Patients' values and preferences for health states in allergic rhinitis—An artificial intelligence supported systematic review

Abstract

BackgroundAllergic rhinitis (AR) impacts patients' physical and emotional well‐being. Assessing patients' values and preferences (V&P) related to AR is an essential part of patient‐centered care and of the guideline development process. We aimed to systematically summarize the information about patients' V&P on AR and its symptoms and impact on daily life.MethodsWe conducted systematic review in a MEDLINE, Embase, PsychInfo, and CINAHL databases. We included studies which quantitatively assessed patients' V&P for specific outcomes in AR by assessing utilities, applying discrete choice approaches, or rating and ranking outcomes. We grouped outcomes as AR symptoms, functional status, and care‐related patient experience. Study selection and data extraction were supported by the Laser AI tool. We rated the certainty of evidence (CoE) using the GRADE approach.ResultsThirty‐six studies (41 records) were included: nine utility studies, seven direct‐choice studies and 21 studies of rating or ranking outcomes. Utilities were lower with increased AR severity and with the concomitant presence of asthma, but not with whether AR was seasonal or perennial (CoE = low–high). Patients rated AR symptom‐related outcomes as more important than those related to care‐related patient experience and functional status (CoE = very low–moderate). Nasal symptoms (mainly nasal congestion) followed by breathing disorders, general and ocular symptoms were rated as the symptoms with the highest impact.ConclusionsThis systematic review provides a comprehensive overview of V&P of patients with AR. Patients generally considered nasal symptoms as the most important. Future studies with standardized methods are needed to provide more information on V&P in AR.

Impact of Uncontrolled Symptoms on the Health‐Related Quality of Life (EQ‐5D‐5L) of Patients With Allergic Rhinitis: A MASK‐air Study

“…Overall, we found that poor symptom control was associated with decreased QoL. Poor control of eye and nose symptoms seems to have a similar impact on QoL in patients with AR alone and AR+asthma, underscoring the importance of controlling both ocular and nasal symptoms in patients with AR, although considering patients' preferences [8]. The largest differences in QoL concerned comparisons between poor versus other levels of control for all symptoms, particularly for the EQ-5D VAS.…”

Embedding patients' values and preferences in guideline development for allergic diseases: The case study of Allergic Rhinitis and its Impact on Asthma 2024

“…Therefore, for the next revision of the ARIA guidelines (ARIA 2024), we conducted a systematic review to synthesise and appraise all available evidence on patients' V&P for health outcomes associated with AR. 29 Our systematic review of 36 primary studies found that: � Increased AR severity or comorbid asthma were associated with lower utilities, therefore having a larger impact than that of considering whether AR was seasonal or perennial. Even though the certainty of the evidence tended to be generally low in our systematic review, and some of the primary studies had important limitations (prompting the need for unbiased future utility studies assessing larger cohorts of patients and making use of realworld data), decision-making in guideline development must be based on the best available evidence.…”

“…Therefore, for the next revision of the ARIA guidelines (ARIA 2024), we conducted a systematic review to synthesise and appraise all available evidence on patients' V&P for health outcomes associated with AR. 29 …”