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Metcalfe RK, Dobischok S, Bansback N, MacDonald S, Byres D, Lajeunesse J, Harrison S, Koch B, Topping B, Brock T, Foreman J, Schechter M, Oviedo-Joekes E. Client preferences for the design and delivery of injectable opioid agonist treatment services: Results from a best-worst scaling task. Addiction 2024. [PMID: 39054406 DOI: 10.1111/add.16620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 06/19/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND AND AIMS Clinical trials support injectable opioid agonist treatment (iOAT) for individuals with opioid use disorder (OUD) for whom other pharmacological management approaches are not well-suited. However, despite substantial research indicating that person-centered care improves engagement, retention and health outcomes for individuals with OUD, structural requirements (e.g. drug policies) often dictate how iOAT must be delivered, regardless of client preferences. This study aimed to quantify clients' iOAT delivery preferences to improve client engagement and retention. DESIGN Cross-sectional preference elicitation survey. SETTING Metro Vancouver, British Columbia, Canada. PARTICIPANTS 124 current and former iOAT clients. MEASUREMENTS Participants completed a demographic questionnaire package and an interviewer-led preference elicitation survey (case 2 best-worst scaling task). Latent class analysis was used to identify distinct preference groups and explore demographic differences between preference groups. FINDINGS Most participants (n = 100; 81%) were current iOAT clients. Latent class analysis identified two distinct groups of client preferences: (1) autonomous decision-makers (n = 73; 59%) and (2) shared decision-makers (n = 51; 41%). These groups had different preferences for how medication type and dosage were selected. Both groups prioritized access to take-home medication (i.e. carries), the ability to set their own schedule, receiving iOAT in a space they like and having other services available at iOAT clinics. Compared with shared decision-makers, fewer autonomous decision-makers identified as a cis-male/man and reported flexible preferences. CONCLUSIONS Injectable opioid agonist treatment (iOAT) clients surveyed in Vancouver, Canada, appear to prefer greater autonomy than they currently have in choosing OAT medication type, dosage and treatment schedule.
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Affiliation(s)
- Rebecca Kathleen Metcalfe
- Centre for Advancing Health Outcomes, Providence Health Care, St. Paul's Hospital, Vancouver, Canada
| | - Sophia Dobischok
- Centre for Advancing Health Outcomes, Providence Health Care, St. Paul's Hospital, Vancouver, Canada
- Department of Education and Counselling Psychology, McGill University, Montreal, Canada
| | - Nick Bansback
- Centre for Advancing Health Outcomes, Providence Health Care, St. Paul's Hospital, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Scott MacDonald
- Providence Health Care, Providence Crosstown Clinic, Vancouver, Canada
| | - David Byres
- Provincial Health Services Authority, Vancouver, Canada
| | | | - Scott Harrison
- Providence Health Care, Providence Crosstown Clinic, Vancouver, Canada
| | - Bryce Koch
- Doctor Peter Center, Vancouver, BC, Canada
| | - Blue Topping
- Downtown Community Health Centre, Vancouver, Canada
| | - Terry Brock
- Lookout Housing and Health Society, Surrey, Canada
| | - Julie Foreman
- Hope to Health Research and Innovation Centre, Vancouver, Canada
| | - Martin Schechter
- Centre for Advancing Health Outcomes, Providence Health Care, St. Paul's Hospital, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Eugenia Oviedo-Joekes
- Centre for Advancing Health Outcomes, Providence Health Care, St. Paul's Hospital, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
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McGrady ME, Ketterl TG, Webster RT, Schwartz LE, Brock MY, Szulczewski L, Burke M, Hommel KA, Pai ALH, Mara CA, Steele AC, Regan GG, Norris RE. Feasibility pilot trial of a tailored medication adherence-promotion intervention for adolescents and young adults with cancer: Study design and protocol. Contemp Clin Trials 2024; 139:107483. [PMID: 38431133 PMCID: PMC10960689 DOI: 10.1016/j.cct.2024.107483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/13/2024] [Accepted: 02/28/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Medication non-adherence is common among adolescents and young adults (AYAs) with cancer and associated with poor health outcomes. AYAs with cancer endorse multiple barriers to adherence that differ across individuals, suggesting that tailoring intervention content to an AYA's specific barriers may have the potential to improve adherence. The purpose of this manuscript is to report on ORBIT-guided Phase I design efforts to create the first tailored adherence-promotion intervention for AYAs with cancer and the study protocol for the ongoing Phase II pilot feasibility trial. METHODS Phase I design included qualitative interviews (n = 15 AYAs) to understand patient preferences for adherence-promotion care, development and refinement of a best-worst scaling exercise barriers tool (n = 5 AYAs), and development of intervention modules and a tailoring algorithm. In the ongoing Phase II pilot feasibility trial, AYAs (ages 15-24 years) with cancer currently taking oral chemotherapy or prophylactic medication will be recruited from three children's hospitals. Feasibility, acceptability, and usability will be assessed and these outcomes along with data on medication adherence will be used to inform the next phases of intervention development and testing. CONCLUSIONS If promising, this program of research ultimately has the potential to equip clinicians with additional strategies for supporting adherence among AYAs with cancer. NCT05706610.
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Affiliation(s)
- Meghan E McGrady
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Tyler G Ketterl
- Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, WA, USA; Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Rachel Tillery Webster
- Department of Psychology and Biobehavioral Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA; Comprehensive Cancer Center, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Laura E Schwartz
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Margaret Y Brock
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Lauren Szulczewski
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Kevin A Hommel
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ahna L H Pai
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Constance A Mara
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Amii C Steele
- Division of Pediatric Psychology and Neuropsychology, Levine Children's Hospital at Atrium Health, Charlotte, NC, USA
| | - Gillian G Regan
- Division of Pediatric Psychology and Neuropsychology, Levine Children's Hospital at Atrium Health, Charlotte, NC, USA
| | - Robin E Norris
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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3
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Pinto CA, Tervonen T, Jimenez-Moreno C, Levitan B, Soriano Gabarró M, Girman C, Norquist JM, Hauber B. Current Practices and Challenges When Submitting Patient Experience Data for Regulatory Decisions by the US Food and Drug Administration: An Industry Survey. THE PATIENT 2024; 17:147-159. [PMID: 38085458 PMCID: PMC10894141 DOI: 10.1007/s40271-023-00653-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/08/2023] [Indexed: 02/25/2024]
Abstract
OBJECTIVES To understand industry practices and challenges when submitting patient experience data (PED) for regulatory decisions by the US Food and Drug Administration (FDA). METHODS A two-part online survey related to collection, submission, and use of PED by FDA in regulatory decision-making (part 1) and a best-worst exercise for prioritizing potential PED initiatives (part 2) was completed by industry and contract research organization (CRO) members with ≥ 2 years of recent experience with patient-reported outcome (PRO), natural history study (NHS), or patient preference (PP) data; and direct experience with FDA filings including PED. RESULTS A total of 50 eligible respondents (84% industry) completed part 1 of the survey, among which 46 completed part 2. Respondents mostly had PRO (86%) and PP (50%) experience. All indicated that FDA meetings should have a standing agenda item to discuss PED. Most (78%) reported meetings should occur before pivotal trials. A common challenge was justifying inclusion without knowing if and how data will be used. Most agreed that FDA and industry should co-develop the PED table in the FDA clinical review (74%), and the table should report reason(s) for not using PED (96%) in regulatory decision-making. Most important efforts to advance PED use in decision-making were a dedicated meeting pathway and expanded FDA guidance (51% each). CONCLUSIONS FDA has policy targets expanding PED use, but challenges remain regarding pathways for PED submission and transparency in regulatory decision-making. Alignment on the use of existing meeting opportunities to discuss PED, co-development of the PED table, and expanded guidance are encouraged.
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Affiliation(s)
| | | | | | | | | | | | | | - Brett Hauber
- Pfizer, New York, NY, USA
- Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, University of Washington School of Pharmacy, Seattle, WA, USA
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4
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Te Molder MEM, Verhoef LM, Smolders JMH, Heesterbeek PJC, van den Ende CHM. Prioritization of Adverse Consequences After Total Knee Arthroplasty Contributing to a Poor Response: A Best-Worst Scaling Exercise Among Total Knee Arthroplasty Patients and Knee Specialists. J Arthroplasty 2024; 39:651-657.e1. [PMID: 37611678 DOI: 10.1016/j.arth.2023.08.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Total knee arthroplasty (TKA) can have a number of adverse consequences for patients that might contribute to a poor outcome. This study aimed to prioritize these consequences, from the perspective of patients and knee specialists. METHODS There were 95 TKA patients and 63 knee specialists who prioritized a set of 29 adverse consequences, based on a previous qualitative study, using a Maximum Difference Scaling method. A hierarchical Bayesian analysis was used to calculate relative importance scores. Differences and agreements between patients versus knee specialists and satisfied versus dissatisfied patients were analyzed using Mann-Whitney-U tests and Kendall's coefficients of concordance. RESULTS There were 4 out of 5 items in the top-5 of both patients and knee specialists that were similar, however, the ranking was different. The highest-ranked consequence for patients was: "Inability to do normal activities such as walking, cycling, swimming and heavy household chores", while knee specialists ranked: "No improvement in pain during the day" as the highest. "No improvement in walking" was in the patients' top-5, but was not ranked in the top-5 of knee specialists. For satisfied and dissatisfied patients, the top-5 of consequences was similar. CONCLUSION Comparable perspectives were found for patients versus knee specialists and satisfied versus dissatisfied patients on the importance of adverse consequences after TKA. However, when looking in more detail, differences in ranking of specific subitems suggest that patients place slightly more importance on the inability to perform valued activities, while knee specialists prioritize lack of pain relief to a higher degree.
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Affiliation(s)
- Malou E M Te Molder
- Department of Orthopedic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Lise M Verhoef
- Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - José M H Smolders
- Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands
| | | | - Cornelia H M van den Ende
- Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands; Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
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5
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Djekic I, Hambardzumyan G, Nikolić A, Mujčinović A, Nakov D, Nikolova AS, Semenova AA, Kuznetsova OA, Oz F, Oz E, Terjung N, Volker H, Tomasevic I. Confronting Views of Companies and Authorities on Food Safety Issues-A Cross-Country Survey. Foods 2024; 13:773. [PMID: 38472886 DOI: 10.3390/foods13050773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/19/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
This study investigated food safety issues as perceived by food companies and food safety authorities in six countries in Europe and Central Asia. A total of 66 companies and 16 authorities participated in the survey. The results provide important insights related to what the main food safety priorities are, how they are addressed in the countries that participated in the survey, and what the role of the main stakeholders is in the food value chain. Almost 50% of food companies identified 'food fraud' as the most influential food safety attribute. One-third of food safety authorities recognized 'food safety management system' as the most influential food safety attribute. Principal component analysis separated food safety statements into two dimensions named 'food safety hazards and risks' and 'food safety system'. Although there are slight differences in food safety statements between the two stakeholders, i.e., food companies and food safety authorities, it is the country of origin that plays a more important role in understanding their views. Food companies will need to implement a systemic approach and transform the entire food value chain continuum while considering new food safety challenges. It is expected that food safety authorities will have to play a more proactive role in the future.
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Affiliation(s)
- Ilija Djekic
- Faculty of Agriculture, University of Belgrade, 11080 Belgrade, Serbia
| | - Garegin Hambardzumyan
- Veterinary Sanitary Examination, Food Safety and Hygiene Department, Armenian National Agrarian University, Yerevan 0009, Armenia
| | - Aleksandra Nikolić
- Faculty of Agriculture and Food Sciences, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Alen Mujčinović
- Faculty of Agriculture and Food Sciences, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Dimitar Nakov
- Faculty of Agriculture, "Goce Delčev" University in Štip, 2000 Shtip, North Macedonia
| | - Aleksandra Silovska Nikolova
- Faculty of Agricultural Sciences and Food, SS Cyril and Methodius University in Skopje, 1000 Shtip, North Macedonia
| | | | - Oksana A Kuznetsova
- V. M. Gorbatov Federal Research Center for Food Systems, Moscow 107023, Russia
| | - Fatih Oz
- Faculty of Agriculture, Ataturk University, Erzurum 25030, Türkiye
| | - Emel Oz
- Faculty of Agriculture, Ataturk University, Erzurum 25030, Türkiye
| | - Nino Terjung
- DIL German Institute of Food Technology, 49610 Quakenbrück, Germany
| | - Heinz Volker
- DIL German Institute of Food Technology, 49610 Quakenbrück, Germany
| | - Igor Tomasevic
- Faculty of Agriculture, University of Belgrade, 11080 Belgrade, Serbia
- DIL German Institute of Food Technology, 49610 Quakenbrück, Germany
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6
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Boxebeld S, Mouter N, van Exel J. Participatory Value Evaluation (PVE): A New Preference-Elicitation Method for Decision Making in Healthcare. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024; 22:145-154. [PMID: 38103158 DOI: 10.1007/s40258-023-00859-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/17/2023]
Abstract
Participatory value evaluation (PVE) has recently been introduced in the field of health as a new method to elicit stated preferences for public policies. PVE is a method in which respondents in a choice experiment are presented with various policy options and their attributes, and are asked to compose their portfolio of preference given a public-resource constraint. This paper aims to illustrate PVE's potential for informing healthcare decision making and to position it relative to established preference-elicitation methods. We first describe PVE and its theoretical background. Next, by means of a narrative review of the eight existing PVE applications within and outside the health domain, we illustrate the different implementations of the main features of the method. We then compare PVE to several established preference-elicitation methods in terms of the structure and nature of the choice tasks presented to respondents. The portfolio-based choice task in a PVE requires respondents to consider a set of policy alternatives in relation to each other and to make trade-offs subject to one or more constraints, which more closely resembles decision making by policymakers. When using a flexible budget constraint, respondents can trade-off their private income with public expenditures. Relative to other methods, a PVE may be cognitively more demanding and is less efficient; however, it seems a promising complementary method for the preference-based assessment of health policies. Further research into the feasibility and validity of the method is required before researchers and policymakers can fully appreciate the advantages and disadvantages of the PVE as a preference-elicitation method.
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Affiliation(s)
- Sander Boxebeld
- Department of Health Economics, Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands.
- Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands.
- Erasmus Choice Modelling Centre (ECMC), Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Niek Mouter
- Transport and Logistics Group, Department of Technology, Policy and Management, Delft University of Technology, Delft, The Netherlands
- Populytics B.V. Leiden, Leiden, The Netherlands
| | - Job van Exel
- Department of Health Economics, Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus Choice Modelling Centre (ECMC), Erasmus University Rotterdam, Rotterdam, The Netherlands
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Mühlbacher A, Beaudet A, Brand M, Janssen EM, Gunz H, Li W, Preiss M, Sadler A, DiSantostefano RL. Patient Preferences in Pulmonary Arterial Hypertension, a Latent Class Analysis to Identify Preference Heterogeneity. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:206-215. [PMID: 37949354 DOI: 10.1016/j.jval.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/26/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES Pulmonary arterial hypertension (PAH) is a chronic, progressive disease of the pulmonary circulation characterized by vascular remodeling that, if untreated, can lead to right heart dysfunction and death. This analysis measured heterogeneity in patient preferences for PAH-specific treatment regimens. METHOD Adult patients with PAH with slight to marked limitations during physical activity were recruited through a patient organization in Germany. Participants completed an online best-worst scaling case 3 survey. Patients chose among 3 hypothetical treatment profiles defined by 6 benefits and risks at varying levels. Participants completed 12 choice tasks. Preference heterogeneity was assessed using latent class analysis. RESULTS A total of 83 participants (76% female) completed the survey. Best-fit model revealed 4 classes. Class 1 (19% of participants) assigned importance to multiple attributes particularly side effects, class 2 (34%) to physical activity limitations, class 3 (30%) to survival and physical activity limitations, and class 4 (17%) to survival. No differences in sociodemographic characteristics were observed across classes. Compared with other classes, class 4 was most likely to report having marked physical activity limitations (79%) and needing daily help (100%), while considering higher daily activity levels to be ordinary (walking >1 km [71%] or climbing several flights of stairs [50%]). CONCLUSION This first patient preference study in a PAH population suggests that physical activity limitations in addition to survival matter most to patients; however, preference heterogeneity between groups of patients was observed. Patient preferences should be considered in treatment decision making to better balance patient's expectations regarding the known risk-benefit ratio of treatment.
