Gutknecht Mandy, Schaarschmidt Marthe-Lisa, Danner Marion, Blome Christine, Augustin Matthias
German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Department of Dermatology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
Patient Prefer Adherence. 2018 Mar 15;12:363-373. doi: 10.2147/PPA.S152509. eCollection 2018.
Psoriasis affects different aspects of health-related quality of life (eg, physical, psychological, and social impairments); these health domains can be of different importance for patients. The importance of domains can be measured with the Patient Benefit Index (PBI). This questionnaire weights the achievement of treatment goals by Likert scales (0, "not important at all" to 4, "very important") using the Patient Needs Questionnaire (PNQ). Treatment goals assessed with the PBI have been assigned to five health domains; the importance of each domain can be calculated as the average importance of the respective treatment goals. In this study, the PBI approach of deriving importance weights is contrasted to a discrete choice experiment (DCE), in order to determine the importance of health domains in psoriasis, and to find if the resulting weights will differ when derived from these two methods.
Adult patients with psoriasis completed both questionnaires (PNQ, DCE). The PBI domains were used as attributes in the DCE with the levels "did not help at all", "helped moderately", and "helped a lot".
Using DCE, "improving physical functioning" was the most important health domain, followed by "improving psychological well-being". Using PNQ, these domains were ranked in position two and three following "strengthening confidence in the therapy and in a possible healing". The latter was least important using DCE. The only agreement of ranking was shown in "reducing impairments due to therapy" (position four). "Improving social functioning" was ranked in position three (DCE) and five (PNQ).
Health domains have different importance to patients with psoriasis. Using PNQ or DCE to determine the importance of domains results in markedly different rankings; both approaches can thus not be considered equivalent. However, in this study, importance was assessed at the domain level in DCE and at the single item level in PNQ, which may have added to the differences.
银屑病会影响健康相关生活质量的不同方面（如身体、心理和社会功能损害）；这些健康领域对患者的重要性可能各不相同。领域的重要性可用患者获益指数（PBI）来衡量。该问卷使用患者需求问卷（PNQ），通过李克特量表（0表示“完全不重要”至4表示“非常重要”）对治疗目标的达成情况进行加权。用PBI评估的治疗目标已被归入五个健康领域；每个领域的重要性可通过相应治疗目标的平均重要性来计算。在本研究中，将PBI得出重要性权重的方法与离散选择实验（DCE）进行对比，以确定银屑病患者健康领域的重要性，并探究从这两种方法得出的权重是否会有所不同。
成年银屑病患者完成了两份问卷（PNQ、DCE）。PBI领域被用作DCE中的属性，其水平为“完全没有帮助”“有一定帮助”和“帮助很大”。
使用DCE时，“改善身体功能”是最重要的健康领域，其次是“改善心理健康”。使用PNQ时，这两个领域在“增强对治疗及可能治愈的信心”之后分别排在第二和第三位。后者在DCE中是最不重要的。唯一排名一致的是“减少治疗引起的损害”（第四位）。“改善社会功能”在DCE中排名第三，在PNQ中排名第五。
健康领域对银屑病患者具有不同的重要性。使用PNQ或DCE来确定领域的重要性会得出明显不同的排名；因此不能认为这两种方法是等效的。然而，在本研究中，DCE是在领域层面评估重要性，而PNQ是在单个项目层面评估，这可能加剧了差异。
