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Ozdemir S, Quaife M, Mohamed AF, Norman R. An Overview of Data Collection in Health Preference Research. THE PATIENT 2024:10.1007/s40271-024-00695-6. [PMID: 38662323 DOI: 10.1007/s40271-024-00695-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Abstract
This paper focuses on survey administration and data collection methods employed for stated-preference studies in health applications. First, it describes different types of survey administration methods, encompassing web-based surveys, face-to-face (in-person) surveys, and mail surveys. Second, the concept of sampling frames is introduced, clarifying distinctions between the target population and survey frame population. The discussion then extends to different types of sampling methods, such as probability and non-probability sampling, along with an evaluation of potential issues associated with different sampling methods within the context of health preference research. Third, the paper provides information about different recruitment methods, including web-surveys, leveraging patient groups, and in-clinic recruitment. Fourth, a crucial aspect addressed is the calculation of response rate, with insights into determining an adequate response rate and strategies to improve response rates in stated-preference surveys. Lastly, the paper concludes by discussing data management plans and suggesting insights for future research in this field. In summary, this paper examines the nuanced aspects of survey administration and data collection methods in stated-preference studies, offering valuable guidance for researchers and practitioners in the health domain.
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Affiliation(s)
- Semra Ozdemir
- Department of Population Health Sciences, Duke Clinical Research Institute, Duke University, Durham, NC, USA.
| | | | | | - Richard Norman
- Curtin School of Population Health, Curtin University, Perth, Australia
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Speckemeier C, Abels C, Höfer K, Walendzik A, Wasem J, Neusser S. A Best-Worst Scaling Study of the General Population's Preferences for Activities in Living Arrangements for Persons With Dementia. THE PATIENT 2024; 17:121-131. [PMID: 38063993 PMCID: PMC10894109 DOI: 10.1007/s40271-023-00661-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND Activity involvement is a central element of dementia care. However, few studies have examined preferences for types of activities for persons who may be in need of care in the future. In this study, a best-worst scaling (BWS) was conducted to gather insights on preferred activities in small-scale living arrangements for dementia in the general population aged 50-65 years from rural and urban regions. METHODS BWS tasks were developed based on literature searches and focus groups. The final BWS contains ten activities, namely 'interaction with animals', 'gardening', 'painting, handicrafts, manual activities', 'household activities (e.g., folding laundry, cooking)', 'watching television', 'practicing religion', 'listening to music and singing familiar songs', 'conversations about the past', 'walks and excursions', 'sport activities (e.g., gymnastics)'. Each participant had to fill out subsets of four objects each and identify them as best and worst. A postal survey was sent to a total of 4390 persons from rural and urban regions aged between 50 and 65 years. Results were analyzed by count analysis and logit models. It was examined if preferences differ with respect to gender, religiousness, and informal caregiving experience. RESULTS A total of 840 questionnaires were returned, and 627 surveys were included in the analysis. In the rural sample, the highest relative importance (RI) was assigned to 'walks and excursions' (RI: 100%), 'sport activities (e.g., gymnastics)' (RI: 56%), 'gardening' (RI: 28%), and 'interaction with animals' (26%). In the urban sample, 'walks and excursions' (RI: 100%), 'sport activities (e.g., gymnastics)' (RI: 37%), 'interaction with animals' (25%) and 'gardening' (RI: 22%) were perceived as most important. In both groups, household activities and practicing religion were of lowest importance. Importance ranks differed between subgroups. Results of the logit models with random effects showed the same order as results from the count analyses. DISCUSSION Our findings show that respondents generally favored activities with an outdoor component, while the household activities that are part of many concepts were of low importance to respondents. Thus, our study can inform the design of a preference-based specific range of activities in small-scale living arrangements for dementia.