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Affiliation(s)
- Axel Mühlbacher
- Health Economics and Health Care Management, Hochschule Neubrandenburg, Neubrandenburg, Germany; Gesellschaft für empirische Beratung GmbH, Berlin, Germany.
| | - Amélie Beaudet
- Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical Company of Johnson & Johnson, Allschwil, Switzerland
| | - Monika Brand
- Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical Company of Johnson & Johnson, Allschwil, Switzerland
| | - Ellen M Janssen
- Janssen-Cilag Germany, Johnson & Johnson Platz, Neuss North Rhine-Westphalia, Germany
| | - Holger Gunz
- Janssen-Cilag Germany, Johnson & Johnson Platz, Neuss North Rhine-Westphalia, Germany
| | - Wenjing Li
- Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical Company of Johnson & Johnson, Allschwil, Switzerland
| | - Michael Preiss
- Actelion Pharmaceuticals Ltd, a Janssen Pharmaceutical Company of Johnson & Johnson, Allschwil, Switzerland
| | - Andrew Sadler
- Gesellschaft für empirische Beratung GmbH, Berlin, Germany
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Zwack CC, Haghani M, de Bekker-Grob EW. Research trends in contemporary health economics: a scientometric analysis on collective content of specialty journals. HEALTH ECONOMICS REVIEW 2024; 14:6. [PMID: 38270771 PMCID: PMC10809694 DOI: 10.1186/s13561-023-00471-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 11/28/2023] [Indexed: 01/26/2024]
Abstract
INTRODUCTION Health economics is a thriving sub-discipline of economics. Applied health economics research is considered essential in the health care sector and is used extensively by public policy makers. For scholars, it is important to understand the history and status of health economics-when it emerged, the rate of research output, trending topics, and its temporal evolution-to ensure clarity and direction when formulating research questions. METHODS Nearly 13,000 articles were analysed, which were found in the collective publications of the ten most specialised health economic journals. We explored this literature using patterns of term co-occurrence and document co-citation. RESULTS The research output in this field is growing exponentially. Five main research divisions were identified: (i) macroeconomic evaluation, (ii) microeconomic evaluation, (iii) measurement and valuation of outcomes, (iv) monitoring mechanisms (evaluation), and (v) guidance and appraisal. Document co-citation analysis revealed eighteen major research streams and identified variation in the magnitude of activities in each of the streams. A recent emergence of research activities in health economics was seen in the Medicaid Expansion stream. Established research streams that continue to show high levels of activity include Child Health, Health-related Quality of Life (HRQoL) and Cost-effectiveness. Conversely, Patient Preference, Health Care Expenditure and Economic Evaluation are now past their peak of activity in specialised health economic journals. Analysis also identified several streams that emerged in the past but are no longer active. CONCLUSIONS Health economics is a growing field, yet there is minimal evidence of creation of new research trends. Over the past 10 years, the average rate of annual increase in internationally collaborated publications is almost double that of domestic collaborations (8.4% vs 4.9%), but most of the top scholarly collaborations remain between six countries only.
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Affiliation(s)
- Clara C Zwack
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia.
| | - Milad Haghani
- School of Civil and Environmental Engineering, University of New South Wales, Sydney, NSW, Australia
| | - Esther W de Bekker-Grob
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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9
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Yesuf W, Hiko D, Alemayehu E, Kusheta S, Shita A, Beyene M. Health-related quality of life in epilepsy and its associated factors among adult patients with epilepsy attending Mizan Tepi University Teaching Hospital, Southwest Ethiopia: a cross-sectional study. BMJ Open 2024; 14:e079165. [PMID: 38262645 PMCID: PMC10806578 DOI: 10.1136/bmjopen-2023-079165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/04/2024] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE To determine the mean score of health-related quality of life in epilepsy and its associated factors among adult patients with epilepsy. DESIGN Institution-based cross-sectional study based on random case selection was conducted. SETTING The study was carried out at Mizan-Tepi University Teaching Hospital located in Southwest Ethiopia. PARTICIPANTS A total of 346 patients with epilepsy who visited the psychiatric clinic for follow-up for at least 3 months and who were 18 years or older were included in the study. MAIN OUTCOME MEASURE Health-related quality of life in epilepsy measured using quality-of-life in epilepsy (QOLIE)-31 health survey evaluated as a dependent variable with simple and multivariable linear regressions. RESULTS The overall weighted mean score of health-related quality of life was 55.6 (SD=20.9). Only 50.3% of patients scored above a total score of 50. Age (β=-0.35, 95% CI-0.46 to -0.23), anxiety (β=-6.79, 95% CI -9.26 to -4.32), depression (β=-7.36, 95% CI -10.16 to -4.55), low self-esteem (β=-5.29, 95% CI -8.07 to -2.51), perceived stigma (β=-3.62, 95% CI -6.30 to -0.94), taking medication two times or more times per day (β=-2.4, 95% CI -4.58 to -0.27), being illiterate (β=-4.1, 95% CI -6.87 to -1.31) and having more than two seizures for a year (β=-4.18, 95% CI -6.97 to -1.39) were negatively affecting health-related quality of life while income of >1000 birr per month (β=4.5, 95% CI 2.00 to 6.99), social support (β=0.34, 95% CI 0.27 to 0.40) and being free of seizure for a year (β=6.5, 95% CI 3.66 to 9.33) were positively affecting health-related quality of life. CONCLUSIONS Only half of the patients with epilepsy in the study area are leading a better quality of life and the overall mean health-related quality of life score is lower than the global mean score. Health-related quality of life was inversely associated with age, anxiety, depression, low self-esteem, perceived stigma, taking medication two times a day or more, being illiterate and experiencing more than two seizures in a year. Besides controlling seizures, public educational campaigns should be conducted to raise public awareness regarding the need for social support.
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Affiliation(s)
- Wudu Yesuf
- Department of Public Health, Mizan-Aman College of Health Sciences, Aman, Ethiopia
| | - Desta Hiko
- Department of Epidemiology, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Eshetu Alemayehu
- Department of Epidemiology, Jimma University College of Public Health and Medical Sciences, Jimma, Ethiopia
| | - Samuel Kusheta
- Department of Public Health, Hosanna College of Health Sciences, Hosanna, Ethiopia
| | - Abel Shita
- Department of Public Health, Mizan-Aman College of Health Sciences, Aman, Ethiopia
| | - Melkamu Beyene
- Department of Epidemiology, Mizan-Tepi University, Mizzan, Ethiopia
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10
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Mühlbacher AC, Sadler A, Juhnke C. Preferences for Monitoring Comprehensive Heart Failure Care: A Latent Class Analysis. THE PATIENT 2024; 17:83-95. [PMID: 38017336 PMCID: PMC10770186 DOI: 10.1007/s40271-023-00656-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/15/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE To measure preference heterogeneity for monitoring systems among patients with a chronic heart failure. METHODS A best-worst scaling experiment (BWS case 3) was conducted among patients with chronic heart failure to assess preferences for hypothetical monitoring care scenarios. These were characterized by the attributes mobility, risk of death, risk of hospitalization, type and frequency of monitoring, risk of medical device, and system-relevant complications. A latent class analysis (LCA) was used to analyze and interpret the data. In addition, a market simulator was used to examine which treatment configurations participants in the latent classes preferred. RESULTS Data from 278 respondents were analyzed. The LCA identified four heterogeneous classes. For class 1, the most decisive factor was mobility with a longer distance covered being most important. Class 2 respondents directed their attention toward attribute "monitoring," with a preferred monitoring frequency of nine times per year. The attribute risk of hospitalization was most important for respondents of class 3, closely followed by risk of death. For class 4, however, risk of death was most important. A market simulation showed that, even with high frequency of monitoring, most classes preferred therapy with high improvement in mobility, mortality, and hospitalization. CONCLUSION Using LCA, variations in preferences among different groups of patients with chronic heart failure were examined. This allows treatment alternatives to be adapted to individual needs of patients and patient groups. The findings of the study enhance clinical and allocative decision-making while elevating the quality of clinical data interpretation.
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Affiliation(s)
- Axel C Mühlbacher
- Health Economics and Health Care Management, Hochschule Neubrandenburg, Neubrandenburg, Germany.
- Gesellschaft für empirische Beratung GmbH (GEB), Freiburg, Germany.
- Duke Department of Population Health Sciences and Duke Global Health Institute, Duke University, Durham, NC, USA.
| | - Andrew Sadler
- Health Economics and Health Care Management, Hochschule Neubrandenburg, Neubrandenburg, Germany
| | - Christin Juhnke
- Health Economics and Health Care Management, Hochschule Neubrandenburg, Neubrandenburg, Germany
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11
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Djekic I, Smigic N. Consumer Perception of Food Fraud in Serbia and Montenegro. Foods 2023; 13:53. [PMID: 38201081 PMCID: PMC10778550 DOI: 10.3390/foods13010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/06/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
The main objective of this study was to investigate how food fraud is perceived among consumers in Serbia and Montenegro. A total of 1264 consumers from the two countries participated in an online survey during the second half of 2022, using Google forms®. In the Serbian population, older or highly educated respondents are aware of different types of fraudulent activities such as substitution, mislabeling, concealment, and counterfeiting. Dilution is mostly recognized by women, the younger population, and students. Consumers believe that trust is the most important factor when purchasing food. The highest level of agreement regarding food fraud is that such activities may pose serious health risks to consumers, and that food inspection services are the most responsible actors in the food chain continuum. When it comes to purchasing food, open green markets are most trustworthy, followed by hypermarkets. Concerning the types of food, fish is most susceptible to fraud, followed by olive oil. This study builds upon existing knowledge of food consumers about food fraud in Europe.
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Affiliation(s)
- Ilija Djekic
- Department of Food Safety and Quality Management, Faculty of Agriculture, University of Belgrade, Nemanjina 6, 11080 Belgrade, Serbia;
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12
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Juhnke C, Mühlbacher AC. Which body functions and activities matter for stroke patients? Study protocol for best-Worst scalings to value core elements of the International Classification of Functioning, Disability and Health. PLoS One 2023; 18:e0295267. [PMID: 38060585 PMCID: PMC10703233 DOI: 10.1371/journal.pone.0295267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Stroke is a common, serious, and disabling healthcare problem with increasing incidence and prevalence. Following a stroke, identifying the factors associated with decisions about rehabilitation interventions is important to assess rehabilitation after stroke. The aim is to guide clinical staff to make patient-centered decisions. Fundamentally, decision makers cannot draw on evidence to consider the relevance of distinct functions and activities from the patient's perspective. Until now, outcomes of rehabilitation are generally categorized using the International Classification of Functioning, Disability and Health (ICF). This can be seen as a conceptual basis for the assessment of health and disability. Since the ICF does not distinguish importance between these aspects there is a need to value the most important clinical factors as well as related activities from a patients and public perspective to help guide therapists in effectively designing post-acute rehabilitation care for individuals following stroke. The research question is which ICF body functions and activities are of value to stroke patients? Which trade-offs are patients willing to make within the core elements? Health preference research (HPR) answers the need to develop additional preference weights for certain ICF dimensions. Patient preference information (PPI) values health conditions based on the ICF from a patient perspective. METHODS In this study we conduct three best-worst scaling (BWS) experiments to value body function and activities from patients' and public perspective. Out of all ICF dimensions this research covers health conditions relevant to stroke patients in terms of body function, perception, and activities of daily living. Stroke patients as well as members of the general population will be recruited to participate in the online BWS surveys. Fractional, efficient designs are applied regarding the survey design. Conditional and multinominal logit analyses will be used as the main analysis method, with the best-worst count analysis as a secondary analysis. The survey is being piloted prior to commencing the process of data collection. Results are expected by the autumn of 2023. DISCUSSION The research will add to the current literature on clinical decision-making in stroke rehabilitation and the value of certain body functions as well as related activities in neurorehabilitation. Moreover, the study will show whether body functions and activities that are currently equally weighted in international guidelines are also equally important from the point of view of those affected, or whether there are disconcordances in terms of differences between public judgements and patients' preferences.
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Affiliation(s)
- Christin Juhnke
- Health Economics and Health Care Management, Hochschule Neubrandenburg, Neubrandenburg, Germany
| | - Axel Christian Mühlbacher
- Health Economics and Health Care Management, Hochschule Neubrandenburg, Neubrandenburg, Germany
- Duke Department of Population Health Sciences and Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
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13
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Hall NY, Le L, Abimanyi-Ochom J, Mihalopoulos C. Measuring the importance of different barriers to opioid agonist treatment using best-worst scaling in an Australian setting. Health Policy 2023; 138:104939. [PMID: 37949002 DOI: 10.1016/j.healthpol.2023.104939] [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: 04/28/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE Opioid agonist treatment (OAT) is an effective treatment for opioid use disorder (OUD), however several client barriers to OAT are reported. Client importance of these barriers using economic preference elicitation measures have not been identified. This paper determines the most important OAT barriers using best-worst scaling (BWS) and compares the results of BWS to Likert scale. METHODS Cross-sectional self-completed survey with 191 opioid dependent clients who attended Australian needle and syringe sites. Participants were presented 15 Likert scale barriers and 15 BWS barrier scenarios. The BWS data was presented using count analysis, multinomial logit and mixed logit models. The ranking of barrier items was completed using three BWS methods and one Likert scale method, with share preference results (BWS) or mean scores (Likert) used to rank the 15 barriers. RESULTS The most important client barriers were 'enjoy using opioids', 'lack of support services' and 'hard to access'. The four ranking methods produced different barrier rankings for the most important barriers, but similar results for the least important barriers. CONCLUSION Policies around OAT as a harm reduction approach, increased support services and increased availability of OAT services would be beneficial in improving OAT uptake. Comparing BWS and Likert methods produced different highest ranked barriers, indicating the method used to identify preferences has significant implications on the type of intervention prioritised.
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Affiliation(s)
| | - Long Le
- Public Health and Preventative Medicine, Monash University, Australia
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Norton JD, Zeng C, Bayliss EA, Shetterly SM, Williams N, Reeve E, Wynia MK, Green AR, Drace ML, Gleason KS, Sheehan OC, Boyd CM. Ethical Aspects of Physician Decision-Making for Deprescribing Among Older Adults With Dementia. JAMA Netw Open 2023; 6:e2336728. [PMID: 37787993 PMCID: PMC10548310 DOI: 10.1001/jamanetworkopen.2023.36728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/27/2023] [Indexed: 10/04/2023] Open
Abstract
Importance Physicians endorse deprescribing of risky or unnecessary medications for older adults (aged ≥65 years) with dementia, but there is a lack of information on what influences decisions to deprescribe in this population. Objective To understand how physicians make decisions to deprescribe for older adults with moderate dementia and ethical and pragmatic concerns influencing those decisions. Design, Setting, and Participants A cross-sectional national mailed survey study of a random sample of 3000 primary care physicians from the American Medical Association Physician Masterfile who care for older adults was conducted from January 15 to December 31, 2021. Main Outcomes and Measures The study randomized participants to consider 2 clinical scenarios in which a physician may decide to deprescribe a medication for older adults with moderate dementia: 1 in which the medication could cause an adverse drug event if continued and the other in which there is no evidence of benefit. Participants ranked 9 factors related to possible ethical and pragmatic concerns through best-worst scaling methods (from greatest barrier to smallest barrier to deprescribing). Conditional logit regression quantified the relative importance for each factor as a barrier to deprescribing. Results A total of 890 physicians (35.0%) returned surveys; 511 (57.4%) were male, and the mean (SD) years since graduation was 26.0 (11.7). Most physicians had a primary specialty in family practice (50.4% [449 of 890]) and internal medicine (43.5% [387 of 890]). A total of 689 surveys were sufficiently complete to analyze. In both clinical scenarios, the 2 greatest barriers to deprescribing were (1) the patient or family reporting symptomatic benefit from the medication (beneficence and autonomy) and (2) the medication having been prescribed by another physician (autonomy and nonmaleficence). The least influential factor was ease of paying for the medication (justice). Conclusions and Relevance Findings from this national survey study of primary care physicians suggests that understanding ethical aspects of physician decision-making can inform clinician education about medication management and deprescribing decisions for older adults with moderate dementia.
