Menges Dominik, Piatti Michela C, Cerny Thomas, Puhan Milo A
Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland.
Foundation Board, Cancer Research Switzerland (Krebsforschung Schweiz KFS), Bern, Switzerland.
Patient Prefer Adherence. 2022 Jun 28;16:1539-1557. doi: 10.2147/PPA.S362802. eCollection 2022.
Patient preference studies can inform decision-making across all stages of the medical product life cycle (MPLC). The treatment landscape for advanced prostate cancer (APC) treatment has substantially changed in recent years. However, the most patient-relevant aspects of APC treatment remain unclear. This systematic review of patient preference studies in APC aimed to summarize the evidence on patient preferences and patient-relevant aspects of APC treatments, and to evaluate the potential contribution of existing studies to decision-making within the respective stages of the MPLC.
We searched MEDLINE and EMBASE for studies evaluating patient preferences related to APC treatment up to October 2020. Two reviewers independently performed screening, data extraction and quality assessment in duplicate. We descriptively summarized the findings and analyzed the studies regarding their contribution within the MPLC using an analytical framework.
Seven quantitative preference studies were included. One study each was conducted in the marketing approval and the health technology assessment (HTA) and reimbursement stage, and five were conducted in the post-marketing stage of the MPLC. While almost all stated to inform clinical practice, the specific contributions to clinical decision-making remained unclear for almost all studies. Evaluated attributes related to benefits, harms, and other treatment-related aspects and their relative importance varied relevantly between studies. All studies were judged of high quality overall, but some methodological issues regarding sample selection and the definition of patient-relevant treatment attributes were identified.
The most patient-relevant aspects regarding the benefits and harms of APC treatment are not yet established, and it remains unclear which APC treatments are preferred by patients. Findings from this study highlight the importance of transparent reporting and discussion of study findings according to their aims and with respect to their stage within the MPLC. Future research may benefit from using the MPLC framework for analyzing or determining the aims and design of patient preference studies.
患者偏好研究可为医疗产品生命周期（MPLC）各阶段的决策提供参考。近年来，晚期前列腺癌（APC）的治疗格局发生了重大变化。然而，APC治疗中与患者最相关的方面仍不明确。这项对APC患者偏好研究的系统评价旨在总结关于患者偏好及APC治疗中与患者相关方面的证据，并评估现有研究在MPLC各阶段对决策的潜在贡献。
我们检索了MEDLINE和EMBASE数据库中截至2020年10月评估与APC治疗相关患者偏好的研究。两名评审员独立进行重复筛选、数据提取和质量评估。我们对研究结果进行了描述性总结，并使用分析框架分析了这些研究在MPLC中的贡献。
纳入了七项定量偏好研究。在MPLC的上市批准、卫生技术评估（HTA）和报销阶段各有一项研究，在上市后阶段有五项研究。虽然几乎所有研究都表示为临床实践提供参考，但几乎所有研究对临床决策的具体贡献仍不明确。各研究中与益处、危害及其他治疗相关方面相关的评估属性及其相对重要性差异很大。所有研究总体质量被判定为高，但发现了一些关于样本选择和与患者相关治疗属性定义的方法学问题。
APC治疗中与患者最相关的益处和危害方面尚未确定，患者更喜欢哪种APC治疗也仍不清楚。本研究结果强调了根据研究目的并结合其在MPLC中的阶段对研究结果进行透明报告和讨论的重要性。未来的研究可能会受益于使用MPLC框架来分析或确定患者偏好研究的目的和设计。
