Patient and oncologist preferences for attributes of treatments in advanced melanoma

A discrete choice experiment

Frank Xiaoqing Liu, Edward A. Witt, Scot Ebbinghaus, Grace Dibonaventura Beyer, Reshma Shinde, Enrique Basurto, Richard W Joseph

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: To examine and compare patient and oncologist preferences for advanced melanoma treatment attributes and to document their trade-offs for benefits with risks. Materials and methods: A discrete choice experiment (DCE) was conducted among advanced melanoma patients and oncologists. Qualitative pilot testing was used to inform the DCE design. A series of scenarios asked stakeholders to choose between two hypothetical medications, each with seven attributes: mode of administration (MoA), dosing schedule (DS), median duration of therapy (MDT), objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and grade 3–4 adverse events (AEs). Hierarchical Bayesian logistic regression models were used to determine patients’ and oncologists’ choice-based preferences, analysis of variance models were used to estimate the relative importance of attributes, and independent t-tests were used to compare relative importance estimates between stakeholders. Results: In total, 200 patients and 226 oncologists completed the study. OS was most important to patients (33%), followed by AEs (29%) and ORR (25%). For oncologists, AEs were most important (49%), followed by OS (34%) and ORR (12%). An improvement from 55% to 75% in 1-year OS was valued similar in magnitude to a 23% decrease (from 55% to 32%) in likelihood of AEs for oncologists. Conclusion: Patients valued OS, AEs, and ORR sequentially as the most important attributes in making a treatment decision, whereas oncologists valued AEs most, followed by OS and ORR. In comparison, patients differed significantly from oncologists on the importance of ORR, AEs, and PFS, but were consistent in OS and the rest of attributes.

Original languageEnglish (US)
Pages (from-to)1389-1399
Number of pages11
JournalPatient Preference and Adherence
Volume11
DOIs
StatePublished - Aug 14 2017

Fingerprint

Patient Preference
Melanoma
event
experiment
Survival
Disease-Free Survival
Therapeutics
stakeholder
Logistic Models
Oncologists
analysis of variance
medication
school grade
logistics
Analysis of Variance
Appointments and Schedules
scenario
regression

Keywords

  • Discrete choice experiment
  • Metastatic melanoma
  • Systemic therapy
  • Unresectable

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Social Sciences (miscellaneous)
  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
  • Health Policy

Cite this

Patient and oncologist preferences for attributes of treatments in advanced melanoma : A discrete choice experiment. / Liu, Frank Xiaoqing; Witt, Edward A.; Ebbinghaus, Scot; Beyer, Grace Dibonaventura; Shinde, Reshma; Basurto, Enrique; Joseph, Richard W.

In: Patient Preference and Adherence, Vol. 11, 14.08.2017, p. 1389-1399.

Research output: Contribution to journalArticle

Liu, Frank Xiaoqing ; Witt, Edward A. ; Ebbinghaus, Scot ; Beyer, Grace Dibonaventura ; Shinde, Reshma ; Basurto, Enrique ; Joseph, Richard W. / Patient and oncologist preferences for attributes of treatments in advanced melanoma : A discrete choice experiment. In: Patient Preference and Adherence. 2017 ; Vol. 11. pp. 1389-1399.
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abstract = "Purpose: To examine and compare patient and oncologist preferences for advanced melanoma treatment attributes and to document their trade-offs for benefits with risks. Materials and methods: A discrete choice experiment (DCE) was conducted among advanced melanoma patients and oncologists. Qualitative pilot testing was used to inform the DCE design. A series of scenarios asked stakeholders to choose between two hypothetical medications, each with seven attributes: mode of administration (MoA), dosing schedule (DS), median duration of therapy (MDT), objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and grade 3–4 adverse events (AEs). Hierarchical Bayesian logistic regression models were used to determine patients’ and oncologists’ choice-based preferences, analysis of variance models were used to estimate the relative importance of attributes, and independent t-tests were used to compare relative importance estimates between stakeholders. Results: In total, 200 patients and 226 oncologists completed the study. OS was most important to patients (33{\%}), followed by AEs (29{\%}) and ORR (25{\%}). For oncologists, AEs were most important (49{\%}), followed by OS (34{\%}) and ORR (12{\%}). An improvement from 55{\%} to 75{\%} in 1-year OS was valued similar in magnitude to a 23{\%} decrease (from 55{\%} to 32{\%}) in likelihood of AEs for oncologists. Conclusion: Patients valued OS, AEs, and ORR sequentially as the most important attributes in making a treatment decision, whereas oncologists valued AEs most, followed by OS and ORR. In comparison, patients differed significantly from oncologists on the importance of ORR, AEs, and PFS, but were consistent in OS and the rest of attributes.",
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AB - Purpose: To examine and compare patient and oncologist preferences for advanced melanoma treatment attributes and to document their trade-offs for benefits with risks. Materials and methods: A discrete choice experiment (DCE) was conducted among advanced melanoma patients and oncologists. Qualitative pilot testing was used to inform the DCE design. A series of scenarios asked stakeholders to choose between two hypothetical medications, each with seven attributes: mode of administration (MoA), dosing schedule (DS), median duration of therapy (MDT), objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and grade 3–4 adverse events (AEs). Hierarchical Bayesian logistic regression models were used to determine patients’ and oncologists’ choice-based preferences, analysis of variance models were used to estimate the relative importance of attributes, and independent t-tests were used to compare relative importance estimates between stakeholders. Results: In total, 200 patients and 226 oncologists completed the study. OS was most important to patients (33%), followed by AEs (29%) and ORR (25%). For oncologists, AEs were most important (49%), followed by OS (34%) and ORR (12%). An improvement from 55% to 75% in 1-year OS was valued similar in magnitude to a 23% decrease (from 55% to 32%) in likelihood of AEs for oncologists. Conclusion: Patients valued OS, AEs, and ORR sequentially as the most important attributes in making a treatment decision, whereas oncologists valued AEs most, followed by OS and ORR. In comparison, patients differed significantly from oncologists on the importance of ORR, AEs, and PFS, but were consistent in OS and the rest of attributes.

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