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Affiliation(s)
| | - Chan Zeng
- Institute for Health Research, Kaiser Permanente Colorado, Aurora
| | - Elizabeth A. Bayliss
- Institute for Health Research, Kaiser Permanente Colorado, Aurora
- Department of Family Medicine, University of Colorado School of Medicine, Aurora
| | | | - Nicole Williams
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Emily Reeve
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia
| | - Matthew K. Wynia
- University of Colorado Center for Bioethics and Humanities, Anschutz Medical Campus, Aurora
- Department of Internal Medicine, University of Colorado School of Medicine, Aurora
- Department of Health Policy and Management, Colorado School of Public Health, Aurora
| | - Ariel R. Green
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Melanie L. Drace
- Institute for Health Research, Kaiser Permanente Colorado, Aurora
| | - Kathy S. Gleason
- Institute for Health Research, Kaiser Permanente Colorado, Aurora
| | | | - Cynthia M. Boyd
- Johns Hopkins University School of Medicine, Baltimore, Maryland
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15
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Armeni P, Meregaglia M, Borsoi L, Callea G, Torbica A, Benazzo F, Tarricone R. Collecting Physicians' Preferences on Medical Devices: Are We Doing It Right? Evidence from Italian Orthopedists Using 2 Different Stated Preference Methods. Med Decis Making 2023; 43:886-900. [PMID: 37837325 PMCID: PMC10848602 DOI: 10.1177/0272989x231201805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 08/15/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVES Physician preference items (PPIs) are high-cost medical devices for which clinicians express firm preferences with respect to a particular manufacturer or product. This study aims to identify the most important factors in the choice of new PPIs (hip or knee prosthesis) and infer about the existence of possible response biases in using 2 alternative stated preference techniques. METHODS Six key attributes with 3 levels each were identified based on a literature review and clinical experts' opinions. An online survey was administered to Italian hospital orthopedists using type 1 best-worst scaling (BWS) and binary discrete choice experiment (DCE). BWS data were analyzed through descriptive statistics and conditional logit model. A mixed logit regression model was applied to DCE data, and willingness-to-pay (WTP) was estimated. All analyses were conducted using Stata 16. RESULTS A sample of 108 orthopedists were enrolled. In BWS, the most important attribute was "clinical evidence," followed by "quality of products," while the least relevant items were "relationship with the sales representative" and "cost." DCE results suggested instead that orthopedists prefer high-quality products with robust clinical evidence, positive health technology assessment recommendation and affordable cost, and for which they have a consolidated experience of use and a good relationship with the sales representative. CONCLUSIONS The elicitation of preferences for PPIs using alternative methods can lead to different results. The BWS of type 1, which is similar to a ranking exercise, seems to be more affected by acquiescent responding and social desirability than the DCE, which introduces tradeoffs in the choice task and is likely to reveal more about true preferences. HIGHLIGHTS Physician preference items (PPIs) are medical devices particularly exposed to physicians' choice with regard to type of product and supplier.Some established techniques of collecting preferences can be affected by response biases such as acquiescent responding and social desirability.Discrete choice experiments, introducing more complex tradeoffs in the choice task, are likely to mitigate such biases and reveal true physicians' preferences for PPIs.
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Affiliation(s)
- Patrizio Armeni
- Research Centre on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milan, Italy
| | - Michela Meregaglia
- Research Centre on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milan, Italy
| | - Ludovica Borsoi
- Research Centre on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milan, Italy
| | - Giuditta Callea
- Research Centre on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milan, Italy
| | - Aleksandra Torbica
- Research Centre on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milan, Italy
- Department of Social and Political Science, Bocconi University, Milan, Italy
| | - Francesco Benazzo
- Scuola Universitaria di Istruzione Superiore (IUSS), Pavia, Italy
- Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
| | - Rosanna Tarricone
- Research Centre on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milan, Italy
- Department of Social and Political Science, Bocconi University, Milan, Italy
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16
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Aschmann HE, Musinguzi A, Kadota JL, Namale C, Kakeeto J, Nakimuli J, Akello L, Welishe F, Nakitende A, Berger C, Dowdy DW, Cattamanchi A, Semitala FC, Kerkhoff AD. Preferences of people living with HIV for features of tuberculosis preventive treatment regimens - a discrete choice experiment. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.13.23295043. [PMID: 37745521 PMCID: PMC10516058 DOI: 10.1101/2023.09.13.23295043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Background Tuberculosis (TB) preventive treatment (TPT) is recommended for people living with HIV (PLHIV) in high TB burden settings. While 6 months of daily isoniazid remains widely used, shorter regimens are now available. However, little is known about preferences of PLHIV for key features of TPT regimens. Methods We conducted a discrete choice experiment among adult PLHIV engaged in care at an urban HIV clinic in Kampala, Uganda. In nine random choice tasks, participants chose between two hypothetical TPT regimens with different features (pills per dose, frequency, duration, need for adjusted antiretroviral therapy [ART] dosage and side effects). We analyzed preferences using hierarchical Bayesian estimation, latent class analysis, and willingness-to-trade simulations. Results Of 400 PLHIV, 392 (median age 44, 72% female, 91% TPT-experienced) had high quality choice task responses. Pills per dose was the most important attribute (relative importance 32.4%, 95% confidence interval [CI] 31.6 - 33.2), followed by frequency (20.5% [95% CI 19.7 - 21.3]), duration (19.5% [95% CI 18.6 - 20.5]), and need for ART dosage adjustment (18.2% [95% CI 17.2 - 19.2]). Latent class analysis identified three preference groups: one prioritized less frequent, weekly dosing (N=222; 57%); another was averse to ART dosage adjustment (N=107; 27%); and the last prioritized short and tolerable regimens (N=63; 16%). All groups highly valued fewer pills per dose. Participants were willing to accept a regimen of 2.8 months' additional duration [95% CI: 2.4 - 3.2] to reduce pills per dose from five to one, 3.6 [95% CI 2.4 - 4.8] months for weekly rather than daily dosing, and 2.2 [95% CI 1.3 - 3.0] months to avoid ART dosage adjustment. Conclusions To align with preferences of PLHIV, decision-makers should prioritize the development and implementation of TPT regimens with fewer pills, less frequent dosing, and no need for ART dosage adjustment, rather than focus primarily on duration of treatment.
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Affiliation(s)
- Hélène E Aschmann
- Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, CA USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA USA
- Center for Tuberculosis, University of California San Francisco, San Francisco, CA USA
| | | | - Jillian L Kadota
- Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, CA USA
- Center for Tuberculosis, University of California San Francisco, San Francisco, CA USA
| | - Catherine Namale
- Uganda Tuberculosis Implementation Research Consortium, Walimu, Kampala, Uganda
| | - Juliet Kakeeto
- Uganda Tuberculosis Implementation Research Consortium, Walimu, Kampala, Uganda
| | - Jane Nakimuli
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Lydia Akello
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Fred Welishe
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Anne Nakitende
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Christopher Berger
- Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, CA USA
- Center for Tuberculosis, University of California San Francisco, San Francisco, CA USA
| | - David W Dowdy
- Uganda Tuberculosis Implementation Research Consortium, Walimu, Kampala, Uganda
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Adithya Cattamanchi
- Center for Tuberculosis, University of California San Francisco, San Francisco, CA USA
- Uganda Tuberculosis Implementation Research Consortium, Walimu, Kampala, Uganda
- Division of Pulmonary Diseases and Critical Care Medicine, University of California Irvine, Irvine, CA USA
| | - Fred C Semitala
- Infectious Diseases Research Collaboration, Kampala, Uganda
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Makerere University Joint AIDS Program, Kampala, Uganda
| | - Andrew D Kerkhoff
- Center for Tuberculosis, University of California San Francisco, San Francisco, CA USA
- Division of HIV, Infectious Diseases, and Global Medicine, University of California San Francisco, San Francisco, CA USA
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Tönsing KM, Mothapo NRB, Morwane RE, Soto G. Stakeholder validation of a Sepedi core vocabulary list as a resource for augmentative and alternative communication. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023:1-12. [PMID: 37675943 DOI: 10.1080/17549507.2023.2241671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
PURPOSE The development of culturally and linguistically appropriate resources to support communication interventions for underserved communities is an urgent necessity. The purpose of the study was to obtain stakeholder feedback on vocabulary items from a Sepedi core vocabulary list developed as a resource for vocabulary selection for augmentative and alternative communication (AAC) systems, and to expand the list based on stakeholders' vocabulary recommendations. METHOD A questionnaire was used to obtain the ratings of 57 stakeholders regarding the importance of including 155 Sepedi words from the Sepedi core vocabulary list on an AAC system for a child with receptive language skills at the level of a 4-year-old or higher. Stakeholders also suggested additional words to include on the system. RESULT All words were rated as important or very important. However, there was a statistically significant inverse relationship between the average frequency of occurrence of words belonging to a specific category and the average importance rating that stakeholders assigned to words in that category. A total of 48 words were additionally suggested by three or more stakeholders. CONCLUSION Stakeholder ratings validated the list as relevant to consult in vocabulary selection for Sepedi AAC systems for children. Stakeholder-suggested words may be a useful supplement to this list.
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Affiliation(s)
- Kerstin M Tönsing
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
| | - Ngwanamashiane R B Mothapo
- Department of Speech-Language Pathology and Audiology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Refilwe E Morwane
- Department of Speech Language Pathology and Audiology, University of the Witwatersrand, Johannesburg, South Africa and
| | - Gloria Soto
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
- Department of Special Education and Department of Speech, Language and Hearing Sciences, San Francisco State UniversitySan Francisco, USA
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Knox J, Schwartz S, Duncan DT, Curran G, Schneider J, Stephenson R, Wilson P, Nash D, Sullivan P, Geng E. Proposing the observational-implementation hybrid approach: designing observational research for rapid translation. Ann Epidemiol 2023; 85:45-50. [PMID: 37015306 DOI: 10.1016/j.annepidem.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/01/2023] [Accepted: 03/24/2023] [Indexed: 04/04/2023]
Abstract
We propose the observational-implementation hybrid approach-the incorporation of implementation science methods and measures into observational studies to collect information that would allow researchers to anticipate, estimate, or infer the effects of interventions and implementation strategies. Essentially, we propose that researchers collect implementation data early in the research pipeline, in situations where they might not typically be thinking about implementation science. We describe three broad contextual scenarios through which the observational-implementation hybrid approach would most productively be applied. The first application is for observational cohorts that individually enroll participants-either for existing (to which implementation concepts could be added) or for newly planned studies. The second application is with routinely collected program data, at either the individual or aggregate levels. The third application is to the collection of data from study participants enrolled in an observational cohort study who are also involved in interventions linked to that study (e.g., collecting data about their experiences with those interventions). Examples of relevant implementation data that could be collected as part of observational studies include factors relevant to transportability, participant preferences, and participant/provider perspectives regarding interventions and implementation strategies. The observational-implementation hybrid model provides a practical approach to make the research pipeline more efficient and to decrease the time from observational research to health impact. If this approach is widely adopted, observational and implementation science studies will become more integrated; this will likely lead to new collaborations, will encourage the expansion of epidemiological training, and, we hope, will push both epidemiologists and implementation scientists to increase the public health impact of their work.
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Affiliation(s)
- Justin Knox
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY; HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York; Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY.
| | - Sheree Schwartz
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY
| | - Geoff Curran
- Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock
| | - John Schneider
- Department of Medicine, University of Chicago, Chicago, IL
| | - Rob Stephenson
- The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor
| | - Patrick Wilson
- Department of Psychology, University of California, Los Angeles
| | - Denis Nash
- Department of Epidemiology, School of Public Health, City University of New York, New York
| | - Patrick Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Elvin Geng
- Washington University School of Medicine, St. Louis, MO
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Feng Z, Meng J, Sun Y, Xie T, Lu W, Wang G, Geng J. Assessment of patients' preferences for new anticancer drugs in China: a best-worst discrete choice experiment on three common cancer types. BMJ Open 2023; 13:e072469. [PMID: 37270199 DOI: 10.1136/bmjopen-2023-072469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVES Despite the advancement in anticancer drug therapies, cancer treatment decisions are often complex and preference-sensitive, making them well suited for studying shared decision-making (SDM). Our study aimed to assess preferences for new anticancer drugs among three common types of patients with cancer to inform SDM. DESIGN We identified five attributes of new anticancer drugs and used a Bayesian-efficient design to generate choice sets for a best-worst discrete choice experiment (BWDCE). The mixed logit regression model was applied to estimate patient-reported preferences for each attribute. The interaction model was used to investigate preference heterogeneity. SETTING The BWDCE was conducted in Jiangsu province and Hebei province in China. PARTICIPANTS Patients aged 18 years or older, who had a definite diagnosis of lung cancer, breast cancer or colorectal cancer were recruited. RESULTS Data from 468 patients were available for analysis. On average, the most valued attribute was the improvement in health-related quality of life (HRQoL) (p<0.001). The low incidence of severe to life-threatening side effects, prolonged progression-free survival and the low incidence of mild to moderate side effects were also positive predictors of patients' preferences (p<0.001). Out-of-pocket cost was a negative predictor of their preferences (p<0.001). According to subgroup analysis by type of cancer, the improvement in HRQoL remained the most valuable attribute. However, the relative importance of other attributes varied by type of cancer. Whether patients were newly diagnosed or previously diagnosed cancer cases played a dominant role in the preference heterogeneity within each subgroup. CONCLUSIONS Our study can assist in the implementation of SDM by providing evidence on patients' preferences for new anticancer drugs. Patients should be informed of the multiattribute values of new drugs and encouraged to make decisions reflecting their values.
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Affiliation(s)
- Zhe Feng
- Department of Medical Informatics, Nantong University Medical School, Nantong, Jiangsu, China
| | - Jingyi Meng
- Department of Medical Informatics, Nantong University Medical School, Nantong, Jiangsu, China
| | - Yanjun Sun
- Department of Radiotherapy, Tinghu District People's Hospital, Yancheng, Jiangsu, China
| | - Tongling Xie
- Department of Medical Informatics, Nantong University Medical School, Nantong, Jiangsu, China
- Department of Medical Informatics, The People's Hospital of Rugao, Nantong, Jiangsu, China
| | - Wenzhang Lu
- Department of Respiratory, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Guohua Wang
- Institute of Special Environmental Medicine, Nantong University, Nantong, Jiangsu, China
| | - Jinsong Geng
- Department of Medical Informatics, Nantong University Medical School, Nantong, Jiangsu, China
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Gillette C, Bodner GB, Bell Sisson CG, Bates N, DeTroye A, Hussaini SS, Crandall S. What Physician Assistants Prefer in a Postprofessional Doctorate Program: A Cross-Sectional Rating and Rankings Study. J Physician Assist Educ 2023; 34:147-151. [PMID: 37133895 DOI: 10.1097/jpa.0000000000000502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
PURPOSE The physician assistant (PA) literature has focused on the implications of creating an entry-level doctoral degree; however, there is scant primary literature on postprofessional doctorates, which are becoming more popular as the number of institutions offering them increases. The purposes of this project were to: (1) describe interest and motivation of currently practicing PAs to enroll in a postprofessional doctorate program and (2) identify the most- and least-preferred attributes of a postprofessional doctorate program. METHODS This was a quantitative cross-sectional survey of recent alumni from one institution. Measures included interest in obtaining a postprofessional doctorate, a nonrandomized Best-Worst Scaling (BWS) exercise, and motivators for enrolling in a postprofessional doctorate. The main outcome of interest was the BWS standardized score for each attribute. RESULTS The research team received 172 eligible responses (n = 172, response rate = 25.83%). Results indicate that 47.67% of respondents (n = 82) expressed interest in a postprofessional doctorate. The most preferred doctorate program attribute was a clinically based program, ending with a residency, conferring a Doctor of Medical Science (DMSc) degree, with a hybrid course delivery. DISCUSSION This sample included various interests, motivations, and preferred program attributes. Understanding these factors may help inform the design and redesign of doctoral programs.
