Comparing the Relative Importance of Attributes of Metastatic Renal Cell Carcinoma Treatments to Patients and Physicians in the United States: A Discrete-Choice Experiment
Comparing the Relative Importance of Attributes of Metastatic Renal Cell Carcinoma Treatments to Patients and Physicians in the United States: A Discrete-Choice Experiment
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DOI：
10.1007/s40273-018-0640-7
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发表时间：
2018-08-01
影响因子：
4.4
通讯作者：
Fishman, Mayer
中科院分区：
文献类型：
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作者：
Gonzalez, Juan Marcos;Doan, Justin;Fishman, Mayer
目的转移性肾细胞癌（RCC）新疗法的价值评估应包括对患者最重要的结果。本研究的目的是量化和比较条件的相对重要性，RCC治疗的患者和医生的属性在UnitedStates.Methods RCC患者和医生谁治疗RCC完成了一个在线离散选择实验调查与部分析因D-最优实验设计。在一系列的12个问题中，受访者选择两种假设的治疗方法，这些治疗方法根据六个属性定义：无进展生存期（PFS），生存≥ 3年的概率（PL 3 Y），皮肤反应，疲劳的严重程度，给药方式和每月共同支付。治疗选择进行了分析，使用随机参数logit模型估计属性水平和条件相对属性重要性（即属性的重要性相对于所有其他属性的水平范围的条件）的相对偏好权重。对于患者和医生，PL 3 Y是具有最大和统计学显著性条件相对重要性的属性。PFS、皮肤反应和给药方式对患者的条件相对重要性以及PFS和给药方式对医生的条件相对重要性的估计值无统计学显著性。患者和医生对PFS改善的偏好与PL 3 Y水平无关。条件相对属性重要性因患者疾病分期而异。结论患者和医生表示PL 3 Y是最重要的治疗属性，并且比PFS更重要。医生和患者之间以及所有患者和晚期/转移性疾病患者之间的重要性排名不同。
Objectives Value assessments of new treatments for metastatic renal cell carcinoma (RCC) should include outcomes that are most important to patients. This study aimed to quantify and compare the conditional relative importance of the attributes of RCC treatments to patients and physicians in the United States.Methods Patients with RCC and physicians who treat RCC completed an online discrete-choice experiment survey with a fractional factorial D-optimal experimental design. In a series of 12 questions, respondents chose between two hypothetical treatments defined in terms of six attributes: progression-free survival (PFS), probability of living >= 3 years (PL3Y), skin reactions, severity of fatigue, mode of administration, and monthly co-payment. Treatment choices were analyzed using a random-parameters logit model to estimate relative preference weights for the attribute levels and conditional relative attribute importance (i.e. the importance of an attribute relative to all other attributes conditional on the range of levels of that attribute).Results Overall, 201 patients and 142 physicians completed the survey. For both patients and physicians, PL3Y was the attribute with the greatest and statistically significant conditional relative importance. Estimates of the conditional relative importance of PFS, skin reactions, and mode of administration for patients, and for PFS and mode of administration for physicians, were not statistically significant. The preferences for improvements in PFS were independent of the level of PL3Y for both patients and physicians. Conditional relative attribute importance varied by patient disease stage.Conclusions Patients and physicians indicated that PL3Y was the most important treatment attribute and was significantly more important than PFS. Importance rankings differed between physicians and patients and between all patients and those with advanced/metastatic disease.