreal, Canada
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Robinson JK, Perez M, Abou-El-Seoud D, Kim K, Brown Z, Liko-Hazizi E, Friedewald SM, Kwasny M, Spring B. Targeted Melanoma Screening: Risk Self-Assessment and Skin Self-Examination Education Delivered During Mammography of Women. JNCI Cancer Spectr 2019; 3:pkz047. [PMID: 32328556 PMCID: PMC7049996 DOI: 10.1093/jncics/pkz047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/09/2019] [Accepted: 06/19/2019] [Indexed: 01/27/2023] Open
Abstract
Background Melanoma, which is the sixth most common cancer in women, is visible on the surface of the skin; therefore, self-screening (skin self-examination [SSE]) may be beneficial. Methods A convenience sample of women undergoing mammography was sequentially assigned by week into this two-arm targeted melanoma screening intervention. Both groups saw an informational poster and received a brochure promoting risk self-identification and SSE education. One group received an additional 1-week SSE reminder. Participants completed baseline and 1- and 3-month follow-up surveys assessing SSE performance, identifying a concerning mole, scheduling a dermatology appointment, and anxiety due to the program. Performance of SSE between groups was compared using χ2 analysis. The electronic medical record was reviewed for diagnosis of concerning moles. Results At 1 month, 384 of 420 (91.4% retention) women completed the survey. Of those, 311 (80.9%) performed SSE. Of those who performed SSE, 54 (14%) found a concerning mole at either 1 or 3 months. At 3 months, 346 (82.4% retention) women completed the survey. The number of women who performed SSE did not differ between groups at 1 month (χ2 = 1.64, P = .17) or 3 months (χ2 = 1.58, P = .12). Seven melanomas were found among 34 women who identified a concerning mole; examination of 4.8 women yielded one melanoma. Anxiety was low with a median score of 9.5 (range = 0–42.9). Conclusions Introducing melanoma risks and SSE education during mammography was feasible and did not demonstrate harms; thus, there is an opportunity to reach a large, at-risk population with limited burden for the participant and clinics.
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Affiliation(s)
- June K Robinson
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Megan Perez
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Dalya Abou-El-Seoud
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Kathryn Kim
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Zoe Brown
- Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Elona Liko-Hazizi
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Sarah M Friedewald
- Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, IL.,Lynn Sage Comprehensive Breast Center of Northwestern Medicine/Prentice Women's Hospital Northwestern Medicine, Chicago, IL
| | - Mary Kwasny
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL
| | - Bonnie Spring
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL
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Coffin T, Wu YP, Mays D, Rini C, Tercyak KP, Bowen D. Relationship of parent-child sun protection among those at risk for and surviving with melanoma: Implications for family-based cancer prevention. Transl Behav Med 2019; 9:480-488. [PMID: 31094442 PMCID: PMC6520807 DOI: 10.1093/tbm/ibz032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Preventing melanoma, the most serious form of skin cancer, is an important cancer control priority. This is especially true among children living in families previously affected by the disease because the risks for melanoma typically begin early in life. These risks accrue into adulthood but may be mitigated by parental intervention. Melanoma prevention behaviors that could be associated between adults and their children include use of sunscreen, protective clothing, seeking shade, or limiting sun exposure. This study sought to investigate how parent perceptions and behaviors influence sun protection and avoidance behaviors in their children, among relatives of melanoma survivors. In this cross-sectional study, parents (N = 313), all relatives of people diagnosed with melanoma, were surveyed about their melanoma risk-reduction behaviors and efforts to protect their children from sun exposure. Linear multiple regressions examined associations among parental behaviors, beliefs, and their reports of risk reduction for their children. Parents who practiced high sun protection themselves (i.e., wearing protective clothing, avoiding the sun, using sunscreen) were significantly more likely to report their child also wore protective clothing (B = 0.04, p < .004). Findings suggest that parents' use of risk-reducing behavioral measures extended to protective measures among their children. These findings have implications for the clinical care of melanoma survivors' families, including the design of targeted interventions that alter parental beliefs and behaviors surrounding both their own and their children's cancer prevention strategies.