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Affiliation(s)
- Christian Speckemeier
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany.
| | - Carina Abels
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Klemens Höfer
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Anke Walendzik
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Jürgen Wasem
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
| | - Silke Neusser
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Thea-Leymann-Str. 9, 45127, Essen, Germany
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Wood L, Foster NE, Lewis M, Bronfort G, Groessl EJ, Hewitt C, Miyamoto GC, Reme SE, Bishop A. Matching the Outcomes to Treatment Targets of Exercise for Low Back Pain: Does it Make a Difference? Results of Secondary Analyses From Individual Patient Data of Randomised Controlled Trials and Pooling of Results Across Trials in Comparative Meta-analysis. Arch Phys Med Rehabil 2023; 104:218-228. [PMID: 35934047 DOI: 10.1016/j.apmr.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To explore whether using a single matched or composite outcome might affect the results of previous randomized controlled trials (RCTs) testing exercise for non-specific low back pain (NSLBP). The first objective was to explore whether a single matched outcome generated greater standardized mean differences (SMDs) when compared with the original unmatched primary outcome SMD. The second objective was to explore whether a composite measure, composed of matched outcomes, generated a greater SMD when compared with the original primary outcome SMD. DESIGN We conducted exploratory secondary analyses of data. SETTING Seven RCTs were included, of which 2 were based in the USA (University research clinic, Veterans Affairs medical center) and the UK (primary care clinics, nonmedical centers). One each were based in Norway (clinics), Brazil (primary care), and Japan (outpatient clinics). PARTICIPANTS The first analysis comprised 1) 5 RCTs (n=1033) that used an unmatched primary outcome but included (some) matched outcomes as secondary outcomes, and the second analysis comprised 2) 4 RCTs (n=864) that included multiple matched outcomes by developing composite outcomes (N=1897). INTERVENTION Exercise compared with no exercise. MAIN OUTCOME MEASURES The composite consisted of standardized averaged matched outcomes. All analyses replicated the RCTs' primary outcome analyses. RESULTS Of 5 RCTs, 3 had greater SMDs with matched outcomes (pooled effect SMD 0.30 [95% confidence interval {CI} 0.04, 0.56], P=.02) compared with an unmatched primary outcome (pooled effect SMD 0.19 [95% CI -0.03, 0.40] P=.09). Of 4 composite outcome analyses, 3 RCTs had greater SMDs in the composite outcome (pooled effect SMD 0.28 [95% CI 0.05, 0.51] P=.02) compared with the primary outcome (pooled effect SMD 0.24 [95% CI -0.04, 0.53] P=.10). CONCLUSIONS These exploratory analyses suggest that using an outcome matched to exercise treatment targets in NSLBP RCTs may produce greater SMDs than an unmatched primary outcome. Composite outcomes could offer a meaningful way of investigating superiority of exercise than single domain outcomes.
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Affiliation(s)
- Lianne Wood
- Primary Care Centre Versus Arthritis, School of Medicine, Faculty of Medicine, Keele University, Newcastle-under-Lyme, UK; Nottingham University Hospitals NHS Trust, Queens Medical Centre, Derby Road, Nottingham, UK.
| | - Nadine E Foster
- Primary Care Centre Versus Arthritis, School of Medicine, Faculty of Medicine, Keele University, Newcastle-under-Lyme, UK
| | - Martyn Lewis
- Primary Care Centre Versus Arthritis, School of Medicine, Faculty of Medicine, Keele University, Newcastle-under-Lyme, UK
| | - Gert Bronfort
- Earl E Bakken Centre for Spirituality and Healing, University of Minnesota, Minneapolis, MN, USA
| | - Erik J Groessl
- University of California San Diego, Herbert Wertheim School of Public Health and UCSD Health Services Research Centre, La Jolla, CA, USA
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, University of York, UK
| | - Gisela C Miyamoto
- Master's and Doctoral Program in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Silje E Reme
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Annette Bishop
- Primary Care Centre Versus Arthritis, School of Medicine, Faculty of Medicine, Keele University, Newcastle-under-Lyme, UK
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Tokunboh I, Sung EM, Chatfield F, Gaines N, Nour M, Starkman S, Saver JL. Improving Visualization Methods of Utility-Weighted Disability Outcomes for Stroke Trials. Front Neurol 2022; 13:875350. [PMID: 35645952 PMCID: PMC9136165 DOI: 10.3389/fneur.2022.875350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe modified Rankin Scale (mRS) is the most common endpoint in acute stroke trials, but its power is limited when analyzed dichotomously and its indication of effect size is challenging to interpret when analyzed ordinally. To address these issues, the utility-weighted-mRS (UW-mRS) has been developed as a patient-centered, linear scale. However, appropriate data visualizations of UW-mRS results are needed, as current stacked bar chart displays do not convey crucial utility-weighting information.Design/MethodsTwo UW-mRS display formats were devised: (1) Utility Staircase charts, and (2) choropleth-stacked-bar-charts (CSBCs). In Utility Staircase displays, mRS segment height reflects the utility value of each mRS level. In CSBCs, mRS segment color intensity reflects the utility of each mRS level. Utility Staircase and CSBC figures were generated for 15 randomized comparisons of