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Affiliation(s)
- Chris Gillette
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship, Department of PA Studies, and an associate professor, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Gayle B. Bodner, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Caroline Grey Bell Sisson, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Nathan Bates, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Alisha DeTroye, MMS, PA-C, is director of advanced practice at Atrium Health Wake Forest Baptist, and adjunct assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sobia S. Hussaini, MHA, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sonia Crandall, PhD, MS, is a professor and director of research and scholarship, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Gayle B Bodner
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship, Department of PA Studies, and an associate professor, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Gayle B. Bodner, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Caroline Grey Bell Sisson, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Nathan Bates, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Alisha DeTroye, MMS, PA-C, is director of advanced practice at Atrium Health Wake Forest Baptist, and adjunct assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sobia S. Hussaini, MHA, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sonia Crandall, PhD, MS, is a professor and director of research and scholarship, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Caroline Grey Bell Sisson
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship, Department of PA Studies, and an associate professor, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Gayle B. Bodner, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Caroline Grey Bell Sisson, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Nathan Bates, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Alisha DeTroye, MMS, PA-C, is director of advanced practice at Atrium Health Wake Forest Baptist, and adjunct assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sobia S. Hussaini, MHA, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sonia Crandall, PhD, MS, is a professor and director of research and scholarship, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Nathan Bates
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship, Department of PA Studies, and an associate professor, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Gayle B. Bodner, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Caroline Grey Bell Sisson, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Nathan Bates, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Alisha DeTroye, MMS, PA-C, is director of advanced practice at Atrium Health Wake Forest Baptist, and adjunct assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sobia S. Hussaini, MHA, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sonia Crandall, PhD, MS, is a professor and director of research and scholarship, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Alisha DeTroye
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship, Department of PA Studies, and an associate professor, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Gayle B. Bodner, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Caroline Grey Bell Sisson, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Nathan Bates, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Alisha DeTroye, MMS, PA-C, is director of advanced practice at Atrium Health Wake Forest Baptist, and adjunct assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sobia S. Hussaini, MHA, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sonia Crandall, PhD, MS, is a professor and director of research and scholarship, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Sobia S Hussaini
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship, Department of PA Studies, and an associate professor, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Gayle B. Bodner, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Caroline Grey Bell Sisson, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Nathan Bates, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Alisha DeTroye, MMS, PA-C, is director of advanced practice at Atrium Health Wake Forest Baptist, and adjunct assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sobia S. Hussaini, MHA, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sonia Crandall, PhD, MS, is a professor and director of research and scholarship, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Sonia Crandall
- Chris Gillette, PhD, is an associate professor and assistant director of research and scholarship, Department of PA Studies, and an associate professor, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Gayle B. Bodner, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Caroline Grey Bell Sisson, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Nathan Bates, MMS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Alisha DeTroye, MMS, PA-C, is director of advanced practice at Atrium Health Wake Forest Baptist, and adjunct assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sobia S. Hussaini, MHA, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Sonia Crandall, PhD, MS, is a professor and director of research and scholarship, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
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21
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Currie GR, Groothuis-Oudshoorn CGM, Twilt M, Kip MMA, IJzerman MJ, Benseler SM, Swart JF, Vastert SJ, Wulffraat NM, Yeung R, Marshall DA. What matters most to pediatric rheumatologists in deciding whether to discontinue biologics in a child with juvenile idiopathic arthritis? A best-worst scaling survey. Clin Rheumatol 2023:10.1007/s10067-023-06616-6. [PMID: 37202606 DOI: 10.1007/s10067-023-06616-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/31/2023] [Accepted: 04/27/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVES Care for JIA patients has been transformed in the biologics era; however, biologics carry important (although rare) risks and are costly. Flares after biological withdrawal are seen frequently, yet there is little clinical guidance to identify which patients in clinical remission can safely have their biologic discontinued (by stopping or tapering). We examined what characteristics of the child or their context are important to pediatric rheumatologists when making the decision to discuss withdrawal of biologics. METHODS We conducted a survey including a best-worst scaling (BWS) exercise in pediatric rheumatologists who are part of the UCAN CAN-DU network to assess the relative importance of 14 previously identified characteristics. A balanced incomplete block design was used to generate choice tasks. Respondents evaluated 14 choice sets of 5 characteristics of a child with JIA and identified for each set which was the most and least important in the decision to offer withdrawal. Results were analyzed using conditional logit regression. RESULTS Fifty-one (out of 79) pediatric rheumatologists participated (response rate 65%). The three most important characteristics were how challenging it was to achieve remission, history of established joint damage, and time spent in remission. The three least important characteristics were history of temporomandibular joint involvement, accessibility of biologics, and the patient's age. CONCLUSIONS These findings give quantitative insight about factors important to pediatric rheumatologists' decision-making about biologic withdrawal. In addition to high quality clinical evidence, further research is needed to understand the perspective of patients and families to inform shared decision-making about biologic withdrawal for JIA patients with clinically inactive disease. Key Points ● What is already known on this topic-there is limited clinical guidance for pediatric rheumatologists in making decisions about biologic withdrawal for patients with juvenile idiopathic arthritis who are in clinical remission. ● What this study adds-this study quantitatively examined what characteristic of the child in clinical remission, or of their context, are most important to pediatric rheumatologists in deciding whether to offer withdrawal of biologics. ● How this study might affect research, practice or policy-understanding of these characteristics can provide useful information to other pediatric rheumatologists in making their decisions, and may guide areas to focus on for future research.
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Affiliation(s)
- Gillian R Currie
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
- Health Research Innovation Centre, Room 3C56, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| | - Catherina G M Groothuis-Oudshoorn
- Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, the Netherlands
| | - Marinka Twilt
- Section of Rheumatology, Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Michelle M A Kip
- Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, the Netherlands
| | - Maarten J IJzerman
- Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, the Netherlands
| | - Susanne M Benseler
- Section of Rheumatology, Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Joost F Swart
- Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital/UMC Utrecht, Utrecht, the Netherlands
- Faculty of Medicine, Utrecht University, Utrecht, the Netherlands
| | - Sebastiaan J Vastert
- Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital/UMC Utrecht, Utrecht, the Netherlands
- Faculty of Medicine, Utrecht University, Utrecht, the Netherlands
| | - Nico M Wulffraat
- Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital/UMC Utrecht, Utrecht, the Netherlands
- Faculty of Medicine, Utrecht University, Utrecht, the Netherlands
| | - Rae Yeung
- Departments of Paediatrics, Immunology and Medical Science, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Deborah A Marshall
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
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22
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Paczkowski R, Poon JL, Cutts KN, Krucien N, Osumili B, de Oliveira CP, Hankosky ER, Perez-Nieves M, Radawski C, Gelhorn HL. The Burden and Impacts of Mealtime Insulin from the Perspective of People with Diabetes. Diabetes Ther 2023; 14:1057-1072. [PMID: 37184631 PMCID: PMC10184069 DOI: 10.1007/s13300-023-01405-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/06/2023] [Indexed: 05/16/2023] Open
Abstract
INTRODUCTION While there have been continued advances in insulin treatment for diabetes since the discovery of insulin 100 years ago, some unmet needs still remain, including those related to mealtime insulin (MTI). The objective of this study was to explore the impacts related to MTI and the relative burden of the impacts on people with diabetes. METHODS This study was conducted across two phases, namely, a qualitative and quantitative phase. People with type 1 and 2 diabetes using MTI in the USA and UK were recruited for the study. The qualitative phase involved 30 interviews to explore the impacts associated with MTI. Based on the results of the qualitative phase, a list of impacts was developed to evaluate the importance of MTI impacts using best-worst scaling. RESULTS A total of 30 participants completed interviews, and 336 completed the quantitative phase. Participants described a range of impacts associated with MTI, including psychological (72.0%), social (63.0%), work/school (53.8%), and sleep (51.7%). Impacts for the quantitative phase were categorized under the following domains: diabetes distress, diabetes management, work productivity, and social. The three most burdensome impacts were related to diabetes distress, but the diabetes management domain contributed more than diabetes distress to the relative burden. There were minor differences in the relative importance of impacts by diabetes type, diabetes duration, and experience with continuous glucose monitoring. CONCLUSION This study confirms that people with diabetes using MTI still have an array of unmet needs, including those related to the management of their diabetes and the emotional distress of having diabetes. These findings may be useful for healthcare provider (HCP)-patient interactions to ensure HCPs are allowing patients an opportunity to discuss their experiences with MTI.
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Affiliation(s)
| | - J L Poon
- Eli Lilly and Company, Indianapolis, IN, USA
| | - K N Cutts
- Evidera, Patient-Centered Research, 7101 Wisconsin Ave, Suite 1400, Bethesda, MD, 20814, USA
| | - N Krucien
- Evidera, Patient-Centered Research, 7101 Wisconsin Ave, Suite 1400, Bethesda, MD, 20814, USA
| | - B Osumili
- Eli Lilly and Company Ltd, Bracknell, UK
| | | | | | | | - C Radawski
- Eli Lilly and Company, Indianapolis, IN, USA
| | - H L Gelhorn
- Evidera, Patient-Centered Research, 7101 Wisconsin Ave, Suite 1400, Bethesda, MD, 20814, USA.
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23
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Kim DD, Do LA, Synnott PG, Lavelle TA, Prosser LA, Wong JB, Neumann PJ. Developing Criteria for Health Economic Quality Evaluation Tool. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023:S1098-3015(23)02561-5. [PMID: 37068557 DOI: 10.1016/j.jval.2023.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 03/01/2023] [Accepted: 04/04/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVES Because existing publication guidelines and checklists have limitations when used to assess the quality of cost-effectiveness analysis, we developed a novel quality assessment tool for cost-effectiveness analyses, differentiating methods and reporting quality and incorporating the relative importance of different quality attributes. METHODS We defined 15 quality domains from a scoping review and identified 72 methods and reporting quality attributes (36 each). After designing a best-worst scaling survey, we fielded an online survey to researchers and practitioners to estimate the relative importance of the attributes in February 2021. We analyzed the survey data using a sequential conditional logit model. The final tool included 48 quality attributes deemed most important for assessing methods and reporting quality (24 each), accompanied by a free and web-based scoring system. RESULTS A total of 524 participants completed the methodology section, and 372 completed both methodology and reporting sections. Quality attributes pertaining to the "modeling" and "data inputs and evidence synthesis" domains were deemed most important for methods quality, including "structure of the model reflects the underlying condition and intervention's impact" and "model validation is conducted." Quality attributes pertaining to "modeling" and "Intervention/comparator(s)" domains were considered most important for reporting quality, including "model descriptions are detailed enough for replication." Despite its growing prominence, "equity considerations" were not deemed as important as other quality attributes. CONCLUSIONS The Criteria for Health Economic Quality Evaluation tool allows users to differentiate methods and reporting as well as quantifies the relative importance of quality attributes. Alongside other considerations, it could help assess and improve the quality of cost-effectiveness evidence to inform value-based decisions.
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Affiliation(s)
- David D Kim
- Section of Hospital Medicine, Department of Medicine, The University of Chicago, Chicago, IL, USA.
| | - Lauren A Do
- Center for the Evaluation of Value and Risk in Health (CEVR), Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Patricia G Synnott
- Center for the Evaluation of Value and Risk in Health (CEVR), Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Tara A Lavelle
- Center for the Evaluation of Value and Risk in Health (CEVR), Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Lisa A Prosser
- The Susan B. Meister Child Health Evaluation and Research (CHEAR) Center, Michigan Medicine, Ann Arbor, MI, USA; Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - John B Wong
- Department of Medicine, Tufts University School of Medicine, Boston, MA, USA; Division of Clinical Decision Making, Tufts Medical Center, Boston, MA, USA
| | - Peter J Neumann
- Center for the Evaluation of Value and Risk in Health (CEVR), Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
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24
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Phan A, Schloemann D, Calderon T, Hammert WC. Using MaxDiff Analysis to Elicit Patients' Treatment Preferences for Distal Radius Fractures in Patients Aged 60 Years and Older. J Hand Surg Am 2023:S0363-5023(23)00120-X. [PMID: 37029035 DOI: 10.1016/j.jhsa.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/17/2023] [Accepted: 03/08/2023] [Indexed: 04/09/2023]
Abstract
PURPOSE The objective of our study was to determine how the attributes of surgical and nonsurgical distal radius fracture (DRF) treatments affect patient treatment preferences. METHODS Two hundred fifty patients aged 60 years and older were contacted from a single-hand surgeon's practice, and 172 chose to participate. We built a series of best-worst scaling experiments for the MaxDiff analysis to determine the relative importance of treatment attributes. Hierarchical Bayes analysis was used to generate individual-level item scores (ISs) for each attribute that together have a total sum of 100. RESULTS One hundred general hand clinic patients without a history of a DRF and 43 patients with a history of a DRF completed the survey. For the general hand clinic patients, the most important attributes to avoid when choosing a DRF treatment (in descending order) were the longer time to full recovery (IS, 24.9; 95% confidence interval [CI]: 23.4-26.3), longer time spent in a cast (IS, 22.8; 95% CI, 21.5-24.2), and higher complication rates (IS, 18.4; 95% CI, 16.9-19.8). Meanwhile, for patients with a history of a DRF, the most important attributes to avoid (in descending order) were a longer time to full recovery (IS, 25.6; 95% CI, 23.3-27.9), longer time spent in a cast (IS, 22.8; 95% CI, 19.9-25.7), and abnormal alignment of the radius on x-ray (IS, 18.3; 95% CI, 15.4-21.3). For both the groups, the least concerning attributes based on the IS were appearance-scar, appearance-bump, and the need for anesthesia. CONCLUSIONS Eliciting patient preferences is a vital component of shared decision-making and advancing patient-centered care. As conceptualized in this MaxDiff analysis, when choosing a DRF treatment, patients mostly want to avoid a longer time to full recovery and a longer time in a cast, whereas patients have the least concern about appearance and need for anesthesia. CLINICAL RELEVANCE Eliciting patient preferences is a vital component of shared decision-making. Our results may provide guidance to surgeons in discussions on the relative benefits of surgical and nonsurgical DRF treatments, by quantifying the most and least important factors to patients.
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Affiliation(s)
- Amy Phan
- Department of Orthopaedics and Physical Performance, University of Rochester, Rochester, NY
| | - Derek Schloemann
- Department of Orthopaedics and Physical Performance, University of Rochester, Rochester, NY
| | - Thais Calderon
- Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, WA
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25
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Tervonen T, Veldwijk J, Payne K, Ng X, Levitan B, Lackey LG, Marsh K, Thokala P, Pignatti F, Donnelly A, Ho M. Quantitative Benefit-Risk Assessment in Medical Product Decision Making: A Good Practices Report of an ISPOR Task Force. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:449-460. [PMID: 37005055 DOI: 10.1016/j.jval.2022.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/06/2022] [Indexed: 05/06/2023]
Abstract
Benefit-risk assessment is commonly conducted by drug and medical device developers and regulators, to evaluate and communicate issues around benefit-risk balance of medical products. Quantitative benefit-risk assessment (qBRA) is a set of techniques that incorporate explicit outcome weighting within a formal analysis to evaluate the benefit-risk balance. This report describes emerging good practices for the 5 main steps of developing qBRAs based on the multicriteria decision analysis process. First, research question formulation needs to identify the needs of decision makers and requirements for preference data and specify the role of external experts. Second, the formal analysis model should be developed by selecting benefit and safety endpoints while eliminating double counting and considering attribute value dependence. Third, preference elicitation method needs to be chosen, attributes framed appropriately within the elicitation instrument, and quality of the data should be evaluated. Fourth, analysis may need to normalize the preference weights, base-case and sensitivity analyses should be conducted, and the effect of preference heterogeneity analyzed. Finally, results should be communicated efficiently to decision makers and other stakeholders. In addition to detailed recommendations, we provide a checklist for reporting qBRAs developed through a Delphi process conducted with 34 experts.
