Division of Evidence-Based Medicine (dEBM), Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Venerology and Allergy, Berlin, Germany.
Division of Evidence-Based Medicine (dEBM), Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Venerology and Allergy, Berlin, Germany.
J Clin Epidemiol. 2021 Jan;129:40-50. doi: 10.1016/j.jclinepi.2020.09.026. Epub 2020 Sep 26.
We aimed to generate evidence on patients' values and preferences to inform the development of the German national Evidence-based Anal Cancer Guideline.
We developed a list of health outcomes based on a systematic search. We then asked anal cancer patients and experts of the guideline development group in an online survey to (a) rate the relative importance of the outcomes in different clinical situations using a nine-point, three-category scale, and (b) select seven outcomes they considered most important for decision-making in each situation.
Participants rated almost half of the outcomes (45%) as critical for decision-making, and more than half (53%) as important. Only two outcomes (2%) were rated as low in importance. Agreement between expert and patient ratings was low to fair, and we found important discrepancies in how the relative importance of the outcomes was perceived. However, the rankings of outcomes were highly correlated.
Determining the relative importance placed by anal cancer patients on outcomes provided useful information for developing guideline recommendations. Our approach may be useful for guideline developers who aim to include the patient perspective. Moreover, our findings may help health professionals caring for anal cancer patients in joint decision-making.
为了为德国国家循证肛门癌指南的制定提供信息,我们旨在生成患者价值观和偏好的证据。
我们根据系统搜索制定了一份健康结果清单。然后,我们在一项在线调查中要求肛门癌患者和指南制定专家组的专家:(a)使用九点三分制对不同临床情况下的结果的相对重要性进行评分;(b)在每种情况下选择他们认为对决策最重要的七个结果。
参与者认为近一半的结果(45%)对决策至关重要,超过一半(53%)认为很重要。只有两个结果(2%)被评为重要性低。专家和患者评分之间的一致性低至中等,我们发现对结果的相对重要性的看法存在重要差异。然而,结果的排名高度相关。
确定肛门癌患者对结果的重视程度为制定指南建议提供了有用的信息。我们的方法可能对旨在纳入患者观点的指南制定者有用。此外,我们的发现可能有助于照顾肛门癌患者的卫生专业人员进行联合决策。