acute ischemic/hemorrhagic stroke therapies, including fibrinolysis, endovascular reperfusion, blood pressure moderation, and hemicraniectomy. Display accuracy in showing utility outcomes was assessed with the Tufte-lie-factor and ease-of-use assessed by formal ratings completed by a panel of 4 neurologists and emergency physicians and one nurse-coordinator.ResultsThe Utility Staircase and CSBC displays rapidly conveyed patient-centered valuation of trial outcome distributions not available in conventional ordinal stacked bar charts. Tufte-lie-factor (LF) scores indicated “substantial distortion” of utility-valued outcomes for 93% (14/15) of conventional stacked bar charts, vs. “no distortion” for all Utility Staircase and CSBC displays. Clinician ratings on the Figural Display Questionnaire indicated that utility information encoded in row height (Utility Staircase display) was more readily assimilated than that conveyed in segment hue intensity (CSBC), both superior to conventional stacked bar charts.ConclusionsUtility Staircase displays are an efficient graphical format for conveying utility weighted–modified Rankin Scale primary endpoint results of acute stroke trials, and choropleth-stacked-bar-charts a good alternative. Both are more accurate in depicting quantitative, health-related quality of life results and preferred by clinician users for utility results visualization, compared with conventional stacked bar charts.
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Affiliation(s)
- Ivie Tokunboh
- Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Eleanor Mina Sung
- Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
- *Correspondence: Eleanor Mina Sung
| | - Fiona Chatfield
- Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Nathan Gaines
- Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - May Nour
- Department of Neurology, Division of Interventional Neuroradiology, and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Sidney Starkman
- Departments of Emergency Medicine and Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jeffrey L. Saver
- Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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Hara H, Onuma Y, Serruys PW. Reply: Composite endpoints in clinical trials - simplicity or perfection? EUROINTERVENTION 2022; 17:1121-1122. [PMID: 35089138 PMCID: PMC9724920 DOI: 10.4244/eij-d-21-00440r] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Hironori Hara
- Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands,Department of Cardiology, National University of Ireland, Galway, Ireland
| | - Yoshinobu Onuma
- Department of Cardiology, National University of Ireland, Galway, Ireland
| | - Patrick W. Serruys
- National University of Ireland, University Road, Galway, H91 TK33, Ireland
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von Birgelen C, Ploumen E. Similar long-term outcome of dissimilar drug-eluting stents: is it time to change the assessment? EUROINTERVENTION 2021; 16:e1468-e1469. [PMID: 33792543 PMCID: PMC9707436 DOI: 10.4244/eijv16i18a266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Clemens von Birgelen
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Postbus 50.000, 7500 KA Enschede, the Netherlands
| | - Eline Ploumen
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the Netherlands,Department of Health Technology and Services Research, Faculty BMS, Technical Medical Centre, University of Twente, Enschede, the Netherlands
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Hurst JR, Agarwal G, van Boven JFM, Daivadanam M, Gould GS, Wan-Chun Huang E, Maulik PK, Miranda JJ, Owolabi MO, Premji SS, Soriano JB, Vedanthan R, Yan L, Levitt N. Critical review of multimorbidity outcome measures suitable for low-income and middle-income country settings: perspectives from the Global Alliance for Chronic Diseases (GACD) researchers. BMJ Open 2020; 10:e037079. [PMID: 32895277 PMCID: PMC7478040 DOI: 10.1136/bmjopen-2020-037079] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/28/2020] [Accepted: 07/18/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES There is growing recognition around the importance of multimorbidity in low-income and middle-income country (LMIC) settings, and specifically the need for pragmatic intervention studies to reduce the risk of developing multimorbidity, and of mitigating the complications and progression of multimorbidity in LMICs. One of many challenges in completing such research has been the selection of appropriate outcomes measures. A 2018 Delphi exercise to develop a core-outcome set for multimorbidity research did not specifically address the challenges of multimorbidity in LMICs where the global burden is greatest, patterns of disease often differ and health systems are frequently fragmented. We, therefore, aimed to summarise and critically review outcome measures suitable for studies investigating mitigation of multimorbidity in LMIC settings. SETTING LMIC. PARTICIPANTS People with multimorbidity. OUTCOME MEASURES Identification of all outcome measures. RESULTS We present a critical review of outcome measures across eight domains: mortality, quality of life, function, health economics, healthcare access and utilisation, treatment burden, measures of 'Healthy Living' and self-efficacy and social functioning. CONCLUSIONS Studies in multimorbidity are necessarily diverse and thus different outcome measures will be appropriate for different study designs. Presenting the diversity of outcome measures across domains should provide a useful summary for researchers, encourage the use of multiple domains in multimorbidity research, and provoke debate and progress in the field.