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Affiliation(s)
| | - Jorien Veldwijk
- Erasmus School of Health Policy and Management & Erasmus Choice Modelling Center, Rotterdam, The Netherlands
| | - Katherine Payne
- Manchester Centre for Health Economics, School of Health Sciences, The University of Manchester, Manchester, England, UK
| | - Xinyi Ng
- Office of Biostatistics and Pharmacovigilance, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | | | - Leila G Lackey
- Decision Support and Analysis Staff, Office of Program and Strategic Analysis, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
| | | | - Praveen Thokala
- School of Health and Related Research, University of Sheffield, Sheffield, England, UK
| | | | - Anne Donnelly
- Patient Council of the Michael J. Fox Foundation for Parkinson's Research, New York, NY, USA
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26
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Paller AS, Weidinger S, Capozza K, Pink AE, Tang M, Guillaume X, Praestgaard A, Leclerc M, Chuang CC, Thomas RB, Prescilla R. Similarities and Differences in the Perception of Atopic Dermatitis Burden Between Patients, Caregivers, and Independent Physicians (AD-GAP Survey). Dermatol Ther (Heidelb) 2023; 13:961-980. [PMID: 36922463 DOI: 10.1007/s13555-022-00850-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/31/2022] [Indexed: 03/17/2023] Open
Abstract
INTRODUCTION Atopic dermatitis (AD)-a chronic inflammatory skin disease characterized by intense itching-can have a detrimental impact on quality of life (QoL). We report results of a quantitative assessment of pediatric patient, caregiver, and physician perceptions of AD burden in children and adolescents. METHODS Pediatric patients (aged 6-11 [children] or 12-17 [adolescents] years) with moderate-to-severe AD, their caregivers, and independent physicians were recruited in 13 countries. Caregivers and their children/adolescents completed an online survey about the impact of AD on 16 key items of patient QoL. Physicians completed surveys on their patients aged 6-11 and 12-17 years. Best-worst scaling was used to rank the importance of the QoL items. RESULTS Overall, 1447 children/adolescents with moderate-to-severe AD (aged 6-11 years: 701; 12-17 years: 746), 1447 caregivers, and 1092 physicians participated. Patients and caregivers in both age groups ranked disturbed sleep as the most important QoL item, followed by feeling ashamed because of AD. Independent physicians ranked feeling ashamed because of AD as the most important QoL item for both age groups, followed by disturbed sleep for those aged 6-11 years and being singled out for those aged 12-17 years. The relative importance of the 16 QoL items to patients was strongly aligned between patients in both age groups and their caregivers, but somewhat less so between patients and physicians. Between-country differences were more apparent in physician- versus patient-/caregiver-reported results. CONCLUSION The most burdensome QoL items were impact of AD on sleep and feeling ashamed. Caregivers and physicians correctly identified the QoL items most burdensome to patients. However, patient and caregiver perceptions were generally more closely aligned than patient and physician perceptions. Between-country differences in perceptions (particularly for physicians) were observed, probably due to multifactorial reasons, necessitating further evaluation. Video Abstract (MP4 42,877 kb) INFOGRAPHIC.
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Affiliation(s)
- Amy S Paller
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Ann and Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | | | - Korey Capozza
- Global Parents for Eczema Research, Santa Barbara, CA, USA
| | - Andrew E Pink
- St John's Institute of Dermatology, Guy's & St. Thomas' Hospitals, London, UK
| | - Mark Tang
- Mount Alvernia Medical Centre, Singapore, Singapore
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27
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Payne J, Talavera M, Koppel K. Consumer perceptions of hotel shampoos and lotions. J SENS STUD 2023. [DOI: 10.1111/joss.12817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- Jessie Payne
- Sensory and Consumer Research Center Kansas State University Olathe Kansas USA
| | - Martin Talavera
- Sensory and Consumer Research Center Kansas State University Olathe Kansas USA
| | - Kadri Koppel
- Sensory and Consumer Research Center Kansas State University Olathe Kansas USA
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Soekhai V, Donkers B, Johansson JV, Jimenez-Moreno C, Pinto CA, de Wit GA, de Bekker-Grob E. Comparing Outcomes of a Discrete Choice Experiment and Case 2 Best-Worst Scaling: An Application to Neuromuscular Disease Treatment. THE PATIENT 2023; 16:239-253. [PMID: 36781628 PMCID: PMC10121531 DOI: 10.1007/s40271-023-00615-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND AND OBJECTIVES Case 2 best-worst scaling (BWS-2) is an increasingly popular method to elicit patient preferences. Because BWS-2 potentially has a lower cognitive burden compared with discrete choice experiments, the aim of this study was to compare treatment preference weights and relative importance scores. METHODS Patients with neuromuscular diseases completed an online survey at two different moments in time, completing one method per occasion. Patients were randomly assigned to either first a discrete choice experiment or BWS-2. Attributes included: muscle strength, energy endurance, balance, cognition, chance of blurry vision, and chance of liver damage. Multinomial logit was used to calculate overall relative importance scores and latent class logit was used to estimate heterogeneous preference weights and to calculate the relative importance scores of the attributes for each latent class. RESULTS A total of 140 patients were included for analyses. Overall relative importance scores showed differences in attribute importance rankings between a discrete choice experiment and BWS-2. Latent class analyses indicated three latent classes for both methods, with a specific class in both the discrete choice experiment and BWS-2 in which (avoiding) liver damage was the most important attribute. Ex-post analyses showed that classes differed in sex, age, level of education, and disease status. The discrete choice experiment was easier to understand compared with BWS-2. CONCLUSIONS This study showed that using a discrete choice experiment and BWS-2 leads to different outcomes, both in preference weights as well as in relative importance scores, which might have been caused by the different framing of risks in BWS-2. However, a latent class analysis revealed similar latent classes between methods. Careful consideration about method selection is required, while keeping the specific decision context in mind and pilot testing the methods.
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Affiliation(s)
- Vikas Soekhai
- Erasmus Choice Modelling Centre, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands. .,Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands. .,Department of Public Health, Erasmus MC, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Bas Donkers
- Erasmus Choice Modelling Centre, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.,Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jennifer Viberg Johansson
- Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden.,Institute of Futures Studies, Stockholm, Sweden
| | - Cecilia Jimenez-Moreno
- Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle-Upon-Tyne, UK.,Patient Centered Research, Evidera, London, UK
| | | | - G Ardine de Wit
- Juliuscenter for Healthsciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Esther de Bekker-Grob
- Erasmus Choice Modelling Centre, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.,Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Caron B, D'Amico F, Jairath V, Netter P, Danese S, Peyrin-Biroulet L. Available Methods for Benefit-risk Assessment: Lessons for Inflammatory Bowel Disease Drugs. J Crohns Colitis 2023; 17:137-143. [PMID: 35952722 DOI: 10.1093/ecco-jcc/jjac113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND AIMS Medical treatment for inflammatory bowel disease has advanced significantly over the two past decades. The advent of biologics and small molecules has revolutionised outcomes for patients with inflammatory bowel disease. Knowledge of drug pharmacology, indications, and adverse events is essential to ensure the best clinical care while minimising toxicity. Our aim was to review the literature on current methods of benefit-risk assessment, and consider their practical applicability to inflammatory bowel disease. METHODS A literature search was conducted to investigate studies documenting benefit-risk assessment. RESULTS Several structured frameworks and quantitative methodologies have been developed to evaluate benefit-risk profiles of drugs in a more comprehensive and consistent framework. Quantitative methods integrate benefit and risk outcome measures or incorporate preference weights for benefit and risk criteria into the evaluation. Incorporation of preference weights from patients is an essential aspect of quantitative benefit-risk assessment. Benefit-risk assessment is still evolving in inflammatory bowel disease. CONCLUSIONS The risks and benefits of each medical therapy must be discussed with the patient and a shared decision-making process is recommended. Future initiatives should be developed to perform a benefit-risk assessment considering the characteristics of inflammatory bowel disease drugs.
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Affiliation(s)
- Bénédicte Caron
- Department of Gastroenterology and Inserm NGERE U1256, Nancy University Hospital, University of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Ferdinando D'Amico
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele Milano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Vipul Jairath
- Department of Medicine, Department of Epidemiology and Biostatistics, Western University, London, ON, CanadaAlimentiv Inc., London, ON, Canada
| | - Patrick Netter
- Ingénierie Moléculaire et Ingénierie Articulaire [IMoPA], UMR-7365 CNRS, Faculté de Médecine, University of Lorraine and University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Silvio Danese
- Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele and University Vita-Salute San Raffaele Milano, Milan, Italy
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology and Inserm NGERE U1256, Nancy University Hospital, University of Lorraine, Vandoeuvre-lès-Nancy, France
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Xiong X, Dalziel K, Huang L, Rivero-Arias O. Test-Retest Reliability of EQ-5D-Y-3L Best-Worst Scaling Choices of Adolescents and Adults. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:50-54. [PMID: 35970707 DOI: 10.1016/j.jval.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 07/01/2022] [Accepted: 07/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is an increasing interest to obtain adolescents' own health state valuation preferences and to understand how these differ from adult preferences for the same health state. An important question in health state valuation is whether adolescents can report preferences reliably, yet research remains limited. OBJECTIVE This study aims to investigate the test-retest reliability of best-worst scaling (BWS) to elicit adolescent preferences compared with adults. METHODS Identical BWS tasks designed to value 3-level version of EQ-5D-Y health states were administered online in samples of 1000 adolescents (aged 11-17 years) and 1006 adults in Spain. The valuation survey was repeated approximately 3 days later. We calculated (1) simple percentage agreement and (2) kappa statistic as measures of test-retest reliability. We also compared BWS marginal frequencies and relative attribute importance between baseline and follow-up to explore similarities in the obtained preferences. RESULTS We found that both adolescents and adults were able to report their preferences with moderate reliability (kappa: 0.46 for adolescents, 0.46 for adults) for best choices and fair to moderate reliability (kappa: 0.39 for adolescents, 0.41 for adults) for worst choices. No notable difference was observed across years of child age. Higher consistency was observed for best choices than worst in some dimensions for both populations. No significant differences were found in the relative attribute importance between baseline and follow-up in both populations. CONCLUSION Our results suggest that BWS is a reliable elicitation technique to value 3-level version of EQ-5D-Y health states in both adolescents and adults.
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Affiliation(s)
- Xiuqin Xiong
- Health Economics Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Kim Dalziel
- Health Economics Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Li Huang
- Health Economics Unit, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Oliver Rivero-Arias
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, England, UK.
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Kerkhoff AD, Muiruri C, Geng EH, Hickey MD. A world of choices: preference elicitation methods for improving the delivery and uptake of HIV prevention and treatment. Curr Opin HIV AIDS 2023; 18:32-45. [PMID: 36409315 PMCID: PMC9772083 DOI: 10.1097/coh.0000000000000776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE OF REVIEW Despite the growing availability of effective HIV prevention and treatment interventions, there are large gaps in their uptake and sustained use across settings. It is crucial to elicit and apply patients' and stakeholders' preferences to maximize the impact of existing and future interventions. This review summarizes quantitative preference elicitation methods (PEM) and how they can be applied to improve the delivery and uptake of HIV prevention and treatment interventions. RECENT FINDINGS PEM are increasingly applied in HIV implementation research; however, discrete choice experiments (DCEs) have predominated. Beyond DCEs, there are other underutilized PEM that may improve the reach and effectiveness of HIV prevention and treatment interventions among individuals by prioritizing their barriers to engagement and determining which attributes of interventions and delivery strategies are most valued. PEM can also enhance the adoption and sustained implementation of strategies to deliver HIV prevention and treatment interventions by assessing which attributes are the most acceptable and appropriate to key stakeholders. SUMMARY Greater attention to and incorporation of patient's and stakeholders' preferences for HIV prevention and treatment interventions and their delivery has the potential to increase the number of persons accessing and retained in HIV prevention and treatment services.
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Affiliation(s)
- Andrew D. Kerkhoff
- Division of HIV, Infectious Diseases and Global Medicine Zuckerberg San Francisco General Hospital and Trauma Center University of California, San Francisco, San Francisco, CA, USA
| | - Charles Muiruri
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Elvin H. Geng
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Matthew D. Hickey
- Division of HIV, Infectious Diseases and Global Medicine Zuckerberg San Francisco General Hospital and Trauma Center University of California, San Francisco, San Francisco, CA, USA
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Mühlbacher AC, Sadler A, Jordan Y. Population preferences for non-pharmaceutical interventions to control the SARS-CoV-2 pandemic: trade-offs among public health, individual rights, and economics. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:1483-1496. [PMID: 35138495 PMCID: PMC9468277 DOI: 10.1007/s10198-022-01438-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 01/13/2022] [Indexed: 05/25/2023]
Abstract
PROBLEM Policymakers must decide on interventions to control the pandemic. These decisions are driven by weighing the risks and benefits of various non-pharmaceutical intervention alternatives. Due to the nature of the pandemic, these decisions are not based on sufficient evidence regarding the effects, nor are decision-makers informed about the willingness of populations to accept the economic and health risks associated with different policy options. This empirical study seeks to reduce uncertainty by measuring population preferences for non-pharmaceutical interventions. METHODS An online-based discrete choice experiment (DCE) was conducted to elicit population preferences. Respondents were asked to choose between three pandemic scenarios with different interventions and impacts of the Corona pandemic. In addition, Best-worst scaling (BWS) was used to analyze the impact of the duration of individual interventions on people's acceptance. The marginal rate of substitution was applied to estimate willingness-to-accept (WTA) for each intervention and effect by risk of infection. RESULTS Data from 3006 respondents were included in the analysis. The DCE showed, economic effect of non-pharmaceutical measures had a large impact on choice decisions for or against specific lockdown scenarios. Individual income decreases had the most impact. Excess mortality and individual risk of infection were also important factors influencing choice decisions. Curfews, contact restrictions, facility closures, personal data transmissions, and mandatory masking in public had a lesser impact. However, significant standard deviations in the random parameter logit model (RPL) indicated heterogeneities in the study population. The BWS results showed that short-term restrictions were more likely to be accepted than long-term restrictions. According to WTA estimates, people would be willing to accept a greater risk of infection to avoid loss of income. DISCUSSION The results can be used to determine which consequences of pandemic measures would be more severe for the population. For example, the results show that citizens want to limit the decline in individual income during pandemic measures. Participation in preference studies can also inform citizens about potential tradeoffs that decision-makers face in current and future decisions during a pandemic. Knowledge of the population's preferences will help inform decisions that consider people's perspectives and expectations for the future. Survey results can inform decision-makers about the extent to which the population is willing to accept certain lockdown measures, such as curfews, contact restrictions, lockdowns, or mandatory masks.
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Affiliation(s)
- Axel C Mühlbacher
- Gesundheitsökonomie und Medizinmanagement, Hochschule Neubrandenburg, Brodaer Straße 2, 17033, Neubrandenburg, Germany.
- Gesellschaft Für Empirische Beratung GmbH, Freiburg, Germany.
- Duke Department of Population Health Sciences and Duke Global Health Institute, Duke University, Durham, NC, USA.
| | - Andrew Sadler
- Gesundheitsökonomie und Medizinmanagement, Hochschule Neubrandenburg, Brodaer Straße 2, 17033, Neubrandenburg, Germany
| | - Yvonne Jordan
- Gesundheitsökonomie und Medizinmanagement, Hochschule Neubrandenburg, Brodaer Straße 2, 17033, Neubrandenburg, Germany
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Lee SO, Kim J, Han H. Most and least important attributes for domestic travel: A best-worst scaling approach. Front Psychol 2022; 13:987384. [PMID: 36204752 PMCID: PMC9531255 DOI: 10.3389/fpsyg.2022.987384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
This study identifies the most important and least important selection attributes in Korean domestic travel during the COVID-19 pandemic. A total of 632 responses were used as the final analysis by conducting a survey of Koreans who have experienced travel in Korea since the outbreak of COVID-19. In order to explain tourists’ domestic travel selection preferences, best-worst scaling was used. As a result of the study, it was found that the destination environment is most important and is considered relatively important in the order of accommodation, major activities, expenditure, and crowdedness. On the other hand, length of stay, transport mode, travel time, and media exposure showed relatively low importance. In a situation where overseas travel is unstable due to the risk of infectious diseases, it is urgent to identify changes in domestic travel trends/factors that are important to tourists and respond to their needs and expectations. This study is academically expanded in that it not only bridges the research gap that previous studies have missed but also considers and ranks the importance of domestic travel factors at the same time.
