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Thomas M, Marshall DA, Sanchez AL, Bartlett SJ, Boonen A, Fraenkel L, Proulx L, Voshaar M, Bansback N, Buchbinder R, Guillemin F, Hiligsmann M, Richards DP, Richards P, Shea B, Tugwell P, Falahee M, Hazlewood GS. Exploring perceptions of using preference elicitation methods to inform clinical trial design in rheumatology: A qualitative study and OMERACT collaboration. Semin Arthritis Rheum 2023; 58:152112. [PMID: 36372015 DOI: 10.1016/j.semarthrit.2022.152112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/07/2022] [Accepted: 09/14/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Clinical trial design requires value judgements and understanding patient preferences may help inform these judgements, for example when prioritizing treatment candidates, designing complex interventions, selecting appropriate outcomes, determining clinically important thresholds, or weighting composite outcomes. Preference elicitation methods are quantitative approaches that can estimate patients' preferences to quantify the absolute or relative importance of outcomes or other attributes relevant to the decision context. We aimed to explore stakeholder perceptions of using preference elicitation methods to inform judgements when designing clinical trials in rheumatology. METHODS We conducted 1-on-1 semi-structured interviews with patients with rheumatic diseases and rheumatology clinicians/researchers, recruited using purposive and snowball sampling. Participants were provided pre-interview materials, including a video and a document, to introduce the topic of preference elicitation methods and case examples of potential applications to clinical trials. Interviews were conducted via Zoom and were audio-recorded and transcribed. We used thematic analysis to analyze our data. RESULTS We interviewed 17 patients and 9 clinicians/researchers, until data and inductive thematic saturation were achieved within each group. Themes were grouped into overall perceptions, barriers, and facilitators. Patients and clinicians/researchers generally agreed that preference elicitation studies can improve clinical trial design, but that many considerations are required around preference heterogeneity and feasibility. A key barrier identified was the additional resources and expertise required to measure and incorporate preferences effectively in trial design. Key facilitators included developing guidance on how to use preference elicitation to inform trial design, as well as the role of external decision-makers in developing such guidance, and the need to leverage the movement towards patient engagement in research to encourage including patient preferences when designing trials. CONCLUSION Our findings allowed us to consider the potential applications of patient preferences in trial design according to stakeholders within rheumatology who are involved in the trial process. Future research should be conducted to develop comprehensive guidance on how to meaningfully include patient preferences when designing clinical trials in rheumatology. Doing so may have important downstream effects for shared decision-making, especially given the chronic nature of rheumatic diseases.
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Affiliation(s)
- Megan Thomas
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Deborah A Marshall
- Department of Community Health Sciences, University of Calgary, Calgary, Canada; Department of Medicine, University of Calgary, Calgary, Canada
| | - Adalberto Loyola Sanchez
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Susan J Bartlett
- Department of Medicine, McGill University, Montreal, Canada; Centre for Outcomes Research & Evaluation, Research Institute McGill University Health Centre, Montreal, Canada
| | - Annelies Boonen
- Department of Internal Medicine, Maastricht University Medical Center, Care and Public Health Research Institute, Maastricht, The Netherlands
| | - Liana Fraenkel
- Yale University School of Medicine, Section of Rheumatology, Connecticut, USA
| | - Laurie Proulx
- Patient research partner, Canadian Arthritis Patient Alliance, Ottawa, Canada
| | - Marieke Voshaar
- Patient research partner, Radboud University, Department of Pharmacy, Nijmegen, the Netherlands
| | - Nick Bansback
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University and Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Australia
| | | | - Mickaël Hiligsmann
- Department of Health Services Research CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Dawn P Richards
- Patient research partner, Canadian Arthritis Patient Alliance, Ottawa, Canada; Patient research partner, Canadian Arthritis Patient Alliance and Five02 Labs Inc., Toronto, Canada
| | - Pamela Richards
- Patient research partner, University Hospitals, Bristol NHS Trust, Bristol, UK
| | - Beverley Shea
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Marie Falahee
- Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Glen S Hazlewood
- Department of Community Health Sciences, University of Calgary, Calgary, Canada; Department of Medicine, University of Calgary, Calgary, Canada.
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