School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China; Center for Social Science Survey and Data, Tianjin University, Tianjin, China.
School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China; Center for Social Science Survey and Data, Tianjin University, Tianjin, China.
Value Health. 2022 Oct;25(10):1768-1777. doi: 10.1016/j.jval.2022.05.003. Epub 2022 Jun 14.
This study aimed to compare the treatment preference among oncologists, patients with lung cancer, and their family members in China.
A face-to-face discrete choice experiment survey was conducted among oncologists, patients, and their family members. Participants completed 13 choice sets describing 6 key attributes, namely, overall survival time, risk of severe adverse effect, severity of pain, appetite, physical functioning status, and monthly cost. Mixed logit model and latent class analysis were used to estimate attribute level preference weights and the relative importance (RI) for attributes. The willingness to pay (WTP) and maximum acceptable risk (MAR) were also estimated. The RI, WTP, and MAR of oncologists, patients, and family members were compared.
A total of 121 oncologists and 161 dyads of patients and family members completed the survey. Overall survival time, physical functioning status, and pain were the 3 most important attributes across all 3 groups. Oncologists and family members had higher RI on overall survival time than patients (48% and 51% vs 38%). Patients had higher RI on physical functioning status and pain (23% and 14%) than oncologists (13% and 12%) and family members (16% and 11%). For extending survival, patients had the least WTP, and family members had the highest MAR. The latent class analysis identified 2 classes in the patient group and 3 classes in oncologist and family member groups.
There were differences in preferences for survival, risk, quality of life, and costs associated with cancer treatments among patients, oncologists, and family members. This finding highlights the need of involving patients in treatment decision making in China.
本研究旨在比较中国肿瘤医生、肺癌患者及其家属对治疗方案的偏好。
采用面对面离散选择实验调查了肿瘤医生、患者及其家属。参与者完成了 13 个选择集，描述了 6 个关键属性，即总生存时间、严重不良事件风险、疼痛严重程度、食欲、身体功能状态和每月费用。采用混合 logit 模型和潜在类别分析来估计属性水平偏好权重和属性的相对重要性（RI）。还估计了支付意愿（WTP）和最大可接受风险（MAR）。比较了肿瘤医生、患者和家属的 RI、WTP 和 MAR。
共纳入 121 名肿瘤医生和 161 对患者-家属。在所有 3 组中，总生存时间、身体功能状态和疼痛是 3 个最重要的属性。肿瘤医生和家属对总生存时间的 RI 高于患者（48%和 51%比 38%）。患者对身体功能状态和疼痛的 RI 高于肿瘤医生（23%和 14%比 13%和 12%）和家属（16%和 11%）。对于延长生存时间，患者的 WTP 最低，家属的 MAR 最高。潜在类别分析在患者组中确定了 2 个类别，在肿瘤医生和家属组中确定了 3 个类别。
患者、肿瘤医生和家属对癌症治疗相关的生存、风险、生活质量和成本的偏好存在差异。这一发现强调了在中国需要让患者参与治疗决策。
