Patient Preferences Regarding Surgical Treatment Methods for Symptomatic Uterine Fibroids.
Patient Preferences Regarding Surgical Treatment Methods for Symptomatic Uterine Fibroids.
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DOI：
10.1007/s43441-023-00525-1
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发表时间：
2023-09
影响因子：
1.5
通讯作者：
Price, Veronica
中科院分区：
文献类型：
--
作者：
Babalola, Olufemi;Gebben, David;Tarver, Michelle E.;Sangha, Roopina;Roberts, Jason;Price, Veronica
关键词：
本研究的目的是对有症状的子宫肌瘤患者在考虑手术治疗方案时最重要和最不重要的因素进行排序。使用最佳最差评分（BWS）偏好启发方法，参与者完成了一项在线调查，对与肌瘤手术治疗相关的因素进行排名。调查内容基于文献综述，包括以下因素：症状缓解；手术并发症;重复治疗;恢复时间;美容效果;扩散未确诊癌症的风险；性结果;维持生育；经期的延续；不可预知的月经;以及程序的位置。参与者完成了11项BWS任务。对于每个任务，我们从可能的11个因素中向参与者提供5个因素的子集，参与者选择最重要和最不重要的因素。参与者的反应分析使用条件逻辑回归来确定因素的相对重要性。通过年龄和种族进一步探讨患者的优先级。285名有症状的子宫肌瘤患者（69名医生确诊，216名自我报告）之前没有接受过手术治疗。受访者来自两个临床站点（临床站点队列）和一个在线消费者小组（小组队列）。两个队列都认为症状缓解、癌症风险、重复治疗和并发症是选择手术治疗方案和手术位置、术后恢复正常活动的最重要因素，而手术治疗后是否存在疤痕等美容效果是最不重要的因素。值得注意的是，年轻女性（≤40岁）更重视手术后生育能力。关于对症状性子宫肌瘤患者最重要和最不重要的因素的信息可能为新技术和新程序的发展和监管评估提供信息。研究结果可能有助于制定一套结果，包括在未来的肌瘤临床研究。在线版本包含补充材料，下载地址为10.1007/s43441-023-00525-1。
The purpose of this study is to rank the factors that are most and least important to patients with symptomatic uterine fibroids when considering surgical treatment options. Using a best worst scaling (BWS) preference elicitation approach, participants completed an online survey to rank factors associated with fibroid surgical treatments. Survey content was based on a literature review and included the following factors: symptom relief; surgical complications; repeat treatment; recovery time; cosmetic effects; risk of spreading undiagnosed cancer; sexual outcomes; maintenance of child-bearing; continuation of menses; unpredictable menses; and location of procedure. Participants completed 11 BWS tasks. For each task, we presented participants with a subset of 5 factors from the possible 11, and participants chose the most important and least important factor. Participants’ responses were analyzed using conditional logistic regression to determine the relative importance of factors. Patient priorities were further explored via age and race. 285 respondents with symptomatic uterine fibroids (69 physician-confirmed and 216 self-reported) who had not undergone prior surgical treatment completed the survey. Respondents were enrolled from two clinical sites (clinical site cohort) and an online consumer panel (panel cohort). Both cohorts identified symptom relief, cancer risk, repeat treatment and complications as the most important factors in selecting surgical treatment options and location of procedure, return to normal activities after surgery, and cosmetic effects like presence of a scar after the surgical treatment as the least important factors. Of note, younger women (≤ 40) placed greater importance on the ability to have children after the procedure. Information regarding the factors most and least important to patients with symptomatic uterine fibroids might inform development and regulatory evaluation of new technologies and procedures. Study results may be useful in efforts to develop a set of outcomes to include in future fibroids clinical studies. The online version contains supplementary material available at 10.1007/s43441-023-00525-1.
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