Patient centered decision making: Use of conjoint analysis to determine risk–benefit trade-offs for preference sensitive treatment choices

Wilson, Leslie; Loucks, Aimee; Bui, C.T.; Gipson, Greg R; Zhong, Lixian; Schwartzburg, A.; Crabtree, Elizabeth; Goodin, Douglas S.; Waubant, Emmanuelle; McCulloch, Charles E.

doi:10.1016/j.jns.2014.06.030

Cited by 68 publications

(84 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As expected, patients preferred an improvement in outcomes for each attribute, which is consistent with the results of previous DCE studies [Johnson et al 2009;Shingler et al 2013;Poulos et al 2015;Utz et al 2014;Wicks et al 2015;Wilson et al 2014Wilson et al , 2015.…”

Section: Discussionsupporting

confidence: 91%

“…DCEs have been used previously to study preferences for MS treatments [Johnson et al 2009;Shingler et al 2013;Utz et al 2014;Wicks et al 2015;Wilson et al 2014Wilson et al , 2015. Shingler and colleagues assessed patient preference for features of injection devices and treatment efficacy, showing that while efficacy is of primary importance, device attributes can play an important role in patient preference.…”

Section: Introductionmentioning

confidence: 99%

“…However, Utz and colleagues did not assess preferences for efficacy attributes. The studies described by Wicks and colleagues and Wilson and coworkers examined preferences for a broad range of treatment attributes, including efficacy, serious and mild side effects, and mode and frequency of administration [Wicks et al 2015;Wilson et al 2014Wilson et al , 2015. Wicks and colleagues examined preferences for oral DMTs only, while Wilson and coworkers focused on oral and parenteral DMTs.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A discrete-choice experiment to determine patient preferences for injectable multiple sclerosis treatments in Germany

Poulos

Kinter

Yang

et al. 2016

Ther Adv Neurol Disord

View full text Add to dashboard Cite

Objectives: The aim of this study was to assess the relative importance of features of a hypothetical injectable disease-modifying treatment for patients with multiple sclerosis using a discrete-choice experiment. Methods: German residents at least 18 years of age with a self-reported physician diagnosis of multiple sclerosis completed a 25-30 minute online discrete-choice experiment. Patients were asked to choose one of two hypothetical injectable treatments for multiple sclerosis, defined by different levels of six attributes (disability progression, the number of relapses in the next 4 years, injection time, frequency of injections, presence of flu-like symptoms, and presence of injection-site reactions). The data were analyzed using a random-parameters logit model. Results: Of 202 adults who completed the survey, results from 189 were used in the analysis. Approximately 50% of all patients reported a diagnosis of relapsing-remitting multiple sclerosis, and 31% reported secondary progressive multiple sclerosis. Approximately 71% of patients had current or prior experience with injectable multiple sclerosis medication. Approximately 53% had experienced flu-like symptoms caused by their medication, and 47% had experienced mild injection-site reactions. At least one significant difference was seen between levels in all attributes, except injection time. The greatest change in relative importance between levels of an attribute was years until symptoms get worse from 1 to 4 years. The magnitude of this difference was about twice that of relapses in the next 4 years, frequency of injections, and flu-like symptoms. Conclusions: Most attributes examined in this experiment had an influence on patient preference. Patients placed a significant value on improvements in the frequency of dosing and disability progression. Results suggest that changes in injection frequency can be as important as changes in efficacy and safety attributes. Understanding which attributes of injectable therapies influence patient preference could potentially improve outcomes and adherence in patients with multiple sclerosis.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A discrete-choice experiment to determine patient preferences for injectable multiple sclerosis treatments in Germany

Poulos

Kinter

Yang

et al. 2016

Ther Adv Neurol Disord

View full text Add to dashboard Cite

show abstract

“…Only two previous studies compared oral, injection, and intravenous (IV) therapies, and in these studies, IV therapy was described as being administered every month. 9,10 The existing studies do not include DMT options under development that offer different efficacy/safety profiles and administration and dosing options.…”

Section: 2mentioning

confidence: 99%

Preferences for Multiple Sclerosis Treatments

Mansfield¹,

Thomas²,

Gebben³

et al. 2017

International Journal of MS Care

View full text Add to dashboard Cite

show abstract

“…This methodology has recently been applied to clinical research as a method to understand patients' treatment preferences and what risks patients are willing to take for which treatment gains. [9][10][11][12][13][14][15] The conjoint analysis model provides patients with iterative case-based choices to elucidate the relative importance and ranking that individuals place on the various aspects, or attributes, of treatment alternatives. These rankings potentially offer valuable insight in choosing therapies that best meet patients' objectives and can potentially help both patients and physicians determine what patients are willing to sacrifice to reach those outcomes.…”

mentioning

confidence: 99%

Patient-centered Treatment Decisions for Urethral Stricture: Conjoint Analysis Improves Surgical Decision-making

Hampson¹,

Allen

Gaither³

et al. 2017

Urology

Self Cite

View full text Add to dashboard Cite

OBJECTIVE To determine whether the use of a choice-based conjoint analysis (CA) exercise decreased patients’ decisional conflict about treatment preferences for surgical management of urethral stricture disease. Understanding patient preferences for treatment decisions assists in shared decision-making and emphasizes patient-centered outcomes. CA offers a method to understand what risks patients are willing to take for what gains. METHODS The CA methodology was used by providing participants with case-based choices to elucidate the relative importance that individuals place on various treatment aspects. Patients’ decisional conflict regarding surgery for urethral stricture was assessed before and after the CA exercise to assess the impact the exercise had on their decisional conflict. RESULTS Completion of the CA exercise resulted in a significant decrease in decisional conflict (P < .001). The majority (59.5%) of participants with decisional conflict before the CA exercise experienced a decrease in decisional conflict afterwards, with only a minority (16.5%) experiencing new decisional conflict after the exercise. Participants felt the choice-based CA exercise was helpful in deciding what was important in making treatment decisions (70%) and in expressing their priorities and treatment preferences (82%). The number needed to counsel to achieve a decrease in decisional conflict was 1.69 and to achieve no decisional conflict was 3.65. CONCLUSION Choice-based CA improves patients’ ability to express their treatment preferences and decreases decisional conflict. CA may be a new tool that physicians and patients can use to aid in shared decision-making with a focus on patient-centered outcomes.

show abstract

Patient centered decision making: Use of conjoint analysis to determine risk–benefit trade-offs for preference sensitive treatment choices

Cited by 68 publications

References 29 publications

A discrete-choice experiment to determine patient preferences for injectable multiple sclerosis treatments in Germany

A discrete-choice experiment to determine patient preferences for injectable multiple sclerosis treatments in Germany

Preferences for Multiple Sclerosis Treatments

Patient-centered Treatment Decisions for Urethral Stricture: Conjoint Analysis Improves Surgical Decision-making

Contact Info

Product

Resources

About