Department of Medical Decision Making, University Medical Center Leiden, 2300 RCLeiden, the Netherlands.
Patient Educ Couns. 2010 Feb;78(2):224-33. doi: 10.1016/j.pec.2009.05.020. Epub 2009 Jul 5.
Patient values are not routinely assessed in clinical practice. Adaptive Conjoint Analysis (ACA) is increasingly applied in studies assessing treatment preferences, and could provide a means to routinely assess individual patients' treatment preferences.
An ACA-questionnaire was administered three times (7-10 days apart) to 98 long-term rectal cancer survivors either on a portable computer or through internet, to assess whether (a) responses differ according to administration mode, (b) relative importances of rectal cancer treatment outcomes (survival, local control, incontinence, sexual problems) consolidate over time, (c) ACA-outcomes are sufficiently reliable (ICC) for use in individual decision-making. We also evaluated patients' acceptance of ACA.
Mode did not affect ACA-completion or evaluation. Importance scores did not consolidate over time. ICCs were poor for sexual problems and fair for the other outcomes, and were at least equal or higher from first to second retest. Most participants valued completing the ACA-questionnaire and learning their results.
Values did not show consolidation over time. ACA-derived preferences should not determine which treatment patients should choose.
Findings extend ACA-validation studies to the health care setting and suggest that ACA-questionnaires might be appreciated as adjuncts to treatment decision-making in newly diagnosed patients.
患者价值观在临床实践中通常未得到评估。适应性联合分析（ACA）越来越多地应用于评估治疗偏好的研究中，它可能提供一种常规评估个体患者治疗偏好的方法。
我们通过便携式计算机或互联网三次（相隔 7-10 天）向 98 名长期直肠癌幸存者发放 ACA 问卷，以评估（a）不同的管理模式是否会影响响应，（b）直肠癌治疗结果（生存、局部控制、失禁、性功能障碍）的相对重要性是否随时间推移而巩固，（c）ACA 结果是否足够可靠（ICC），可用于个体决策。我们还评估了患者对 ACA 的接受程度。
管理模式不会影响 ACA 的完成或评估。重要性评分不会随时间推移而巩固。对于性功能障碍，ICC 较差，对于其他结果，ICC 较好，且从第一次到第二次复测的 ICC 至少相等或更高。大多数参与者重视完成 ACA 问卷并了解其结果。
价值观并未随时间推移而巩固。ACA 得出的偏好不应决定患者应选择哪种治疗方法。
这些发现将 ACA 验证研究扩展到医疗保健环境，并表明 ACA 问卷可能作为新诊断患者治疗决策的辅助工具。