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Affiliation(s)
- Soyeun Olivia Lee
- Faculty of Hospitality and Tourism Management, Macau University of Science and Technology, Taipa, Macau SAR, China
| | - JooHyang Kim
- Department of Hotel and Airline Management, Hannam University, Daejeon, South Korea
| | - Heesup Han
- College of Hospitality and Tourism Management, Sejong University, Seoul, South Korea
- *Correspondence: Heesup Han,
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34
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Hollin IL, Paskett J, Schuster ALR, Crossnohere NL, Bridges JFP. Best-Worst Scaling and the Prioritization of Objects in Health: A Systematic Review. PHARMACOECONOMICS 2022; 40:883-899. [PMID: 35838889 PMCID: PMC9363399 DOI: 10.1007/s40273-022-01167-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/12/2022] [Indexed: 05/28/2023]
Abstract
BACKGROUND AND OBJECTIVE Best-worst scaling is a theory-driven method that can be used to prioritize objects in health. We sought to characterize all studies of best-worst scaling to prioritize objects in health, to assess trends of using best-worst scaling in prioritization over time, and to assess the relationship between a legacy measure of quality (PREFS) and a novel assessment of subjective quality and policy relevance. METHODS A systematic review identified studies published through to the end of 2021 that applied best-worst scaling to study priorities in health (PROSPERO CRD42020209745), updating a prior review published in 2016. The PubMed, EBSCOhost, Embase, Scopus, APA PsychInfo, Web of Science, and Google Scholar databases were used and were supplemented by a hand search. Data describing the application, development, design, administration/analysis, quality, and policy relevance were summarized and we tested for trends by comparing articles before and after 1 January, 2017. Multivariate statistics were then used to assess the relationships between PREFS, subjective quality, policy relevance, and other possible indicators. RESULTS From a total of 2826 unique papers identified, 165 best-worst scaling studies were included in this review. Applications of best-worst scaling to study priorities in health have continued to grow (p < 0.01) and are now used in all regions of the world, most often to study the priorities of patients/consumers (67%). Several key trends can be observed over time: increased use of pretesting (p < 0.05); increased use of online administration (p < 0.01), and decreased use of paper self-administered surveys (p = 0.02); increased use of heterogeneity analysis (p = 0.02); an increase in having a clearly stated purpose (p < 0.01); and a decrease in comparing respondents to non-respondents (p = 0.01). The average sample size has more than doubled, from 228 to 472 respondents, but formal sample size justifications remain low (5.3%) and unchanged over time (p = 0.68). While the average PREFS score remained unchanged at 3.1/5, both subjective quality and policy relevance trended up, but changes were not statistically significant (p = 0.06 and p = 0.13). Most of the variation in subjective quality was driven by PREFS (R2 = 0.42), but it was also positively assosciated with policy relevance, heterogeneity analysis, and using a balanced incomplete block design, and was negatively associated with not using developmental methods and an increasing sample size. CONCLUSIONS Using best-worst scaling to prioritize objects is now commonly used around the world to assess the priorities of patients and other stakeholders in health. Best practices are clearly emerging for best-worst scaling. Although legacy measures (PREFS) to measure study quality are reasonable, there may need to be new tools to assess both study quality and policy relevance.
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Affiliation(s)
- Ilene L Hollin
- Department of Health Services Administration and Policy, Temple University College of Public Health, Philadelphia, PA, USA
| | - Jonathan Paskett
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Anne L R Schuster
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Norah L Crossnohere
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, OH, USA
| | - John F P Bridges
- Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, OH, USA.
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Mohr W, Rädke A, Afi A, Mühlichen F, Platen M, Scharf A, Michalowsky B, Hoffmann W. Development of a Quantitative Preference Instrument for Person-Centered Dementia Care—Stage 2: Insights from a Formative Qualitative Study to Design and Pretest a Dementia-Friendly Analytic Hierarchy Process Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148554. [PMID: 35886406 PMCID: PMC9321359 DOI: 10.3390/ijerph19148554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 02/05/2023]
Abstract
Person-centered care (PCC) requires knowledge about patient preferences. An analytic hierarchy process (AHP) is one approach to quantify, weigh and rank patient preferences suitable for People living with Dementia (PlwD), due to simple pairwise comparisons of individual criteria from a complex decision problem. The objective of the present study was to design and pretest a dementia-friendly AHP survey. Methods: Two expert panels consisting of n = 4 Dementia Care Managers and n = 4 physicians to ensure content-validity, and “thinking-aloud” interviews with n = 11 PlwD and n = 3 family caregivers to ensure the face validity of the AHP survey. Following a semi-structured interview guide, PlwD were asked to assess appropriateness and comprehensibility. Data, field notes and partial interview transcripts were analyzed with a constant comparative approach, and feedback was incorporated continuously until PlwD had no further comments or struggles with survey completion. Consistency ratios (CRs) were calculated with Microsoft® Excel and ExpertChoice Comparion®. Results: Three main categories with sub-categories emerged: (1) Content: clear task introduction, (sub)criteria description, criteria homogeneity, (sub)criteria appropriateness, retest questions and sociodemography for heterogeneity; (2) Format: survey structure, pairwise comparison sequence, survey length, graphical design (incl. AHP scale), survey procedure explanation, survey assistance and response perspective; and (3) Layout: easy wording, short sentences and visual aids. Individual CRs ranged from 0.08 to 0.859, and the consolidated CR was 0.37 (0.038). Conclusions: Our formative qualitative study provides initial data for the design of a dementia-friendly AHP survey. Consideration of our findings may contribute to face and content validity in future quantitative preference research in dementia.
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Affiliation(s)
- Wiebke Mohr
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Ellernholzstrasse 1-2, D-17487 Greifswald, Germany; (A.R.); (A.A.); (F.M.); (M.P.); (A.S.); (B.M.); (W.H.)
- Correspondence: ; Tel.: +49-3834-8685-37
| | - Anika Rädke
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Ellernholzstrasse 1-2, D-17487 Greifswald, Germany; (A.R.); (A.A.); (F.M.); (M.P.); (A.S.); (B.M.); (W.H.)
| | - Adel Afi
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Ellernholzstrasse 1-2, D-17487 Greifswald, Germany; (A.R.); (A.A.); (F.M.); (M.P.); (A.S.); (B.M.); (W.H.)
| | - Franka Mühlichen
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Ellernholzstrasse 1-2, D-17487 Greifswald, Germany; (A.R.); (A.A.); (F.M.); (M.P.); (A.S.); (B.M.); (W.H.)
| | - Moritz Platen
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Ellernholzstrasse 1-2, D-17487 Greifswald, Germany; (A.R.); (A.A.); (F.M.); (M.P.); (A.S.); (B.M.); (W.H.)
| | - Annelie Scharf
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Ellernholzstrasse 1-2, D-17487 Greifswald, Germany; (A.R.); (A.A.); (F.M.); (M.P.); (A.S.); (B.M.); (W.H.)
| | - Bernhard Michalowsky
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Ellernholzstrasse 1-2, D-17487 Greifswald, Germany; (A.R.); (A.A.); (F.M.); (M.P.); (A.S.); (B.M.); (W.H.)
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases e.V. (DZNE), Site Rostock/Greifswald, Ellernholzstrasse 1-2, D-17487 Greifswald, Germany; (A.R.); (A.A.); (F.M.); (M.P.); (A.S.); (B.M.); (W.H.)
- Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstrasse 1-2, D-17487 Greifswald, Germany
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Thomas M, Marshall DA, Choudhary D, Bartlett SJ, Sanchez AL, Hazlewood GS. The Application of Preference Elicitation Methods in Clinical Trial Design to Quantify Trade-Offs: A Scoping Review. THE PATIENT 2022; 15:423-434. [PMID: 34927216 DOI: 10.1007/s40271-021-00560-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/10/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Patients can express preferences for different treatment options in a healthcare context, and these can be measured with quantitative preference elicitation methods. OBJECTIVE Our objective was to conduct a scoping review to determine how preference elicitation methods have been used in the design of clinical trials. METHODS We conducted a scoping review to identify primary research studies, involving any health condition, that used quantitative preference elicitation methods, including direct utility-based approaches, and stated preference studies, to value health trade-offs in the context of clinical trial design. Studies were identified by screening existing systematic and scoping reviews and with a primary literature search in MEDLINE from 2010 to the present. We extracted study characteristics and the application of preference elicitation methods to clinical trial design according to the SPIRIT checklist from primary studies and summarized the findings descriptively. RESULTS We identified 18 eligible studies. The included studies applied patient preferences to five areas of clinical trial design: intervention selection (n = 1), designing N-of-1 trials (n = 1), outcome selection and weighting composite and ordinal outcomes (n = 12), sample size calculations (n = 2), and recruitment (n = 2). Using preference elicitation methods led to different decisions being made, such as using preference-weighted composite outcomes instead of equally weighted composite outcomes. CONCLUSION Preference elicitation methods are infrequently used to design clinical trials but may lead to changes throughout the trial that could affect the evidence generated. Future work should consider measurement challenges and explore stakeholder perceptions.
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Affiliation(s)
- Megan Thomas
- Department of Community Health Sciences, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
| | - Deborah A Marshall
- Department of Community Health Sciences, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Daksh Choudhary
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, QC, Canada
- Centre for Outcomes Research & Evaluation, Research Institute McGill University Health Centre, Montreal, QC, Canada
| | - Adalberto Loyola Sanchez
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Glen S Hazlewood
- Department of Community Health Sciences, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
- Department of Medicine, University of Calgary, Calgary, AB, Canada.
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Development of a Quantitative Instrument to Elicit Patient Preferences for Person-Centered Dementia Care Stage 1: A Formative Qualitative Study to Identify Patient Relevant Criteria for Experimental Design of an Analytic Hierarchy Process. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137629. [PMID: 35805286 PMCID: PMC9266267 DOI: 10.3390/ijerph19137629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 01/19/2023]
Abstract
Background: Person-centered care (PCC) requires knowledge about patient preferences. This formative qualitative study aimed to identify (sub)criteria of PCC for the design of a quantitative, choice-based instrument to elicit patient preferences for person-centered dementia care. Method: Interviews were conducted with n = 2 dementia care managers, n = 10 People living with Dementia (PlwD), and n = 3 caregivers (CGs), which followed a semi-structured interview guide including a card game with PCC criteria identified from the literature. Criteria cards were shown to explore the PlwD’s conception. PlwD were asked to rank the cards to identify patient-relevant criteria of PCC. Audios were verbatim-transcribed and analyzed with qualitative content analysis. Card game results were coded on a 10-point-scale, and sums and means for criteria were calculated. Results: Six criteria with two sub-criteria emerged from the analysis; social relationships (indirect contact, direct contact), cognitive training (passive, active), organization of care (decentralized structures and no shared decision making, centralized structures and shared decision making), assistance with daily activities (professional, family member), characteristics of care professionals (empathy, education and work experience) and physical activities (alone, group). Dementia-sensitive wording and balance between comprehensibility vs. completeness of the (sub)criteria emerged as additional themes. Conclusions: Our formative study provides initial data about patient-relevant criteria of PCC to design a quantitative patient preference instrument. Future research may want to consider the balance between (sub)criteria comprehensibility vs. completeness.
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Launois R, Cabout E, Benamouzig D, Velpry L, Briot K, Alliot F, Perrin L, Grange L, Sellami R, Touboul C, Joubert JM, Roux C. Barriers and Expectations for Patients in Post-Osteoporotic Fracture Care in France: The EFFEL Study. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:571-581. [PMID: 35365301 DOI: 10.1016/j.jval.2021.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/12/2021] [Accepted: 10/10/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES This study aimed to quantify the relative importance of barriers to better secondary prevention of osteoporotic fractures and of care expectations expressed by patients with osteoporotic fractures in France. METHODS A qualitative exploration of potential barriers to care and expectations was undertaken through a systematic literature review and in-depth patients interviews. A list of 21 barriers and 21 expectations was identified. These were presented to 324 subjects with osteoporotic fractures, identified in a representative sample of the French population, in the form of best-worst scaling questionnaires. Patients rated the relative importance of the attributes, and arithmetic mean importance scores were calculated and ranked. A Bayesian hierarchical model was also performed to generate a relative importance score. Latent class analysis was performed to identify potential subgroups of patients with different response profiles. RESULTS A total of 7 barriers were rated as the most important, relating to awareness of osteoporosis and coordination of care. The highest-ranked barrier, "my fracture is not related to osteoporosis," was significantly more important than all the others (mean importance score 0.45; 95% confidence interval 0.33-0.56). A similar ranking of attributes was obtained with both the arithmetic and the Bayesian approach. For expectations, no clear hierarchy of attributes was identified. Latent class analysis discriminated 3 classes of respondents with significant differences in response profiles (the educated environmentalists, the unaware, and the victims of the system). CONCLUSIONS Better quality of care of osteoporosis and effective secondary fracture prevention will require improvements in patient education, training of healthcare professionals, and coordination of care.
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Affiliation(s)
| | - Elise Cabout
- Health Economic Assessment Network, Paris, France
| | - Daniel Benamouzig
- French National Center for Scientific Research, Paris, France; Sciences Po, Center of the Sociology of Organizations, Paris, France
| | - Livia Velpry
- Sociology and Anthropology Department, Paris 8 University, Paris, France
| | - Karine Briot
- Rhumatology Department, Cochin Hospital, Paris, France
| | | | | | - Laurent Grange
- Rhumatology Department, Grenobles Alpes University Hospital, Echirolles, France
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Nguyen L, Jokimäki H, Linnosmaa I, Saloniki EC, Batchelder L, Malley J, Lu H, Burge P, Trukeschitz B, Forder J. Valuing informal carers' quality of life using best-worst scaling-Finnish preference weights for the Adult Social Care Outcomes Toolkit for carers (ASCOT-Carer). THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:357-374. [PMID: 34468882 PMCID: PMC8964536 DOI: 10.1007/s10198-021-01356-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/13/2021] [Indexed: 06/13/2023]
Abstract
This study developed Finnish preference weights for the seven-attribute Adult Social Care Outcomes Toolkit for carers (ASCOT-Carer) and investigated survey fatigue and learning in best-worst scaling (BWS) experiments. An online survey that included a BWS experiment using the ASCOT-Carer was completed by a sample from the general population in Finland. A block of eight BWS profiles describing different states from the ASCOT-Carer were randomly assigned to each respondent, who consecutively made four choices (best, worst, second best and second worst) per profile. The analysis panel data had 32,160 choices made by 1005 respondents. A scale multinomial logit (S-MNL) model was used to estimate preference weights for 28 ASCOT-Carer attribute levels. Fatigue and learning effects were examined as scale heterogeneity. Several specifications of the generalised MNL model were employed to ensure the stability of the preference estimates. The most and least-valued states were the top and bottom levels of the control over daily life attribute. The preference weights were not on a cardinal scale. We observed the position effect of the attributes on preferences associated with the best or second-best choices. A learning effect was found. The established preference weights can be used in evaluations of the effects of long-term care services and interventions on the quality of life of service users and caregivers. The learning effect implies a need to develop study designs that ensure equal consideration to all profiles (choice tasks) in a sequential choice experiment.
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Affiliation(s)
- Lien Nguyen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
| | - Hanna Jokimäki
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ismo Linnosmaa
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Eirini-Christina Saloniki
- Centre for Health Services Studies (CHSS), University of Kent, Kent, UK
- Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK
| | - Laurie Batchelder
- Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK
| | - Juliette Malley
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Hui Lu
- RAND Europe, Cambridge, UK
| | | | - Birgit Trukeschitz
- Research Institute for Economics of Aging, WU Vienna University of Economics and Business, Vienna, Austria
| | - Julien Forder
- Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK
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40
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Tatar O, Haward B, Zhu P, Griffin-Mathieu G, Perez S, Zimet G, Rosberger Z. Using Best-Worst Scaling to investigate younger adult Canadians' preferences for COVID-19 vaccination and public health measures: An observational study. Prev Med Rep 2022; 26:101755. [PMID: 35284212 PMCID: PMC8902056 DOI: 10.1016/j.pmedr.2022.101755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/27/2022] [Accepted: 03/06/2022] [Indexed: 11/03/2022] Open
Abstract
Containing the COVID-19 pandemic is dependent on compliance with public health recommendations and mandates which is lower in younger compared to older adults. Furthermore, younger adults have demonstrated lower uptake of COVID-19 vaccines. The aim of this study was to assess preferences for COVID-19 related preventive health measures and vaccination and to explore their association with COVID-19 vaccine acceptability. Canadians aged 18-39 years were invited to participate in a web-based survey in August 2021. We used the Best-Worst-Scaling (BWS) methodology to collect and analyze preference data and multivariable binary logistic regression to estimate associations with vaccine acceptability. Based on 266 complete responses, we found strong preferences for physical distancing and wearing face masks, as compared to general hygiene and respiratory etiquette. High vaccine accessibility independent of the location, receiving successive doses of the same vaccine brand and higher vaccine uptake of people in younger adults' social circle were highly preferred. Higher preferences for mandates requiring proof of vaccination and altruistic motives focused on protecting others by getting vaccinated were associated with vaccine acceptability. As the COVID-19 pandemic waxes and wanes, studies using larger, nationally representative samples are needed to replicate and validate these results to assess preferences for health behaviors corresponding to the latest recommendations. The use of this methodology could provide public health authorities with a unique opportunity to develop targeted, preference-based messaging that aligns with the latest guidelines to effectively encourage compliance and COVID-19 vaccine uptake.