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Affiliation(s)
- John R Hurst
- UCL Respiratory, University College London, London, UK
| | - Gina Agarwal
- Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Job F M van Boven
- Department of Clinical Pharmacy & Pharmacology, University Medical Center Groningen, Groningen, The Netherlands
| | - Meena Daivadanam
- Deptartment of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
- Deptartment of Global Public Health, Karolinska Institutet, Solna, Sweden
- International Maternal and Child Health Division, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Gillian Sandra Gould
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton, New South Wales, Australia
| | - Erick Wan-Chun Huang
- Respiratory and Environmental Epidemiology, Woolcock Institute of Medical Research, Sydney, New South Wales, Australia
- Division of Thoracic Medicine, Department of Internal Medicine, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan
| | - Pallab K Maulik
- Research, The George Institute for Global Health, New Delhi, India
- Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Prasanna School of Public Health, Manipal, India
| | - J Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - M O Owolabi
- Medicine, University of Ibadan College of Medicine, Ibadan, Nigeria
| | | | - Joan B Soriano
- Universidad Autónoma de Madrid, Madrid, Spain
- Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Rajesh Vedanthan
- Department of Population Health and Department of Medicine, NYU Langone Health, New York, New York, USA
| | - Lijing Yan
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Naomi Levitt
- Medicine, University of Cape Town, Cape town, South Africa
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Warner JJ, Crook HL, Whelan KM, Bleser WK, Roiland RA, Hamilton Lopez M, Saunders RS, Wang TY, Hernandez AF, McClellan MB, Califf RM, Brown N. Improving Cardiovascular Drug and Device Development and Evidence Through Patient-Centered Research and Clinical Trials. Circ Cardiovasc Qual Outcomes 2020; 13:e006606. [DOI: 10.1161/circoutcomes.120.006606] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The pipeline of new cardiovascular drugs is relatively limited compared with many other clinical areas. Challenges causing lagging drug innovation include the duration and expense of cardiovascular clinical trials needed for regulatory evaluation and approvals, which generally must demonstrate noninferiority to existing standards of care and measure longer-term outcomes. By comparison, there has been substantial progress in cardiovascular device innovation. There has also been progress in cardiovascular trial participation equity in recent years, especially among women, due in part to important efforts by Food and Drug Administration, National Institutes of Health, American Heart Association, and others. Yet women and especially racial and ethnic minority populations remain underrepresented in cardiovascular trials, indicating much work ahead to continue recent success. Given these challenges and opportunities, the multistakeholder Partnering with Regulators Learning Collaborative of the Value in Healthcare Initiative, a collaboration of the American Heart Association and the Robert J. Margolis, MD, Center for Health Policy at Duke University, identified how to improve the evidence generation process for cardiovascular drugs and devices. Drawing on a series of meetings, literature reviews, and analyses of regulatory options, the Collaborative makes recommendations across four identified areas for improvement. First, we offer strategies to enhance patient engagement in trial design, convenient participation, and meaningful end points and outcomes to improve patient recruitment and retention (major expenses in clinical trials). Second, new digital technologies expand the potential for real-world evidence to streamline data collection and reduce cost and time of trials. However, technical challenges must be overcome to routinely leverage real-world data, including standardizing data, managing data quality, understanding data comparability, and ensuring real-world evidence does not worsen inequities. Third, as trials are driven by evidence needs of regulators and payers, we recommend ways to improve their collaboration in trial design to streamline and standardize efficient and innovative trials, reducing costs and delays. Finally, we discuss creative ways to expand the minuscule proportion of sites involved in cardiovascular evidence generation and medical product development. These actions, paired with continued policy research into better ways to pay for and equitably develop therapies, will help reduce the cost and complexity of drug and device research, development, and trials.