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Affiliation(s)
- Tara Coffin
- Institute for Public Health Genetics, University of Washington, Washington, USA
| | - Yelena P Wu
- Huntsman Cancer Institute, University of Utah, Utah, USA
- Department of Dermatology, University of Utah, Utah, USA
| | - Darren Mays
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, NW, Washington, DC, USA
| | - Christine Rini
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, NW, Washington, DC, USA
- Department of Biomedical Research, John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Kenneth P Tercyak
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University Medical Center, NW, Washington, DC, USA
| | - Deborah Bowen
- Department of Bioethics & Humanities, University of Washington, Washington, USA
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Bergeron C, Moran C, Coroiu A, Körner A. Development and initial validation of the Self-Efficacy for Skin Self-Examination Scale in a Canadian sample of patients with melanoma. Eur J Oncol Nurs 2019; 40:78-84. [PMID: 31229210 DOI: 10.1016/j.ejon.2019.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Melanoma is the deadliest type of skin cancer, although survival rates are high if detected early. Skin self-examination (SSE) is a health behaviour that can lead to early detection of melanoma and more positive health outcomes. Self-efficacy for SSE is a potential predictor of engaging in skin self-exams. However, no standardized measures of self-efficacy for SSE are currently available. The present study reports on the development and initial validation of a measure assessing self-efficacy for SSE. METHOD Based on a literature review, including previous studies assessing this construct, the research team developed 9 items capturing confidence in one's ability to conduct SSE. Items were subsequently revised by the research team and two dermatologists, resulting in the elimination of 4 items and modifications to the response options. The final 5-item Self-Efficacy for SSE scale was administered to a sample of 242 melanoma patients recruited from local hospitals. We assessed the scale's factor structure through exploratory factor analysis and the internal consistency with Cronbach's alpha. Scale scores were correlated with intentions to perform SSE, physician support for SSE, skin cancer-specific distress, general distress, and sociodemographic variables to assess convergent and divergent validity. RESULTS The scale was found to be unifactorial with adequate model fit, have acceptable internal consistency (Cronbach alpha = 0.74), and initial evidence of convergent and divergent validity, as indicated by the scale correlating with physicians' support for SSE (r = 0.30, p < 0.01), intention to perform SSE (rs = 0.21, p < 0.01) and a weak correlation with general distress (r = 0.15, p < 0.05). CONCLUSIONS Pending future research corroborating these findings, this measure has potential for use by nurses and other health professionals in follow-up care to identify individuals at risk for low self-efficacy for SSE requiring more targeted educational SSE interventions.
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Affiliation(s)
- Catherine Bergeron
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada.
| | - Chelsea Moran
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Adina Coroiu
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Annett Körner
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada; Department of Oncology, McGill University, Montreal, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada; Louise Granofsky Psychosocial Oncology Program, Segal Cancer Centre, Montreal, Canada; Psychosocial Oncology Program, McGill University Health Centre, Montreal, Canada
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Liu FX, Witt EA, Ebbinghaus S, DiBonaventura Beyer G, Shinde R, Basurto E, Joseph RW. Patient and oncologist preferences for attributes of treatments in advanced melanoma: a discrete choice experiment. Patient Prefer Adherence 2017; 11:1389-1399. [PMID: 28860722 PMCID: PMC5565374 DOI: 10.2147/ppa.s140226] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To examine and compare patient and oncologist preferences for advanced melanoma treatment attributes and to document their trade-offs for benefits with risks. MATERIALS AND METHODS A discrete choice experiment (DCE) was conducted among advanced melanoma patients and oncologists. Qualitative pilot testing was used to inform the DCE design. A series of scenarios asked stakeholders to choose between two hypothetical medications, each with seven attributes: mode of administration (MoA), dosing schedule (DS), median duration of therapy (MDT), objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and grade 3-4 adverse events (AEs). Hierarchical Bayesian logistic regression models were used to determine patients' and oncologists' choice-based preferences, analysis of variance models were used to estimate the relative importance of attributes, and independent t-tests were used to compare relative importance estimates between stakeholders. RESULTS In total, 200 patients and 226 oncologists completed the study. OS was most important to patients (33%), followed by AEs (29%) and ORR (25%). For oncologists, AEs were most important (49%), followed by OS (34%) and ORR (12%). An improvement from 55% to 75% in 1-year OS was valued similar in magnitude to a 23% decrease (from 55% to 32%) in likelihood of AEs for oncologists. CONCLUSION Patients valued OS, AEs, and ORR sequentially as the most important attributes in making a treatment decision, whereas oncologists valued AEs most, followed by OS and ORR. In comparison, patients differed significantly from oncologists on the importance of ORR, AEs, and PFS, but were consistent in OS and the rest of attributes.
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Affiliation(s)
- Frank Xiaoqing Liu
- Merck & Co., Inc., Kenilworth, NJ, USA
- Correspondence: Frank Xiaoqing Liu, Center for Observational and Real World Evidence (CORE), Merck Research Laboratories, 351 N Sumneytown Pike, North Wales, PA 19454, USA, Tel +1 267 305 1265, Email
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