Patient Preferences for Metastatic Hormone-Sensitive Prostate Cancer Treatments: A Discrete Choice Experiment Among Men in Three European Countries

Freitas, Hayley M de; Ito, Tetsuro; Hadi, Monica; Al-Jassar, Gemma; Henry-Szatkowski, M.; Nafees, Beenish; Lloyd, Andrew

doi:10.1007/s12325-018-0861-3

Cited by 20 publications

(47 citation statements)

References 26 publications

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“…For example, in castration-resistant prostate cancer or biochemically recurrent prostate cancer, fatigue was found to be an important risk attribute for patients, and one study observed that these patients valued reducing fatigue more than improving OS. 25,40 In another study, patients with advanced non-small cell lung cancer valued a reduction in fatigue severity from moderate to none equally as an additional 7.3 months of progression-free survival (with mild disease symptoms). 41 Taken together, these findings underscore the importance of carefully balancing the goal of improving survival with the introduction of treatment-related AEs.…”

Section: T a B L E 2 (Continued)mentioning

confidence: 99%

Patient and caregiver benefit‐risk preferences for nonmetastatic castration‐resistant prostate cancer treatment

et al. 2020

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Background Recently approved second‐generation androgen receptor inhibitors (SGARIs) for non‐metastatic castration‐resistant prostate cancer (nmCRPC) have similar efficacy but differ in safety profiles. We used a discrete choice experiment (DCE) to examine how nmCRPC patients and caregivers perceive the benefits versus risks of these new treatments. Methods An online DCE survey with 14 treatment choice questions was administered to nmCRPC patients and caregivers. Each choice question compared two hypothetical medication profiles varying in terms of 5 safety attributes (risk or severity of adverse events [AEs]: fatigue, skin rash, cognitive problems, serious fall, and serious fracture) and two efficacy attributes (duration of overall survival [OS] and time to pain progression). Random parameters logit models were used to estimate each attribute's relative importance. We also estimated the amounts of OS that respondents were willing to forego for a reduction in AEs. Results In total, 143 nmCRPC patients and 149 caregivers viewed the AEs in following order of importance (most to least): serious fracture, serious fall, cognitive problems, fatigue, and skin rash. On average, patients were willing to trade 5.8 and 4.0 months of OS to reduce the risk of serious fracture and fall, respectively, from 3% to 0%; caregivers were willing to trade 6.6 and 5.4 months of OS. Conclusions nmCRPC patients and caregivers preferred treatments with lower AE burdens and were willing to forego OS to reduce the risk and severity of AEs. Our results highlight the importance of carefully balancing risks and benefits when selecting treatments in this relatively asymptomatic population.

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Section: T a B L E 2 (Continued)mentioning

confidence: 99%

Patient and caregiver benefit‐risk preferences for nonmetastatic castration‐resistant prostate cancer treatment

et al. 2020

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“…28 Finally, a recent discrete choice experiment of prostate cancer patients and oncologists identified that treatment efficacy and pain control were similarly important when considering treatment choices. 29 In our study, treatment efficacy emerged as more important than pain control for mPCa survivors, with treatment efficacy identified as the fifth most strongly endorsed consideration. This underscores the importance of treatment efficacy and sequencing among mPCa patients.…”

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confidence: 67%

<p>What Do Men with Metastatic Prostate Cancer Consider When Making Treatment Decisions? A Mixed-methods Study</p>

Oswald¹,

Schumacher²,

Gonzalez³

et al. 2020

PPA

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Objective: Metastatic prostate cancer (mPCa) patients often make complicated treatment decisions, yet decision aids to facilitate shared decision-making for mPCa are uncommon. To inform the development of patient-centered mPCa decision aids, we examined what mPCa survivors considered most important when making treatment decisions. Methods: Using an exploratory sequential approach, we conducted three focus groups with 14 advanced prostate cancer survivors (n=5, n=3, n=6 in each group) to identify considerations for making treatment decisions. Focus groups were audio-recorded and transcribed, and we identified qualitative themes. We then developed a quantitative survey to assess the importance of each theme and administered the survey to mPCa survivors (N=100). We used relative frequencies to determine the most strongly endorsed items and chi-squared and Fisher's exact tests to assess associations with participant characteristics. Results: Focus groups yielded 11 themes, and the resulting survey included 20 items. The most strongly endorsed mPCa treatment considerations were: relying on physician's treatment recommendations (79% strongly agree); wanting to feel well enough to spend quality time with loved ones (72% strongly agree); the importance of dying in a manner consistent with one's wishes (70% strongly agree); hoping to eliminate cancer completely (68% strongly agree); and optimizing treatment efficacy (65% strongly agree). Age, race, marital status, employment status, and self-reported health were related to how strongly men endorsed various considerations for mPCa treatment decision-making. Conclusion: We identified multiple considerations that mPCa survivors appraised when making treatment decisions. These data may inform the development of patient-centered decision aids for mPCa.

