Author Affiliations: Merck & Co, Inc, Kenilworth, New Jersey (Drs Liu and Ebbinghaus); Kantar Health, New York, New York (Dr Witt, Ms Beyer, and Mr Basurto); and Mayo Clinic, Jacksonville, Florida (Dr Joseph).
Cancer Nurs. 2019 Jan/Feb;42(1):E52-E59. doi: 10.1097/NCC.0000000000000557.
Understanding the perceptions of patients and oncology nurses about the relative importance of benefits and risks associated with newer treatments of advanced melanoma can help to inform clinical decision-making.
The aims of this study were to quantify and compare the views of patients and oncology nurses regarding the importance of attributes of treatments of advanced melanoma.
A discrete choice experiment (DCE) was conducted in US-based oncology nurses and patients diagnosed with advanced melanoma. Patients and nurses were enlisted through online panels. In a series of scenarios, respondents had to choose between 2 hypothetical treatments, each with 7 attributes: mode of administration (MoA), dosing schedule (DS), median duration of therapy (DoT), objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and grade 3 or 4 adverse events (AEs). Hierarchical Bayesian logistic regression models were used to estimate preference weights.
A total of 200 patients with advanced melanoma and 150 oncology nurses participated. The relative importance estimates of attributes by patients and nurses, respectively, were as follows: OS, 33% and 28%; AEs, 29% and 26%; ORR, 25% and 27%; PFS, 12% and 15%; DS, 2% and 3%; DoT, 0% and 0%; and MoA, 0% and 0%.
Both patients and oncology nurses valued OS, ORR, and AEs as the most important treatment attributes for advanced melanoma, followed by PFS, whereas DS, DoT, and MoA were given less value in their treatment decisions.
Oncology nurses and patients have similar views on important treatment considerations for advanced melanoma, which can help build trust in shared decision-making.
了解患者和肿瘤护士对晚期黑色素瘤新治疗方法相关益处和风险的相对重要性的看法，可以帮助为临床决策提供信息。
本研究旨在量化和比较患者和肿瘤护士对晚期黑色素瘤治疗属性重要性的看法。
在美国进行了一项基于离散选择实验（DCE）的研究，纳入了确诊为晚期黑色素瘤的肿瘤护士和患者。通过在线小组招募患者和护士。在一系列场景中，受访者必须在两种假设的治疗方法之间进行选择，每种方法都有 7 种属性：给药方式（MoA）、剂量方案（DS）、中位治疗持续时间（DoT）、客观缓解率（ORR）、无进展生存期（PFS）、总生存期（OS）和 3 或 4 级不良事件（AEs）。使用分层贝叶斯逻辑回归模型来估计偏好权重。
共有 200 名晚期黑色素瘤患者和 150 名肿瘤护士参与了研究。患者和护士对属性的相对重要性估计值分别为：OS，33%和 28%；AE，29%和 26%；ORR，25%和 27%；PFS，12%和 15%；DS，2%和 3%；DoT，0%和 0%；以及 MoA，0%和 0%。
患者和肿瘤护士均将 OS、ORR 和 AE 视为晚期黑色素瘤最重要的治疗属性，其次是 PFS，而 DS、DoT 和 MoA 在治疗决策中受到的重视程度较低。
肿瘤护士和患者对晚期黑色素瘤重要治疗考虑因素的看法相似，这有助于建立对共同决策的信任。