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Affiliation(s)
- Ovidiu Tatar
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC, Canada.,Research Center, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Ben Haward
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC, Canada
| | - Patricia Zhu
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | | | - Samara Perez
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC, Canada.,McGill University Health Center (MUHC), Montreal, QC, Canada
| | | | - Zeev Rosberger
- Lady Davis Institute for Medical Research (LDI), Jewish General Hospital, Montreal, QC, Canada.,Departments of Psychology, Psychiatry and Oncology, McGill University, Montreal, QC, Canada
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Rohrbach PJ, Dingemans AE, Groothuis-Oudshoorn CGM, Van Til JA, Essers BA, Van Furth EF, Van den Akker-Van Marle ME. The ICEpop Capability Measure for Adults Instrument for Capabilities: Development of a Tariff for the Dutch General Population. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:125-132. [PMID: 35031091 DOI: 10.1016/j.jval.2021.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/31/2021] [Accepted: 07/21/2021] [Indexed: 05/26/2023]
Abstract
OBJECTIVES The ICEpop Capability Measure for Adults (ICECAP-A) assesses 5 capabilities (stability, attachment, autonomy, achievement, and enjoyment) that are important to one's quality of life and might be an important addition to generic health questionnaires currently used in economic evaluations. This study aimed to develop a Dutch tariff of the Dutch translation of the ICECAP-A. METHODS The methods used are similar to those used in the development of the UK tariff. A profile case best-worst scaling task was presented to 1002 participants from the general Dutch population. A scale-adjusted latent class analysis was performed to test for preferences of ICECAP-A capabilities and scale heterogeneity. RESULTS A 3-preference class 2-scale class model with worst choice as scale predictor was considered optimal and was used to calculate the resulting tariff. Results indicated that the capabilities stability, attachment, and enjoyment were considered more important aspects of quality of life than autonomy and achievement. Additionally, improving capabilities from low to moderate levels had a larger effect on quality of life than improving capabilities that were already at a higher level. CONCLUSIONS The ICECAP-A tariffs found in this study could be used in economic evaluations of healthcare interventions in The Netherlands.
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Affiliation(s)
- Pieter J Rohrbach
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; GGZ Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands.
| | | | | | - Janine A Van Til
- Technical Medical Centre, Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands
| | - Brigitte A Essers
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Eric F Van Furth
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; GGZ Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands
| | - M Elske Van den Akker-Van Marle
- Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
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Dobischok S, Metcalfe RK, Matzinger EA, Lock K, Harrison S, MacDonald S, Amara S, Schechter MT, Bansback N, Oviedo-Joekes E. Feasibility of Testing Client Preferences for Accessing Injectable Opioid Agonist Treatment (iOAT): A Pilot Study. Patient Prefer Adherence 2022; 16:3405-3413. [PMID: 36582266 PMCID: PMC9793789 DOI: 10.2147/ppa.s391532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Injectable opioid agonist treatment (iOAT) is an effective treatment for opioid use disorder (OUD). To our knowledge, no research has systematically studied client preferences for accessing iOAT. Incorporating preferences could help meet the heterogenous needs of clients and make addiction care more person-centred. This paper presents a pilot study of a best-worst scaling (BWS) preference elicitation survey that aimed to assess if the survey was feasible and accessible for our population and to test that the survey could gather sound data that would suit our planned analyses. PATIENTS AND METHODS Current and former iOAT clients (n = 18) completed a BWS survey supported by an interviewer using a think-aloud approach. The survey was administered on PowerPoint, and responses and contextual field notes were recorded manually. Think-aloud audio was recorded on Audacity. RESULTS Clients' feedback fell into five categories: framing of the task, accessibility, conceptualization of attributes and levels, formatting, and behaviour predicting questions. Survey repetitiveness was the most consistent feedback. The data simulation showed that 100 responses should provide an adequate sample size. CONCLUSION This pilot demonstrates the type of analysis that can be done with BWS in our population, suggests that such analysis is feasible, and highlights the importance of the interviewer and participant working side-by-side throughout the task.
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Affiliation(s)
- Sophia Dobischok
- Centre for Health Evaluation & Outcome Sciences, Providence Health Care, Vancouver, BC, Canada
| | - Rebecca K Metcalfe
- Centre for Health Evaluation & Outcome Sciences, Providence Health Care, Vancouver, BC, Canada
| | | | - Kurt Lock
- Centre for Health Evaluation & Outcome Sciences, Providence Health Care, Vancouver, BC, Canada
- BC Centre for Disease Control, Provincial Health Services Authority, Vancouver, BC, Canada
| | - Scott Harrison
- Providence Health Care, Providence Crosstown Clinic, Vancouver, BC, Canada
| | - Scott MacDonald
- Providence Health Care, Providence Crosstown Clinic, Vancouver, BC, Canada
| | - Sherif Amara
- SafePoint Supervised Consumption Site, Fraser Health Authority, Surrey, BC, Canada
| | - Martin T Schechter
- Centre for Health Evaluation & Outcome Sciences, Providence Health Care, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Nick Bansback
- Centre for Health Evaluation & Outcome Sciences, Providence Health Care, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Eugenia Oviedo-Joekes
- Centre for Health Evaluation & Outcome Sciences, Providence Health Care, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Correspondence: Eugenia Oviedo-Joekes, Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, 575-1081 Burrard St, Vancouver, BC, V6Z 1Y6, Canada, Tel +1 604-682-2344 Ext. 62973, Fax +1-604-806-8210, Email
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The Impact of Gastrointestinal Symptoms on Patients' Well-Being: Best-Worst Scaling (BWS) to Prioritize Symptoms of the Gastrointestinal Symptom Score (GIS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111715. [PMID: 34770228 PMCID: PMC8583028 DOI: 10.3390/ijerph182111715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/05/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022]
Abstract
Background: The gastrointestinal symptom score (GIS) is used in a standardized form to ascertain dyspeptic symptoms in patients with functional dyspepsia in clinical practice. As a criterion for evaluating the effectiveness of a treatment, the change in the summed total point value is used. The total score ranges from 0 to 40 points, in which a higher score represents a more serious manifestation of the disease. Each symptom is included with equal importance in the overall evaluation. The objective of this study was to test this assumption from a patients’ perspective. Our aim was to measure the priorities of patients for the ten gastrointestinal symptoms by using best–worst scaling. Method: A best–worst scaling (BWS) object scaling (Case 1) was applied. Therefore, the symptoms of the GIS were included in a questionnaire using a fractional factorial design (BIBD—balanced incomplete block design). In each choice set, the patients selected the component that had the most and the least impact on their well-being. The BIB design generated a total of 15 choice sets, which each included four attributes. Results: In this study, 1096 affected patients were asked for their priorities regarding a treatment of functional dyspepsia and motility disorder. Based on the data analysis, the symptoms abdominal cramps (SQRT (B/W): −1.27), vomiting (SQRT (B/W): −1.07) and epigastric pain (SQRT (B/W): −0.76) were most important and thus have the greatest influence on the well-being of patients with functional dyspepsia and motility disorders. In the middle range are the symptoms nausea (SQRT (B/W): −0.69), acid reflux/indigestion (SQRT (B/W): −0.29), sickness (SQRT (B/W): −0.26) and retrosternal discomfort (SQRT (B/W): 0.26), whereas the symptoms causing the least impact are the feeling of fullness (SQRT (B/W): 0.80), early satiety (SQRT (B/W): 1.54) and loss of appetite (SQRT(B/W): 1.95). Discussion: Unlike the underlying assumption of the GIS, the BWS indicated that patients did not weight the 10 symptoms equally. The results of the survey show that the three symptoms of vomiting, abdominal cramps and epigastric pain are weighted considerably higher than symptoms such as early satiety, loss of appetite and the feeling of fullness. The evaluation of the BWS data has illustrated, however, that the restrictive assumption of GIS does not reflect the reality of dyspeptic patients. Conclusions: In conclusion, a preference-based GIS is necessary to make valid information about the real burden of illness and to improve the burden of symptoms in the indication of gastrointestinal conditions. The findings of the BWS demonstrate that the common GIS is not applicable to represent the real burden of disease. The results suggest the potential modification of the established GIS by future research using a stated preference study.
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Primary Care Physician Perspectives on Recommending E-cigarettes to Smokers: a Best-Worst Discrete Choice Experiment. J Gen Intern Med 2021; 36:3353-3360. [PMID: 33523343 PMCID: PMC8606483 DOI: 10.1007/s11606-021-06615-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 01/07/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Recent clinical trials suggest that e-cigarettes may be more effective for smoking cessation than traditional cessation aids, yet primary care physician (PCP) practices regarding e-cigarette recommendations for smokers have not been studied in-depth. OBJECTIVE To identify factors influencing PCP recommendation of e-cigarettes for smoking cessation. DESIGN Discrete choice experiment and survey. PARTICIPANTS Florida PCPs. MEASURES The survey included a discrete choice experiment in which PCPs indicated whether they would recommend e-cigarettes for each of 8 hypothetical patient profiles with the following contrasting characteristics: e-cigarette use, interest in approved cessation methods, smoking intensity, prior experience with approved cessation medications, quit intention, age, and comorbidity. Responses were summarized using descriptive statistics and standardized scores (SS). KEY RESULTS The sample (n = 216) was predominately male (76%), white (66%), and non-Hispanic (78%), and most respondents had held their medical degree for 20+ years (77%). The response rate was 28.7%. Most PCPs thought e-cigarettes were at least somewhat effective for smoking cessation (66%) and lowering disease risk (65%); 31% perceived e-cigarettes to be equally/more effective than traditional cessation aids. PCPs were split regarding whether e-cigarettes were less (50%) or equally harmful (38%) as cigarettes. Yet, few were very confident in their ability to counsel patients on e-cigarettes risks (27%) or benefits (15%). PCPs recommended e-cigarettes in 27% of patient profiles they evaluated. The most important factors influencing the decision to recommend or not recommend e-cigarette were patients' prior use of nicotine replacement therapy with (SS = 0.22, 95% CI = 0.17-0.27) and without use of other medications for cessation (SS = 0.18, 95% CI = 0.13-0.23), and being middle age (50 years old) with chronic obstructive pulmonary disease (SS = 0.16, 95% CI = 0.10-0.23). CONCLUSIONS Considering the increased patient use of e-cigarettes and increasing use for cessation, this study highlights the need for guidelines and education to aid PCPs' counseling of patients about e-cigarette use.
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Holyer J, Taylor WJ, Gaffo A, Hosie G, Horne A, Mihov B, Su I, Gamble GD, Dalbeth N, Stewart S. Which Attributes Are Most and Least Important to Patients When Considering Gout Flare Burden Over Time? A Best-worst Scaling Choice Study. J Rheumatol 2021; 49:213-218. [PMID: 34725178 DOI: 10.3899/jrheum.210605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Several factors contribute to the patient experience of gout flares, including pain intensity, duration, frequency, and disability. It is unknown which of these factors are most important to patients when considering flare burden over time, including those related to the cumulative experience of all flares, or the experience of a single worst flare. This study aimed to determine which flare attributes are the most and least important to the patient experience of flare burden over time. METHODS Participants with gout completed an anonymous online survey. Questions were aimed at identifying which attributes of gout flares, representing both individual and cumulative flare burden, were the most and least important over a hypothetical 6-month period. A best-worst scaling method was used to determine the importance hierarchy of the included attributes. RESULTS Fifty participants were included. Difficulty doing usual activities during the worst flare and pain of the worst flare were ranked as the most important, whereas average pain of all flares was considered the least important. Overall, attributes related to the single worst gout flare were considered more important than attributes related to the cumulative impact of all flares. CONCLUSION When thinking about the burden of gout flares over time, patients rank activity limitation and pain experienced during their worst gout flare as the most important contributing factors, whereas factors related to the cumulative impact of all flares over time are relatively less important.