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“…This implied these respondents did not perhaps understand the choice task” Damen, 2011 [ 69 ] “Passed the dominant question, demonstrating their understanding of the DCE task” To describe sample “A dominant choice set (i.e. a choice set in which both alternatives used implant material but one was characterised by logically preferable levels on all other attributes) and was included to test for rationality” “In total, 270 of 272 patients (99%) passed the dominant question, demonstrating their understanding of the DCE task” de Bekker-Grob, 2013 [ 81 ] “Experienced difficulty of the questionnaire” Not reported Not reported “93% of the respondents passed the rationality test that was included in the questionnaire, and 76% of the respondents did not find the DCE questions difficult” De Freitas, 2019 [ 52 ] “… comprehension and relevance of the attributes … as well as the survey instructions” To revise DCE instrument “Pretest interviews” “Participants … were able to answer all the questions, and … the instructions were clear and easy to understand. Some participants provided feedback about the wording of some of the attribute levels …” and “no changes to the number of choice tasks or to the experimental design were made on the basis of the pretest interviews” De Vries, 2015 [ 73 ] “Understand the task” To exclude participants “This dominant choice set was added to identify the responders who may not understand the task” NS—10 participants were excluded (assumed because they failed the dominant choice set) Fifer, 2018 [ 89 ] Online pilot with targeted feedback to ensure logic and understanding.…”

Section: Resultsmentioning

confidence: 99%

“…The 18 applied DCEs addressing understanding in the pretesting phase all used the concept of understanding as a way to modify or revise the DCE instrument before final roll out [44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61]. Most used pretesting to test or confirm understanding in relation to the terminology of attributes and medical concepts.…”

Section: Applied Dces Addressing Understanding In the Pretesting Phasementioning

confidence: 99%

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Respondent Understanding in Discrete Choice Experiments: A Scoping Review

Pearce

Harrison

Watson

et al. 2020

Patient

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Introduction Despite the recognised importance of participant understanding for valid and reliable discrete choice experiment (DCE) results, there has been limited assessment of whether, and how, people understand DCEs, and how 'understanding' is conceptualised in DCEs applied to a health context. Objectives Our aim was to identify how participant understanding is conceptualised in the DCE literature in a health context. Our research questions addressed how participant understanding is defined, measured, and used. Methods Searches were conducted (June 2019) in the MEDLINE, EMBASE, PsychINFO and Econlit databases, as well as hand searching. Search terms were based on previous DCE systematic reviews, with additional understanding keywords used in a proximity-based search strategy. Eligible studies were peer-reviewed journal articles in the field of health, related to DCE or best-worst scaling type 3 (BWS3) studies, and reporting some consideration or assessment of participant understanding. A descriptive analytical approach was used to chart relevant data from each study, including publication year, country, clinical area, subject group, sample size, study design, numbers of attributes, levels and choice sets, definition of understanding, how understanding was tested, results of the understanding tests, and how the information about understanding was used. Each study was categorised based on how understanding was conceptualised and used within the study. Results Of 306 potentially eligible articles identified, 31 were excluded based on titles and abstracts, and 200 were excluded on full-text review, resulting in 75 included studies. Three categories of study were identified: applied DCEs (n = 52), pretesting studies (n = 7) and studies of understanding (n = 16). Typically, understanding was defined in relation to either the choice context, such as attribute terminology, or the concept of choosing. Very few studies considered respondents' engagement as a component of understanding. Understanding was measured primarily through qualitative pretesting, rationality or validity tests included in the survey, and participant self-report, however reporting and use of the results of these methods was inconsistent. Conclusions Those conducting or using health DCEs should carefully select, justify, and report the measurement and potential impact of participant understanding in their specific choice context. There remains scope for research into the different components of participant understanding, particularly related to engagement, the impact of participant understanding on DCE validity and reliability, the best measures of understanding, and methods to maximise participant understanding.

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Patient Preferences for Metastatic Hormone-Sensitive Prostate Cancer Treatments: A Discrete Choice Experiment Among Men in Three European Countries

Cited by 20 publications

References 26 publications

Patient and caregiver benefit‐risk preferences for nonmetastatic castration‐resistant prostate cancer treatment

Patient and caregiver benefit‐risk preferences for nonmetastatic castration‐resistant prostate cancer treatment

<p>What Do Men with Metastatic Prostate Cancer Consider When Making Treatment Decisions? A Mixed-methods Study</p>

Respondent Understanding in Discrete Choice Experiments: A Scoping Review

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