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Affiliation(s)
- John J. Warner
- University of Texas Southwestern Medical Center, Dallas (J.J.W.)
| | - Hannah L. Crook
- Robert J. Margolis, MD, Center for Health Policy, Duke University, Washington, DC and Durham, NC (H.L.C., K.M.W., W.K.B., R.A.R., M.H.L., R.S.S., M.B.M.)
| | - Karley M. Whelan
- Robert J. Margolis, MD, Center for Health Policy, Duke University, Washington, DC and Durham, NC (H.L.C., K.M.W., W.K.B., R.A.R., M.H.L., R.S.S., M.B.M.)
| | - William K. Bleser
- Robert J. Margolis, MD, Center for Health Policy, Duke University, Washington, DC and Durham, NC (H.L.C., K.M.W., W.K.B., R.A.R., M.H.L., R.S.S., M.B.M.)
| | - Rachel A. Roiland
- Robert J. Margolis, MD, Center for Health Policy, Duke University, Washington, DC and Durham, NC (H.L.C., K.M.W., W.K.B., R.A.R., M.H.L., R.S.S., M.B.M.)
| | - Marianne Hamilton Lopez
- Robert J. Margolis, MD, Center for Health Policy, Duke University, Washington, DC and Durham, NC (H.L.C., K.M.W., W.K.B., R.A.R., M.H.L., R.S.S., M.B.M.)
| | - Robert S. Saunders
- Robert J. Margolis, MD, Center for Health Policy, Duke University, Washington, DC and Durham, NC (H.L.C., K.M.W., W.K.B., R.A.R., M.H.L., R.S.S., M.B.M.)
| | - Tracy Y. Wang
- Duke University School of Medicine, Duke University, Durham, NC (T.Y.W., A.F.H.)
| | - Adrian F. Hernandez
- Duke University School of Medicine, Duke University, Durham, NC (T.Y.W., A.F.H.)
| | - Mark B. McClellan
- Robert J. Margolis, MD, Center for Health Policy, Duke University, Washington, DC and Durham, NC (H.L.C., K.M.W., W.K.B., R.A.R., M.H.L., R.S.S., M.B.M.)
| | - Robert M. Califf
- Verily Life Sciences, South San Francisco, CA (R.M.C.)
- Google Life Sciences, Palo Alto, CA (R.M.C.)
| | - Nancy Brown
- American Heart Association, Dallas, TX (N.B.)
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Kok MM, von Birgelen C. Involving the patient's perspective and preferences concerning coronary angiography and percutaneous coronary intervention. EUROINTERVENTION 2020; 15:1228-1231. [PMID: 32044732 DOI: 10.4244/eijv15i14a221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Marlies M Kok
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, the Netherlands
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Udogwu UN, Howe A, Frey K, Isaac M, Connelly D, Marinos D, Baker M, Castillo RC, Slobogean GP, O'Toole RV, O'Hara NN. A patient-centered composite endpoint weighting technique for orthopaedic trauma research. BMC Med Res Methodol 2019; 19:242. [PMID: 31878874 PMCID: PMC6933647 DOI: 10.1186/s12874-019-0885-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 12/09/2019] [Indexed: 12/31/2022] Open
Abstract
Background This study aimed to address the current limitations of the use of composite endpoints in orthopaedic trauma research by quantifying the relative importance of clinical outcomes common to orthopaedic trauma patients and use those values to develop a patient-centered composite endpoint weighting technique. Methods A Best-Worst Scaling choice experiment was administered to 396 adult surgically-treated fracture patients. Respondents were presented with ten choice sets, each consisting of three out of ten plausible clinical outcomes. Hierarchical Bayesian modeling was used to determine the utilities associated with the outcomes. Results Death was the outcome of greatest importance (mean utility = − 8.91), followed by above knee amputation (− 7.66), below knee amputation (− 6.97), severe pain (− 5.90), deep surgical site infection (SSI) (− 5.69), bone healing complications (− 5.20), and moderate pain (− 4.59). Mild pain (− 3.30) and superficial SSI (− 3.29), on the other hand, were the outcomes of least importance to respondents. Conclusion This study revealed that patients’ relative importance towards clinical outcomes followed a logical gradient, with distinct and quantifiable preferences for each possible component outcome. These findings were incorporated into a novel composite endpoint weighting technique.
