Nakayama Masahiko, Kobayashi Hisanori, Okazaki Masateru, Imanaka Keiichiro, Yoshizawa Kazutake, Mahlich Jörg
1 Medical Affairs Division, Janssen Pharmaceutical K.K., Tokyo, Japan.
2 Research and Development Division, Janssen Pharmaceutical K.K., Tokyo, Japan.
Am J Mens Health. 2018 Jul;12(4):1094-1101. doi: 10.1177/1557988318776123. Epub 2018 May 18.
The purpose of the present study is to investigate the concordance of treatment preferences between patients and physicians in prostate cancer (PCa) in Japan. An internet-based discrete choice experiment was conducted. Patients and physicians were asked to select their preferred treatment from a pair of hypothetical treatments consisting of four attributes: quality of life (QOL), treatment effectiveness, side effects, and accessibility of treatment. The data were analyzed using a conditional logistic regression model to calculate coefficients and the relative importance (RI) of each attribute. A total of 103 PCa patients and 127 physicians responded. The study looked at 37 patients considered as advanced PCa and 66 who were non-advanced PCa. All of the physicians were urologists. Advanced PCa patients ranked the attributes as follows: treatment effectiveness (RI: 32%), accessibility of treatment (RI: 26%), QOL (RI: 23%), and side effects (RI: 19%). For physicians, the RI ranking was the same as for advanced PCa patients; treatment effectiveness (RI: 29%), accessibility of treatment (RI: 27%), QOL (RI: 26%), and side effects (RI: 18%). For non-advanced PCa patients, accessibility of treatment ranked the highest RI (27%) and treatment effectiveness ranked as the lowest RI (14%). Our study suggests that the ranking of the attributes was consistent between advanced PCa patients and physicians. The most influential attribute was treatment effectiveness. Treatment preferences also vary by disease stage.
本研究的目的是调查日本前列腺癌（PCa）患者与医生之间治疗偏好的一致性。开展了一项基于互联网的离散选择实验。要求患者和医生从由四个属性组成的一对假设治疗方案中选择他们偏好的治疗方案，这四个属性分别为生活质量（QOL）、治疗效果、副作用和治疗可及性。使用条件逻辑回归模型分析数据，以计算每个属性的系数和相对重要性（RI）。共有103名PCa患者和127名医生做出了回应。该研究观察了37名被视为晚期PCa的患者和66名非晚期PCa患者。所有医生均为泌尿科医生。晚期PCa患者对各属性的排序如下：治疗效果（RI：32%）、治疗可及性（RI：26%）、生活质量（RI：23%）和副作用（RI：19%）。对于医生而言，RI排序与晚期PCa患者相同；治疗效果（RI：29%）、治疗可及性（RI：27%）、生活质量（RI：26%）和副作用（RI：18%）。对于非晚期PCa患者，治疗可及性的RI最高（27%），治疗效果的RI最低（14%）。我们的研究表明，晚期PCa患者和医生在属性排序上是一致的。最具影响力的属性是治疗效果。治疗偏好也因疾病阶段而异。
