Townsville Hospital and Health Service, Townsville, Australia; James Cook University - Bebegu Yumba Campus, Townsville, Australia.
Townsville Hospital and Health Service, Townsville, Australia; James Cook University - Bebegu Yumba Campus, Townsville, Australia.
Radiother Oncol. 2022 Feb;167:49-56. doi: 10.1016/j.radonc.2021.11.032. Epub 2021 Dec 7.
There are several options for real-time prostate monitoring during radiation therapy including fiducial markers (FMs) and transperineal ultrasound (TPUS). However, the patient experience for these procedures is very different. This study aimed to determine patient preferences around various aspects of prostate image-guidance, focusing on FMs and TPUS.
A discrete choice experiment (DCE) was conducted, describing the image-guidance approach by: pain, cost, accuracy, side effects, additional appointments, and additional time. Participants were males with prostate cancer (PCa) and from the general Australian population. A DCE survey required participants to make hypothetical choices in each of 8 choice sets. Multinomial logit modelling and Latent Class Analysis (LCA) were used to analyse the responses. Marginal willingness to pay (mWTP) was calculated.
476 respondents completed the survey (236 PCa patients and 240 general population). The most important attributes for both cohorts were pain, cost and accuracy (p < 0.01). PCa patients were willing to pay more to avoid the worst pain than the general population, and willing to pay more for increased accuracy. LCA revealed 3 groups: 2 were focused more on the process-related attributes of pain and cost, and the third was focused on the clinical efficacy attributes of accuracy and side effects.
Both cohorts preferred less cost and pain and improved accuracy, with men with PCa valuing accuracy more than the general population. In addition to the clinical and technical evidence, radiation oncology centres should consider the preferences of patients when considering choice of image-guidance techniques.
在放射治疗过程中有几种实时前列腺监测选项，包括基准标记物（FMs）和经会阴超声（TPUS）。然而，这些程序的患者体验非常不同。本研究旨在确定患者对各种前列腺图像引导方法的偏好，重点是 FMs 和 TPUS。
进行了离散选择实验（DCE），通过疼痛、成本、准确性、副作用、额外预约和额外时间来描述图像引导方法。参与者为患有前列腺癌（PCa）的男性和来自普通澳大利亚人群的男性。DCE 调查要求参与者在每个 8 个选择集中进行假设选择。多项逻辑回归模型和潜在类别分析（LCA）用于分析响应。计算了边际意愿支付（mWTP）。
476 名受访者完成了调查（236 名 PCa 患者和 240 名普通人群）。对于两个队列来说，最重要的属性都是疼痛、成本和准确性（p<0.01）。PCa 患者愿意支付更多费用来避免最严重的疼痛，而不是普通人群，并且愿意支付更多费用来提高准确性。LCA 揭示了 3 个群体：2 个群体更关注与过程相关的疼痛和成本属性，第三个群体更关注准确性和副作用等临床疗效属性。
两个队列都更喜欢成本更低、疼痛更小和准确性更高，而患有 PCa 的男性比普通人群更重视准确性。除了临床和技术证据外，放射肿瘤学中心在考虑图像引导技术的选择时，还应考虑患者的偏好。