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Affiliation(s)
- Jeremy Holyer
- JH was supported by a University of Auckland summer student scholarship. J. Holyer, medical student, G. Hosie, NZ Dip. in Policing, A. Horne, MBChB, B. Mihov, BPHty, I. Su, BSc, G.D. Gamble, MSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Deparment of Medicine, University of Auckland, Auckland, New Zealand; W.J. Taylor, MBChB, PhD, FRACP, FAFRM, Department of Medicine, University of Otago, Wellington, New Zealand; A. Gaffo, MD, MsPH, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. ND reports grants and personal fees from AstraZeneca, personal fees from Horizon, AbbVie, AstraZeneca, Jansen, Hengrui, Dyve Biosciences, Selecta, and Arthrosi; and grants from Amgen and AstraZeneca outside the submitted work. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. S. Stewart, Department of Medicine, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. . Accepted for publication October 13, 2021
| | - William J Taylor
- JH was supported by a University of Auckland summer student scholarship. J. Holyer, medical student, G. Hosie, NZ Dip. in Policing, A. Horne, MBChB, B. Mihov, BPHty, I. Su, BSc, G.D. Gamble, MSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Deparment of Medicine, University of Auckland, Auckland, New Zealand; W.J. Taylor, MBChB, PhD, FRACP, FAFRM, Department of Medicine, University of Otago, Wellington, New Zealand; A. Gaffo, MD, MsPH, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. ND reports grants and personal fees from AstraZeneca, personal fees from Horizon, AbbVie, AstraZeneca, Jansen, Hengrui, Dyve Biosciences, Selecta, and Arthrosi; and grants from Amgen and AstraZeneca outside the submitted work. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. S. Stewart, Department of Medicine, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. . Accepted for publication October 13, 2021
| | - Angelo Gaffo
- JH was supported by a University of Auckland summer student scholarship. J. Holyer, medical student, G. Hosie, NZ Dip. in Policing, A. Horne, MBChB, B. Mihov, BPHty, I. Su, BSc, G.D. Gamble, MSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Deparment of Medicine, University of Auckland, Auckland, New Zealand; W.J. Taylor, MBChB, PhD, FRACP, FAFRM, Department of Medicine, University of Otago, Wellington, New Zealand; A. Gaffo, MD, MsPH, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. ND reports grants and personal fees from AstraZeneca, personal fees from Horizon, AbbVie, AstraZeneca, Jansen, Hengrui, Dyve Biosciences, Selecta, and Arthrosi; and grants from Amgen and AstraZeneca outside the submitted work. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. S. Stewart, Department of Medicine, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. . Accepted for publication October 13, 2021
| | - Graham Hosie
- JH was supported by a University of Auckland summer student scholarship. J. Holyer, medical student, G. Hosie, NZ Dip. in Policing, A. Horne, MBChB, B. Mihov, BPHty, I. Su, BSc, G.D. Gamble, MSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Deparment of Medicine, University of Auckland, Auckland, New Zealand; W.J. Taylor, MBChB, PhD, FRACP, FAFRM, Department of Medicine, University of Otago, Wellington, New Zealand; A. Gaffo, MD, MsPH, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. ND reports grants and personal fees from AstraZeneca, personal fees from Horizon, AbbVie, AstraZeneca, Jansen, Hengrui, Dyve Biosciences, Selecta, and Arthrosi; and grants from Amgen and AstraZeneca outside the submitted work. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. S. Stewart, Department of Medicine, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. . Accepted for publication October 13, 2021
| | - Anne Horne
- JH was supported by a University of Auckland summer student scholarship. J. Holyer, medical student, G. Hosie, NZ Dip. in Policing, A. Horne, MBChB, B. Mihov, BPHty, I. Su, BSc, G.D. Gamble, MSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Deparment of Medicine, University of Auckland, Auckland, New Zealand; W.J. Taylor, MBChB, PhD, FRACP, FAFRM, Department of Medicine, University of Otago, Wellington, New Zealand; A. Gaffo, MD, MsPH, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. ND reports grants and personal fees from AstraZeneca, personal fees from Horizon, AbbVie, AstraZeneca, Jansen, Hengrui, Dyve Biosciences, Selecta, and Arthrosi; and grants from Amgen and AstraZeneca outside the submitted work. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. S. Stewart, Department of Medicine, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. . Accepted for publication October 13, 2021
| | - Borislav Mihov
- JH was supported by a University of Auckland summer student scholarship. J. Holyer, medical student, G. Hosie, NZ Dip. in Policing, A. Horne, MBChB, B. Mihov, BPHty, I. Su, BSc, G.D. Gamble, MSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Deparment of Medicine, University of Auckland, Auckland, New Zealand; W.J. Taylor, MBChB, PhD, FRACP, FAFRM, Department of Medicine, University of Otago, Wellington, New Zealand; A. Gaffo, MD, MsPH, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. ND reports grants and personal fees from AstraZeneca, personal fees from Horizon, AbbVie, AstraZeneca, Jansen, Hengrui, Dyve Biosciences, Selecta, and Arthrosi; and grants from Amgen and AstraZeneca outside the submitted work. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. S. Stewart, Department of Medicine, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. . Accepted for publication October 13, 2021
| | - Isabel Su
- JH was supported by a University of Auckland summer student scholarship. J. Holyer, medical student, G. Hosie, NZ Dip. in Policing, A. Horne, MBChB, B. Mihov, BPHty, I. Su, BSc, G.D. Gamble, MSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Deparment of Medicine, University of Auckland, Auckland, New Zealand; W.J. Taylor, MBChB, PhD, FRACP, FAFRM, Department of Medicine, University of Otago, Wellington, New Zealand; A. Gaffo, MD, MsPH, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. ND reports grants and personal fees from AstraZeneca, personal fees from Horizon, AbbVie, AstraZeneca, Jansen, Hengrui, Dyve Biosciences, Selecta, and Arthrosi; and grants from Amgen and AstraZeneca outside the submitted work. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. S. Stewart, Department of Medicine, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. . Accepted for publication October 13, 2021
| | - Gregory D Gamble
- JH was supported by a University of Auckland summer student scholarship. J. Holyer, medical student, G. Hosie, NZ Dip. in Policing, A. Horne, MBChB, B. Mihov, BPHty, I. Su, BSc, G.D. Gamble, MSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Deparment of Medicine, University of Auckland, Auckland, New Zealand; W.J. Taylor, MBChB, PhD, FRACP, FAFRM, Department of Medicine, University of Otago, Wellington, New Zealand; A. Gaffo, MD, MsPH, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. ND reports grants and personal fees from AstraZeneca, personal fees from Horizon, AbbVie, AstraZeneca, Jansen, Hengrui, Dyve Biosciences, Selecta, and Arthrosi; and grants from Amgen and AstraZeneca outside the submitted work. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. S. Stewart, Department of Medicine, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. . Accepted for publication October 13, 2021
| | - Nicola Dalbeth
- JH was supported by a University of Auckland summer student scholarship. J. Holyer, medical student, G. Hosie, NZ Dip. in Policing, A. Horne, MBChB, B. Mihov, BPHty, I. Su, BSc, G.D. Gamble, MSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Deparment of Medicine, University of Auckland, Auckland, New Zealand; W.J. Taylor, MBChB, PhD, FRACP, FAFRM, Department of Medicine, University of Otago, Wellington, New Zealand; A. Gaffo, MD, MsPH, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. ND reports grants and personal fees from AstraZeneca, personal fees from Horizon, AbbVie, AstraZeneca, Jansen, Hengrui, Dyve Biosciences, Selecta, and Arthrosi; and grants from Amgen and AstraZeneca outside the submitted work. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. S. Stewart, Department of Medicine, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. . Accepted for publication October 13, 2021
| | - Sarah Stewart
- JH was supported by a University of Auckland summer student scholarship. J. Holyer, medical student, G. Hosie, NZ Dip. in Policing, A. Horne, MBChB, B. Mihov, BPHty, I. Su, BSc, G.D. Gamble, MSc, N. Dalbeth, MBChB, MD, FRACP, S. Stewart, PhD, Deparment of Medicine, University of Auckland, Auckland, New Zealand; W.J. Taylor, MBChB, PhD, FRACP, FAFRM, Department of Medicine, University of Otago, Wellington, New Zealand; A. Gaffo, MD, MsPH, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. ND reports grants and personal fees from AstraZeneca, personal fees from Horizon, AbbVie, AstraZeneca, Jansen, Hengrui, Dyve Biosciences, Selecta, and Arthrosi; and grants from Amgen and AstraZeneca outside the submitted work. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. S. Stewart, Department of Medicine, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. . Accepted for publication October 13, 2021
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Wu A, Radhakrishnan V, Targan E, Scarella TM, Torous J, Hill KP. Self-Reported Preferences for Help-Seeking and Barriers to Using Mental Health Supports Among Internal Medicine Residents: Exploratory Use of an Econometric Best-Worst Scaling Framework for Gathering Physician Wellness Preferences. JMIR MEDICAL EDUCATION 2021; 7:e28623. [PMID: 34612838 PMCID: PMC8529465 DOI: 10.2196/28623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 07/23/2021] [Accepted: 08/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Burnout interventions are limited by low use. Understanding resident physician preferences for burnout interventions may increase utilization and improve the assessment of these interventions. OBJECTIVE This study aims to use an econometric best-worst scaling (BWS) framework to survey internal medicine resident physicians to establish help-seeking preferences for burnout and barriers to using wellness supports by quantifying selections for 7 wellness support options and 7 barriers. METHODS Internal medicine resident physicians at our institution completed an anonymous web-based BWS survey during the 2020-2021 academic year. This cross-sectional study was analyzed with multinomial logistic regression and latent class modeling to determine the relative rank ordering of factors for seeking support for burnout and barriers to using wellness supports. Analysis of variance with Tukey honest significant difference posthoc test was used to analyze differences in mean utility scores representing choice for barriers and support options. RESULTS Of the 163 invited residents, 77 (47.2% response rate) completed the survey. Top-ranking factors for seeking wellness supports included seeking informal peer support (best: 71%; worst: 0.6%) and support from friends and family (best: 70%; worst: 1.6%). Top-ranking barriers to seeking counseling included time (best: 75%; worst: 5%) and money (best: 35%; worst: 21%). CONCLUSIONS Overall, our findings suggest that low utilization of formal mental health support is reflective of resident preferences to seek help informally and that increasing utilization will require addressing pragmatic barriers of time and cost. Assessing physician preferences for wellness-related initiatives may contribute to understanding the low utilization of formal mental health services among physicians, which can be determined using a BWS framework.
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Affiliation(s)
- Andrew Wu
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Varsha Radhakrishnan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Elizabeth Targan
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Timothy M Scarella
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - John Torous
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Kevin P Hill
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
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Guerrini CJ, Crossnohere NL, Rasmussen L, Bridges JFP. A best-worst scaling experiment to prioritize concern about ethical issues in citizen science reveals heterogeneity on people-level v. data-level issues. Sci Rep 2021; 11:19119. [PMID: 34580327 PMCID: PMC8476613 DOI: 10.1038/s41598-021-96743-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 08/11/2021] [Indexed: 11/16/2022] Open
Abstract
"Citizen science" refers to the participation of lay individuals in scientific studies and other activities having scientific objectives. Citizen science gives rise to unique ethical issues that stem from the potentially multifaceted contributions of citizen scientists to the research process. We sought to explore the ethical issues that are most concerning to citizen scientist practitioners, participants, and scholars to support ethical practices in citizen science. We developed a best-worst scaling experiment using a balanced incomplete block design and fielded it with respondents recruited through the U.S.-based Citizen Science Association. Respondents were shown repeated subsets of 11 ethical issues and identified the most and least concerning issues in each subset. Latent class analysis revealed two respondent classes. The "Power to the People" class was most concerned about power imbalance between project leaders and participants, exploitation of participants, and lack of diverse participation. The "Show Me the Data" class was most concerned about the quality of data generated by citizen science projects and failure of projects to share data and other research outputs.
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Affiliation(s)
- Christi J Guerrini
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
| | - Norah L Crossnohere
- Department of Biomedical Informatics, The Ohio State University College of Medicine, 220N Lincoln Tower, 1800 Cannon Drive, Columbus, OH, 43210, USA
| | - Lisa Rasmussen
- Department of Philosophy, The University of North Carolina Charlotte, 9201 University City Blvd., Charlotte, NC, 28223, USA
| | - John F P Bridges
- Department of Biomedical Informatics, The Ohio State University College of Medicine, 220N Lincoln Tower, 1800 Cannon Drive, Columbus, OH, 43210, USA
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Choi M, Raeside R, Hyun K, Partridge SR, Thiagalingam A, Redfern J. Understanding Preferences for Lifestyle-Focused Visual Text Messages in Patients With Cardiovascular and Chronic Respiratory Disease: Discrete Choice Experiment. J Med Internet Res 2021; 23:e26224. [PMID: 34542413 PMCID: PMC8491117 DOI: 10.2196/26224] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/15/2021] [Accepted: 07/21/2021] [Indexed: 12/04/2022] Open
Abstract
Background Supporting healthy lifestyle changes is a key aim of cardiovascular and pulmonary rehabilitation programs. SMS text messaging programs have demonstrated effectiveness in cardiovascular disease risk reduction, weight loss, increasing physical activity, and smoking cessation. The optimization of SMS text messaging programs may deliver greater population benefits as mobile phone use becomes ubiquitous. Visual messaging (ie, image-based messages) has the potential to communicate health messages via digital technology and result in enhanced engagement. Objective This study aims to determine and understand patient preferences for lifestyle-focused visual text messages that support cardiovascular and pulmonary rehabilitation. Methods A discrete choice experiment was conducted in a 4-stage iterative process to elicit patient preferences for visual message features. Attribute and level development yielded 3 attributes (purpose, image type, and web address), and 16 choice sets were subsequently constructed according to a full factorial design. Patients participating in cardiovascular and pulmonary rehabilitation were surveyed (on the web) for their preferences regarding the visual message choice sets. Respondents were asked to choose among 16 pairs of visual messages regarding key lifestyle behaviors, namely, physical activity and nutrition. The data were analyzed using a conditional logit model. Results There was a total of 1728 observations from 54 unique respondents. Two factors that were associated with patient preference were gain-framed purpose compared with no purpose (odds ratio [OR] 1.93, 95% CI 1.40-2.65) and real images compared with cartoon images (OR 1.26, 95% CI 1.04-1.54). A loss-framed purpose was less preferred than no purpose (OR 0.55, 95% CI 0.42-0.74). Overall, patients preferred positive images that were colorful and engaged with text that supported the image and had a preference for images of real people rather than cartoons. Conclusions A discrete choice experiment is a scientific method for eliciting patient preferences for a visual messaging intervention that is designed to support changes in lifestyle behaviors. SMS text messaging programs that use visual aids may result in greater patient satisfaction by using a gain frame, using real images, and avoiding a loss frame. Further research is needed to explore the feasibility of implementation and the health and behavioral outcomes associated with such visual messaging programs.
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Affiliation(s)
- Michael Choi
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Rebecca Raeside
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Karice Hyun
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Department of Cardiology, Concord Repatriation General Hospital, Sydney, Australia
| | - Stephanie R Partridge
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Aravinda Thiagalingam
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Department of Cardiology, Westmead Hospital, Sydney, Australia.,George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Julie Redfern
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Consumer Engagement and Codesign Research Hub, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,George Institute for Global Health, University of New South Wales, Sydney, Australia.,Research Education Network, Western Sydney Local Health District, Sydney, Australia
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49
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Mühlbacher AC, Sadler A, Lamprecht B, Juhnke C. Patient preferences in the treatment of hemophilia A: A latent class analysis. PLoS One 2021; 16:e0256521. [PMID: 34424920 PMCID: PMC8382185 DOI: 10.1371/journal.pone.0256521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 08/09/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To examine subgroup-specific treatment preferences and characteristics of patients with hemophilia A. METHODS Best-Worst Scaling (BWS) Case 3 (four attributes: application type; bleeding frequencies/year; inhibitor development risk; thromboembolic events of hemophilia A treatment risk) conducted via online survey. Respondents chose the best and the worst option of three treatment alternatives. Data were analyzed via latent class model (LCM), allowing capture of heterogeneity in the sample. Respondents were grouped into a predefined number of classes with distinct preferences. RESULTS The final dataset contained 57 respondents. LCM analysis segmented the sample into two classes with heterogeneous preferences. Preferences within each were homogeneous. For class 1, the most decisive factor was bleeding frequency/year. Respondents seemed to focus mainly on this in their choice decisions. With some distance, inhibitor development was the second most important. The remaining attributes were of far less importance for respondents in this class. Respondents in class 2 based their choice decisions primarily on inhibitor development, also followed, by some distance, the second most important attribute bleeding frequency/year. There was statistical significance (P < 0.05) between the number of annual bleedings and the probability of class membership. CONCLUSIONS The LCM analysis addresses heterogeneity in respondents' choice decisions, which helps to tailor treatment alternatives to individual needs. Study results support clinical and allocative decision-making and improve the quality of interpretation of clinical data.
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Affiliation(s)
- Axel C. Mühlbacher
- Health Economics and Health Care Management, Hochschule Neubrandenburg, Neubrandenburg, Germany
- Gesellschaft für empirische Beratung GmbH, Freiburg, Germany
- Duke Department of Population Health Sciences and Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America
| | - Andrew Sadler
- Health Economics and Health Care Management, Hochschule Neubrandenburg, Neubrandenburg, Germany
| | | | - Christin Juhnke
- Health Economics and Health Care Management, Hochschule Neubrandenburg, Neubrandenburg, Germany
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50
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Nguyen L, Jokimäki H, Linnosmaa I, Saloniki EC, Batchelder L, Malley J, Lu H, Burge P, Trukeschitz B, Forder J. Do You Prefer Safety to Social Participation? Finnish Population-Based Preference Weights for the Adult Social Care Outcomes Toolkit (ASCOT) for Service Users. MDM Policy Pract 2021; 6:23814683211027902. [PMID: 34291174 PMCID: PMC8274113 DOI: 10.1177/23814683211027902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 06/01/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction. The Adult Social Care Outcomes Toolkit (ASCOT) was developed in England to measure people’s social care–related quality of life (SCRQoL). Objectives. The aim of this article is to estimate preference weights for the Finnish ASCOT for service users (ASCOT). In addition, we tested for learning and fatigue effects in the choice experiment used to elicit the preference weights. Methods. The analysis data (n = 1000 individuals) were obtained from an online survey sample of the Finnish adult general population using gender, age, and region as quotas. The questionnaire included a best-worst scaling (BWS) experiment using ASCOT. Each respondent sequentially selected four alternatives (best, worst; second-best, second-worst) for eight BWS tasks (n = 32,000 choice observations). A scale multinomial logit model was used to estimate the preference parameters and to test for fatigue and learning. Results. The most and least preferred attribute-levels were “I have as much control over my daily life as I want” and “I have no control over my daily life.” The preference weights were not on a cardinal scale. The ordering effect was related to the second-best choices. Learning effect was in the last four tasks. Conclusions. This study has developed a set of preference weights for the ASCOT instrument in Finland, which can be used for investigating outcomes of social care interventions on adult populations. The learning effect calls for the development of study designs that reduce possible bias relating to preference uncertainty at the beginning of sequential BWS tasks. It also supports the adaptation of a modelling strategy in which the sequence of tasks is explicitly modelled as a scale factor.
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Affiliation(s)
- Lien Nguyen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Hanna Jokimäki
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ismo Linnosmaa
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | | | - Laurie Batchelder
- Personal Social Services Research Unit, University of Kent, Kent, UK
| | - Juliette Malley
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Hui Lu
- RAND Europe, Cambridge, UK
| | | | - Birgit Trukeschitz
- Research Institute for Economics of Aging, WU Vienna University of Economics and Business, Vienna, Austria
| | - Julien Forder
- Personal Social Services Research Unit, University of Kent, Kent, UK
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