Are adult patients more tolerant of treatment risks than parents of juvenile patients?
Are adult patients more tolerant of treatment risks than parents of juvenile patients?
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DOI：
10.1111/j.1539-6924.2008.01135.x
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发表时间：
2009-01
期刊：
影响因子：
--
通讯作者：
Sands BE
中科院分区：
文献类型：
--
作者：
Johnson FR;Ozdemir S;Mansfield C;Hass S;Siegel CA;Sands BE
了解患者对新治疗的风险耐受性差异，可以帮助制定新治疗的监管和临床决策，这些新治疗既可能更有效地缓解疾病症状，也可能存在致残或致命副作用的风险。本研究的目的是通过一项国家选择（SC）调查，得出具有不同疗效和风险水平的假设治疗的获益-风险权衡偏好。我们得出的“最大可接受风险”（MAR），可以帮助决策者确定福利增强的替代品的估计。在儿童的情况下，父母照顾者负责治疗决定，他们的风险承受能力可能与成年患者自己对治疗相关风险的承受能力大不相同。我们估计并比较了克罗恩病（CD）患者和青少年CD患者的父母接受严重不良事件（SAE）风险以换取症状缓解的意愿。分析的数据来自345名18岁以上的患者和150名18岁以下儿童的父母。估计结果提供了强有力的证据，证明成年患者和青少年患者的父母愿意接受治疗疗效和SAE风险之间的权衡。青少年CD患者的父母对他们的孩子的风险容忍度与成年CD患者对自己的风险容忍度一样，以提高治疗效果。SC调查提供了一种系统的方法，用于引出对获益-风险权衡的偏好。了解患者自身的风险认知以及他们接受风险以换取治疗益处的意愿有助于为风险管理决策提供信息。
Understanding patient-specific differences in risk tolerance for new treatments that offer improved efficacy can assist in making difficult regulatory and clinical decisions for new treatments that offer both the potential for greater effectiveness in relieving disease symptoms, but also risks of disabling or fatal side effects. The aim of this study is to elicit benefit-risk trade-off preferences for hypothetical treatments with varying efficacy and risk levels using a stated-choice (SC) survey. We derive estimates of “maximum acceptable risk” (MAR) that can help decisionmakers identify welfare-enhancing alternatives. In the case of children, parent caregivers are responsible for treatment decisions and their risk tolerance may be quite different than adult patients' own tolerance for treatment-related risks. We estimated and compared the willingness of Crohn's disease (CD) patients and parents of juvenile CD patients to accept serious adverse event (SAE) risks in exchange for symptom relief. The analyzed data were from 345 patients over the age of 18 and 150 parents of children under the age of 18. The estimation results provide strong evidence that adult patients and parents of juvenile patients are willing to accept tradeoffs between treatment efficacy and risks of SAEs. Parents of juvenile CD patients are about as risk tolerant for their children as adult CD patients are for themselves for improved treatment efficacy. SC surveys provide a systematic method for eliciting preferences for benefit-risk tradeoffs. Understanding patients' own risk perceptions and their willingness to accept risks in return for treatment benefits can help inform risk management decision making.
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影响因子：
3.1
作者：
MACKINNON, B
通讯作者：
MACKINNON, B
影响因子：
6.1
作者：
Kanninen, BJ
通讯作者：
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作者：
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影响因子：
4.4
作者：
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通讯作者：
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影响因子：
4.2
作者：
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通讯作者：
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