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化疗引起的周围神经病的临床评估:患者偏好的离散选择实验。

Clinical assessment of chemotherapy-induced peripheral neuropathy: a discrete choice experiment of patient preferences.

机构信息

University of Technology Sydney (CHERE), Sydney, NSW, Australia.

University of Sydney (Sydney School of Public Health), Sydney, NSW, Australia.

出版信息

Support Care Cancer. 2021 Nov;29(11):6379-6387. doi: 10.1007/s00520-021-06196-8. Epub 2021 Apr 22.

Abstract

PURPOSE

Up to 40% of cancer patients treated with neurotoxic chemotherapies experience chemotherapy-induced peripheral neuropathy (CIPN). Currently, there is no gold standard assessment tool for CIPN and there is little information in the literature on patient preferences for such assessments. This study aims to address this gap by identifying the features of a CIPN assessment tool that cancer patients value.

METHODS

An online discrete choice experiment (DCE) survey of neurotoxic chemotherapy-treated patients was implemented. Respondents completed 8 choice questions each. In each choice question, they chose between two hypothetical CIPN assessment tools, each described by six attributes: impact on quality of life; level of nerve damage detected; questionnaire length; physical tests involved; impact on clinic time; impact on care.

RESULTS

The survey was completed by 117 respondents who had a range of cancers of which breast cancer was the most common. Respondents favoured an assessment tool that includes a physical test and that asks about impact on quality of life. Respondents were strongly opposed to clinicians, alone, deciding how the results of a CIPN assessment might influence their care especially their chemotherapy treatment. They were concerned about small changes in their CIPN, independent of clinical relevance. Respondents were willing to add half an hour to the usual clinic time to accommodate the CIPN assessment.

CONCLUSION

The findings of this DCE will assist clinicians in choosing an assessment tool for CIPN that is satisfactory to both clinician and patient.

摘要

目的

多达 40%接受神经毒性化疗的癌症患者会经历化疗引起的周围神经病(CIPN)。目前,CIPN 没有金标准评估工具,文献中关于患者对此类评估的偏好的信息也很少。本研究旨在通过确定癌症患者重视的 CIPN 评估工具的特征来解决这一差距。

方法

对接受神经毒性化疗的患者进行了在线离散选择实验(DCE)调查。受访者每人完成 8 个选择题。在每个选择题中,他们在两种假设的 CIPN 评估工具之间进行选择,每种工具都由六个属性描述:对生活质量的影响;检测到的神经损伤程度;问卷长度;涉及的体格检查;对就诊时间的影响;对护理的影响。

结果

该调查共完成了 117 名受访者,他们患有多种癌症,其中乳腺癌最常见。受访者倾向于使用包含体格检查且询问对生活质量影响的评估工具。受访者强烈反对临床医生单独决定 CIPN 评估结果如何影响他们的护理,尤其是他们的化疗治疗。他们担心 CIPN 会发生微小变化,而与临床相关性无关。受访者愿意在常规就诊时间上增加半小时,以适应 CIPN 评估。

结论

这项 DCE 的结果将有助于临床医生选择一种令临床医生和患者都满意的 CIPN 评估工具。

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