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Affiliation(s)
- Ugochukwu N Udogwu
- Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca St., Suite 300, Baltimore, MD, 21201, USA
| | - Andrea Howe
- Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca St., Suite 300, Baltimore, MD, 21201, USA
| | - Katherine Frey
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Baltimore, MD, 21205, USA
| | - Marckenley Isaac
- Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca St., Suite 300, Baltimore, MD, 21201, USA
| | - Daniel Connelly
- Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca St., Suite 300, Baltimore, MD, 21201, USA
| | - Dimitrius Marinos
- Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca St., Suite 300, Baltimore, MD, 21201, USA
| | - Mitchell Baker
- Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca St., Suite 300, Baltimore, MD, 21201, USA
| | - Renan C Castillo
- Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca St., Suite 300, Baltimore, MD, 21201, USA
| | - Gerard P Slobogean
- Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca St., Suite 300, Baltimore, MD, 21201, USA
| | - Robert V O'Toole
- Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca St., Suite 300, Baltimore, MD, 21201, USA
| | - Nathan N O'Hara
- Department of Orthopaedics, University of Maryland School of Medicine, 110 S. Paca St., Suite 300, Baltimore, MD, 21201, USA.
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Serruys PW, Tomaniak M, Chichareon P, Modolo R, Kogame N, Takahashi K, Chang CC, Spitzer E, Walsh SJ, Adlam D, Hildick-Smith D, Édes I, van de Harst P, Krackhardt F, Tijssen JG, Rademaker-Havinga T, Garg S, Steg PG, Hamm C, Jüni P, Vranckx P, Onuma Y, Verheugt FW. Patient-oriented composite endpoints and net adverse clinical events with ticagrelor monotherapy following percutaneous coronary intervention: insights from the randomised GLOBAL LEADERS trial. EUROINTERVENTION 2019; 15:e1090-e1098. [DOI: 10.4244/eij-d-19-00202] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Vaanholt MCW, Kok MM, von Birgelen C, Weernink MGM, van Til JA. Are component endpoints equal? A preference study into the practice of composite endpoints in clinical trials. Health Expect 2018; 21:1046-1055. [PMID: 30109764 PMCID: PMC6250862 DOI: 10.1111/hex.12798] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2018] [Indexed: 01/09/2023] Open
Abstract
Objectives To examine patients’ perspectives regarding composite endpoints and the utility patients put on possible adverse outcomes of revascularization procedures. Design In the PRECORE study, a stated preference elicitation method Best‐Worst Scaling (BWS) was used to determine patient preference for 8 component endpoints (CEs): need for redo percutaneous coronary intervention (PCI) within 1 year, minor stroke with symptoms <24 hours, minor myocardial infarction (MI) with symptoms <3 months, recurrent angina pectoris, need for redo coronary artery bypass grafting (CABG) within 1 year, major MI causing permanent disability, major stroke causing permanent disability and death within 24 hours. Setting A tertiary PCI/CABG centre. Participants One hundred and sixty patients with coronary artery disease who underwent PCI or CABG. Main outcome measures Importance weights (IWs). Results Patients considered need for redo PCI within 1 year (IW: 0.008), minor stroke with symptoms <24 hours (IW: 0.017), minor MI with symptoms <3 months (IW: 0.027), need for redo CABG within 1 year (IW: 0.119), recurrent angina pectoris (IW: 0.300) and major MI causing permanent disability (IW: 0.726) less severe than death within 24 hours (IW: 1.000). Major stroke causing permanent disability was considered worse than death within 24 hours (IW: 1.209). Ranking of CEs and the relative values attributed to the CEs differed among subgroups based on gender, age and educational level. Conclusion Patients attribute different weight to individual CEs. This has significant implications for the interpretation of clinical trial data.
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Affiliation(s)
- Melissa C W Vaanholt
- Department of Health Technology and Services Research, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Marlies M Kok
- Department of Cardiology, Medisch Spectrum Twente, Thoraxcentrum Twente, Enschede, The Netherlands
| | - Clemens von Birgelen
- Department of Health Technology and Services Research, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.,Department of Cardiology, Medisch Spectrum Twente, Thoraxcentrum Twente, Enschede, The Netherlands
| | - Marieke G M Weernink
- Department of Health Technology and Services Research, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Janine A van Til
- Department of Health Technology and Services Research, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
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