Use of best-worst scaling to estimate the magnitude of stressful life events in older adults

Identification of Relevant Attributes for Liver Cancer Therapies (IRALCT): a maximum-difference-scaling analysis

The Identification of Relevant Attributes for Liver Cancer Therapies (IRALCT) project is intended to provide new insights into the relevant utility attributes regarding therapy choices for malignant primary and secondary liver tumors from the perspective of those who are involved in the decision-making process. It addresses the potential value of taking patients' expectations and preferences into account during the decision-making and, when possible, adapting therapies according to these preferences. Specifically, it is intended to identify the relevant clinical attributes that influence the patients', medical laymen's, and medical professionals' decisions and compare the three groups' preferences. We conducted maximum difference (MaxDiff) scaling among 261 participants (75 physicians, 97 patients with hepatic malignancies, and 89 medical laymen) to rank the importance of 14 attributes previously identified through a literature review. We evaluated the MaxDiff data using count analysis and hierarchical Bayes estimation (HB). Physicians, patients, and medical laymen assessed the same 7 attributes as the most important: probability (certainty) of a complete removal of the tumor, probability of reoccurrence of the disease, pathological evidence of tumor removal, possible complications during the medical intervention, welfare after the medical intervention, duration and intensity of the pain, and degree of difficulty of the medical intervention. The cumulative relative importance of these 7 attributes was 88.3%. Our results show that the physicians', patients', and medical laymen's preferences were very similar and stable.Trial registration DRKS-ID of the study: DRKS00013304, Date of Registration in DRKS: 2017/11/16.

Study of the Effects of Recognition of Stress on Symptoms and Regular Hospital Visits: An Analysis from Japanese National Statistics

Stress is a risk factor for numerous lifestyle diseases, including dental diseases. The purpose of the present study was to investigate how sensitivity to psychological stress relates to subjective symptoms and regular hospital visits using information from the large-scale database of national statistics. Anonymized data from 10,584 respondents aged 30–79 of the Japanese 2013 Comprehensive Survey of Living Conditions were analyzed. Respondents were classified by age into a middle-aged group and an elderly group, and a contingency table analysis, rank correlation analysis, and binomial logistic regression analysis were performed. Contingency table analysis confirmed that eight items were related to the presence of a recognition of stress, including the presence of subjective symptoms (p < 0.001), the presence of regular hospital visits (p < 0.001), symptoms of periodontal disease (p < 0.001), and self-rated health (p < 0.001). Responses for symptoms and diseases requiring regular hospital visits were ranked in order for a stress group and a no stress group, and it was found that other than fatigue symptoms being ranked highly in the stress group, there were no particular differences. Logistic regression analysis results showed significant odds ratios for six items including: self-rated health (3.91, 95% CI, 3.23 to 4.73), lifestyle awareness (1.96, 95% CI, 1.68 to 2.28), and symptoms of periodontal disease (1.71, 95% CI 1.19 to 2.48). The present study showed that susceptibility to psychological stress is related to awareness of subjective symptoms and to regular hospital visits due to disease, suggesting that these have direct and indirect mutual effects.