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一项评估骨关节炎治疗患者偏好的离散选择实验:ESCEO 工作组。

A discrete-choice experiment to assess patients' preferences for osteoarthritis treatment: An ESCEO working group.

机构信息

Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, P.O. Box 616, 6200, MD, The Netherlands.

MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.

出版信息

Semin Arthritis Rheum. 2020 Oct;50(5):859-866. doi: 10.1016/j.semarthrit.2020.08.005. Epub 2020 Aug 8.

Abstract

OBJECTIVE

To evaluate the preferences of patients with osteoarthritis for treatment.

METHODS

A discrete-choice experiment was conducted among adult OA patients who were presented with 12 choice sets of two treatment options and asked in each to select the treatment they would prefer. Based on literature reviews, expert consultation, patient survey and expert meeting, treatment options were characterized by seven attributes: improvement in pain, improvement in walking, ability to manage domestic activities, ability to manage social activities, improvement in overall energy and well-being, risk of moderate/severe side effects and impact on disease progression. Random parameters logit model was used to estimate patients' preferences and a latent class model was conducted to explore preferences classes.

RESULTS

253 OA patients from seven European countries were included (74% women; mean age 71.3 years). For all seven treatment attributes, significant differences were observed between levels. Given the range of levels of each attribute, the most important treatment attribute in this group was impact on disease progression (29.5%) followed by walking improvement (17.1%) and pain improvement (16.3%). The latent class model identified two preference classes. In the first class (probability of 56%), patients valued impact of disease progression the most (39%). In the second class, walking improvement and improvement in overall energy and well-being were the most important (23%).

CONCLUSION

This study suggests that all seven treatment attributes were important for OA patients. Overall, given the range of levels, the most important outcomes were impact on disease progression and improvement in pain and walking.

摘要

目的

评估骨关节炎患者对治疗的偏好。

方法

对成年 OA 患者进行离散选择实验,向他们呈现 12 个治疗方案的选择集,并在每个方案中选择他们更愿意接受的治疗方案。根据文献回顾、专家咨询、患者调查和专家会议,治疗方案的特征由七个属性描述:疼痛改善、行走能力改善、管理家庭活动的能力、管理社会活动的能力、整体能量和健康状况改善、中度/重度副作用风险和对疾病进展的影响。采用随机参数对数模型估计患者的偏好,并进行潜在类别模型以探索偏好类别。

结果

纳入了来自七个欧洲国家的 253 名 OA 患者(74%为女性;平均年龄 71.3 岁)。对于所有七个治疗属性,不同水平之间存在显著差异。考虑到每个属性的水平范围,该组患者最重要的治疗属性是对疾病进展的影响(29.5%),其次是行走改善(17.1%)和疼痛改善(16.3%)。潜在类别模型确定了两个偏好类别。在第一类(概率为 56%)中,患者最看重疾病进展的影响(39%)。在第二类中,行走改善和整体能量和健康状况改善是最重要的(23%)。

结论

本研究表明,所有七个治疗属性对 OA 患者都很重要。总的来说,考虑到水平范围,最重要的结果是对疾病进展的影响以及疼痛和行走的改善。

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