Patients prioritize local recurrence risk over other attributes for surgical treatment of facial melanomas—Results of a stated preference survey and choice-based conjoint analysis

Etzkorn, Jeremy R.; Tuttle, Stephen W.; Lim, Ilya; Feit, Elea McDonnell; Sobanko, Joseph F.; Shin, Thuzar M.; Neal, Donald; Miller, Christopher J.

doi:10.1016/j.jaad.2018.02.059

Cited by 25 publications

(18 citation statements)

References 61 publications

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“…DCE methodology is favored over ranking/rating approaches as the tasks presented to participants are more consistent with how decisions are made in reality and is underpinned by economic theory (5)(6)(7). DCEs are increasingly being used to evaluate treatment and health care preferences across medical disciplines (8)(9)(10)(11) and have been used to quantify patient and physician preferences for the treatments of dermatological conditions including psoriasis, melanoma and dermatological surgeries (12)(13)(14)(15)(16)(17). No such methods have been used to quantify preferences in AD treatment, nor has there been much research examining how patients and physicians evaluate the benefits and risks of treatment, or how they may differ, using other empirical methods.…”

Section: Introductionmentioning

confidence: 99%

Patient and physician preferences for atopic dermatitis injection treatments in Japan

Okubo

Ho²,

Fifer³

et al. 2019

Journal of Dermatological Treatment

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Background: Recently, biologic agents administered as a subcutaneous injection have been introduced as treatment options for atopic dermatitis (AD). Biologic treatments differ considerably from traditional topical and systemic anti-inflammatory treatments, and it is unclear how this may impact patient and physician preferences for treatments. Objective: To examine the treatment preferences for new injection treatments of patients and physicians. Methods: Discrete choice experiment methodology was used to quantify preferences for treatments via an online survey. Participants were presented with a series of choice scenarios; treatment options were described using the following attributes: add-on or replacement treatment, efficacy of improving rashes and itching, time until response, place of administration, injection site reaction, risk of mild-to-moderate and severe side effects, frequency of administration and cost. Results: 76.67% of physicians and 46.24% of patients opted-in to the new treatment in the scenarios presented. Of those who opted-in to treatment, physicians were more likely to value the efficacy of treating rashes and were more concerned about cost than patients. Patients preferred add-on treatments and were against self-administering the treatment at home. Conclusion: Overall patients and physicians differ in their preferences for AD treatments. These findings have implications for shared decision making and clinical practice.

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Section: Introductionmentioning

confidence: 99%

Patient and physician preferences for atopic dermatitis injection treatments in Japan

Okubo

Ho²,

Fifer³

et al. 2019

Journal of Dermatological Treatment

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“…In two studies [69,70] that had the similar scope of comparing preferences on surgical options (Mohs micrographic surgery over conventional excision) for skin cancer, similar WTP values were obtained. One study reported WTP of $369-$1510 among 136 patients in USA [70] while the other study reported WTP of $1270 among 312 general population in The Netherlands [69]. Interestingly, another two studies [33,71] that investigated WTP for bevacizumab in lung cancer treatment had different results.…”

Section: Wtp Outcomes Reportedmentioning

confidence: 73%

“…The highest WTP value for this category was $62,287 for a hopeful therapy that increased the possibility of long-term survival [54]. In two studies [69,70] that had the similar scope of comparing preferences on surgical options (Mohs micrographic surgery over conventional excision) for skin cancer, similar WTP values were obtained. One study reported WTP of $369-$1510 among 136 patients in USA [70] while the other study reported WTP of $1270 among 312 general population in The Netherlands [69].…”

Section: Wtp Outcomes Reportedmentioning

confidence: 82%

“…For studies using CV method, only 3/24 (12.5%) studies [45,61,66] were considered of high quality, 13/24 (54.2%) were of moderate quality [46,55,58,59,62,64,68,71,73,76,[79][80][81], and 8/24 (33.3%) [47,54,56,60,63,67,70,77] were of low quality. Majority of the CV studies lacked information on test for validity and reliability, with only 50% and 16.7% of the studies reporting on validity and reliability test, respectively.…”

Section: Quality Assessmentmentioning

confidence: 99%

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Willingness-to-pay for cancer treatment and outcome: a systematic review

et al. 2021

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Background Understanding patient preferences in cancer management is essential for shared decision-making. Patient or societal willingness-to-pay (WTP) for desired outcomes in cancer management represents their preferences and values of these outcomes. Objective The aim of this systematic review is to critically evaluate how current literature has addressed WTP in relation to cancer treatment and achievement of outcomes. Methods Seven databases were searched from inception until 2 March 2021 to include studies with primary data of WTP values for cancer treatments or achievement of outcomes that were elicited using stated preference methods. Results Fifty-four studies were included in this review. All studies were published after year 2000 and more than 90% of the studies were conducted in high-income countries. Sample size of the studies ranged from 35 to 2040, with patient being the most studied population. There was a near even distribution between studies using contingent valuation and discrete choice experiment. Based on the included studies, the highest WTP values were for a quality-adjusted life year (QALY)

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“…For NIM on the head and neck, our local recurrence rate was 0.81%, which supports the use of MMS for these locations. Recent data have shown that immunostaining with MART-1, HMB-45, and Mel-5 has the ability to reduce local recurrence rates of NIM and IM down to 0% to 1% 4,[10][11][12] A survey of Mohs surgeons in 2013 revealed only 38.5% and 13.8% of Mohs surgeons performed MMS on MIS and IM, respectively. Of those, only 20.4% of surgeons used immunostains during tissue processing.…”

Section: Recurrencementioning

confidence: 99%

Recurrence Rate for Melanoma Excised by Mohs Micrographic Surgery Without Immunostaining

et al. 2022

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BACKGROUND Mohs micrographic surgery (MMS) is becoming increasingly popular for the treatment of cutaneous melanoma (CM) as multiple studies have demonstrated favorable outcomes for local recurrence and overall survival. OBJECTIVE To analyze the outcomes of noninvasive (NIM) and invasive melanomas (IM) using MMS with fresh frozen sections. The primary outcome was local recurrence. The secondary outcome was to identify mean surgical margins based on tumor type and location. METHODS Retrospective cohort study of 224 cases of CM treated from 2006 to 2016 at a tertiary academic center with MMS and fresh frozen sections by a single Mohs surgeon. RESULTS The overall recurrence rate was 2.6% with a mean follow-up of 36.2 months. The recurrence rate for NIM versus IM was 1.6% and 7%, respectively. The mean margins for NIM and IM were 7.9 mm and 10.1 mm, respectively. These varied by tumor site and location. CONCLUSION This study supports the use of MMS in the treatment of CM and highlights how narrower surgical margins for NIM of the head and neck can be achieved without increasing risk of local recurrence.

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Patients prioritize local recurrence risk over other attributes for surgical treatment of facial melanomas—Results of a stated preference survey and choice-based conjoint analysis

Cited by 25 publications

References 61 publications

Patient and physician preferences for atopic dermatitis injection treatments in Japan

Patient and physician preferences for atopic dermatitis injection treatments in Japan

Willingness-to-pay for cancer treatment and outcome: a systematic review

Recurrence Rate for Melanoma Excised by Mohs Micrographic Surgery Without Immunostaining

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