Meregaglia Michela, Cairns John, Alfieri Salvatore, Favales Federica, Mazzitelli Daniela, Orlandi Ester, Licitra Lisa, Bossi Paolo
Faculty of Public Health and Policy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK; Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy.
Faculty of Public Health and Policy, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK; CCBIO, University of Bergen, Bergen, Norway.
Value Health. 2017 Jun;20(6):799-808. doi: 10.1016/j.jval.2017.01.012. Epub 2017 Mar 31.
There are no commonly accepted standards for monitoring patients treated for head and neck cancer. The aim of this study was to assess patients' preferences for different aspects of follow-up.
A best-worst survey was conducted in a sample of head and neck cancer patients in clinical follow-up at the National Cancer Institute (Milan, Italy). Conditional logit regression with choice as the dependent variable was run to analyse the data. A covariate-adjusted analysis was performed in order to identify socio-demographic and clinical factors related to the selection of best-worst items. The participants were asked to report any difficulties encountered during the survey.
A total of 143 patients, predominantly male (74%) and with a mean age of 58 years were enrolled in the survey. The strongest positive preference was expressed for a hospital-based program of physical examinations with frequency decreasing over time. Conversely, the lowest valued item was not performing any positron emission tomography (PET) scan during follow-up. Patients with high educational levels were more likely to value attending a primary care-based program and undergoing intensive radiological investigations. Other patient-specific variables significantly associated with the choice of items were employment and living status, time already spent in follow-up and number of treatments received.
Overall, patients were more likely to choose an intensive follow-up scheme broadly consistent with the program currently administered by the hospital. There is little evidence of preference heterogeneity that might justify customized programs based on demographics. The best-worst scaling task appeared feasible for most participants.
对于接受头颈部癌症治疗的患者，目前尚无普遍认可的监测标准。本研究旨在评估患者对随访不同方面的偏好。
在意大利米兰国家癌症研究所接受临床随访的头颈部癌症患者样本中进行了最佳-最差调查。以选择为因变量进行条件logit回归分析数据。进行协变量调整分析以确定与最佳-最差项目选择相关的社会人口统计学和临床因素。参与者被要求报告在调查过程中遇到的任何困难。
共有143名患者参与调查，其中男性占主导（74%），平均年龄为58岁。对基于医院的体检项目表现出最强烈的积极偏好，且随着时间推移频率降低。相反，最不受重视的项目是在随访期间不进行任何正电子发射断层扫描（PET）。高学历患者更倾向于参加基于初级保健的项目并接受强化放射学检查。与项目选择显著相关的其他患者特定变量包括就业和生活状况、已接受随访的时间以及接受治疗的次数。
总体而言，患者更倾向于选择一种与医院目前实施的项目大致一致的强化随访方案。几乎没有证据表明偏好异质性足以证明基于人口统计学的定制项目是合理的。最佳-最差评分任务对大多数参与者来说似乎是可行的。
