scholarly journals Patient preferences for the pharmacological treatment of osteoarthritis using adaptive choice-based conjoint (ACBC) analysis: A pilot study

2017 ◽  
Vol 5 (2) ◽  
pp. 220 ◽  
Author(s):  
Basem Al-Omari
Keyword(s):  
Pilot Study ◽  
Side Effects ◽  
Patient Preferences ◽  
Side Effect ◽  
Heart Attack ◽  
Hierarchical Bayes ◽  
Relative Importance ◽  
Pharmaceutical Treatment ◽  
Services Research ◽  
Adaptive Choice

Background: Patient preferences for pharmaceutical treatment of osteoarthritis have been investigated using Conjoint Analysis. Studies have identified the importance of side effects in determining preferences, but noted that methodological limitations precluded further investigation of additional attributes such as hepatic and renal toxicity.Objective: Following on from a feasibility study of adaptive choice-based conjoint (ACBC) analysis, the aim of this study was to evaluate 8 medication attributes for the pharmaceutical treatment of osteoarthritis (OA).Setting and Participants: Eleven participants were recruited from members of a Research Users’ Group (RUG) who had been diagnosed with osteoarthritis. RUG members individually complete the ACBC task. Main outcome measures: The relative importance of each attribute and the utilities (part-worth) of each level of each attribute were estimated using ACBC built-in Hierarchical Bayes (HB).Results: The combined relative importance of the 4 risk side-effect attributes when selecting osteoarthritis medication (kidney and liver side effects, heart attack and stroke side effects, stomach side effects and addiction) was 66% while the effectiveness attribute accounted for 8% of the relative importance of the medication decision.Conclusions: In this study, the gap between relative importance of 4 side-effect attributes and expected benefit was 66% vs 8%. These preliminary findings indicate that OA patients are most concerned with the avoidance of adverse events and that there is a threshold above which expected benefit has little impact on patients’ medication preferences. The study highlights methodological features of ACBC that may be useful more generally in health services research, but the results must be interpreted in conjunction with the study limitations.

scholarly journals Patient Preferences: Results of a German Adaptive Choice-Based Conjoint Analysis (Market Research Study Sponsored by Eli Lilly and Company) in Patients on Palliative Treatment for Advanced Breast Cancer

Breast Care ◽  
2021 ◽  
pp. 1-9
Author(s):  
Mattea Reinisch ◽  
Norbert Marschner ◽  
Thorsten Otto ◽  
Agnieszka Korfel ◽  
Clemens Stoffregen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Advanced Breast Cancer ◽  
Patient Preferences ◽  
Advanced Breast ◽  
Line Treatment ◽  
Second Line ◽  
Quantitative Survey ◽  
Therapy Assessment ◽  
Adaptive Choice

<b><i>Introduction:</i></b> Integration of patient preferences into shared decision making improves disease-related outcomes, but such data from patients with advanced breast cancer (aBC) are limited. The objective of this study was to demonstrate the relative importance of overall survival (OS) and progression-free survival (PFS) in relation to quality of life (QoL) and therapy-associated side effects from the perspective of patients with aBC. <b><i>Methods:</i></b> Postmenopausal patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative aBC receiving first- or second-line treatment were recruited throughout Germany. Patient-relevant attributes for aBC therapy assessment were collected using a stepwise multimodal approach. A conjoint matrix was developed, resulting in 2 attributes for therapy goals (OS and PFS), 4 for QoL, and 6 for side effects. An online quantitative survey was then performed using adaptive choice-based conjoint (ACBC) methodology. <b><i>Results:</i></b> The quantitative survey included 104 patients: 67 (64.4%) receiving first-line treatment and 37 (35.6%) receiving second-line treatment. The QoL attribute “physical agility and mobility” received the highest utility score (19.4 of 100%), reflecting the greatest importance to patients, followed by treatment goals (OS [15.2%] and PFS [14.4%]). Therapy-related side effects were less important, with nausea/vomiting being the most important (9.3%), followed by infection (6.4%) and hair loss (5.0%). The McFadden pseudo <i>R</i><sup>2</sup> (0.805), the root likelihood (0.864), and the χ<sup>2</sup> test (2,809.041; <i>p</i> &#x3c; 0.0001) indicated a very good fit of the statistical model. <b><i>Conclusion:</i></b> Using ACBC analysis, it appears that QoL, OS, and PFS are most important to postmenopausal patients with aBC in relation to cancer treatment. Side effects seem to be less important if OS or PFS are prolonged and the QoL is maintained. Thus, QoL, OS, and PFS should be considered equally when making treatment decisions in aBC.

scholarly journals Intentional Side-Effects of Action

2013 ◽  
Vol 10 (2) ◽  
pp. 179-203 ◽  
Author(s):  
Robin Scaife ◽  
Jonathan Webber
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Experimental Philosophy ◽  
Alternative Interpretation ◽  
Previous Literature ◽  
Relative Importance ◽  
Consensus View ◽  
Broad Consensus

Certain recent experiments are often taken to show that people are far more likely to classify a foreseen side-effect of an action as intentional when that side-effect has some negative normative valence. While there is some disagreement over the details, there is broad consensus among experimental philosophers that this is the finding. We challenge this consensus by presenting an alternative interpretation of the experiments, according to which they show that a side-effect is classified as intentional only if the agent considered its relative importance when deciding on the action. We present two new experiments whose results can be explained by our hypothesis but not by any version of the consensus view. In the course of doing so, we develop a methodological critique of the previous literature on this topic and draw from it lessons for future experimental philosophy research.

scholarly journals Assessing Patient Preferences for the Benefits and Risks of Treating for Acute Myeloid Leukemia (AML): A Pilot Study

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4799-4799 ◽  
Author(s):  
Jaein Seo ◽  
B. Douglas Smith ◽  
Elihu H. Estey ◽  
Ernest S. Voyard ◽  
Bernadette O'Donoghue ◽  
...  
Keyword(s):  
Pilot Study ◽  
Side Effects ◽  
Patient Preferences ◽  
Myeloid Leukemia ◽  
Research Funding ◽  
Z Score ◽  
Short Term ◽  
Stakeholder Committee ◽  
Society Research

Abstract Introduction:Acute Myeloid Leukemia (AML) is a blood cancer which progresses rapidly in the absence of treatment. There have been few advances in the treatment of AML over the last three decades. In 2015 the Leukemia and Lymphoma Society (LLS) initiated a research program to assess patient preferences for AML treatments. The aim of this research was to promote patient-focused drug development and inform future regulatory decisions. We sought to develop and pilot a patient-centered survey instrument to assess patient preferences for the benefits and risks of AML treatments. Methods: Development was informed by a targeted literature review and engagement with an expert stakeholder committee (n=12) to guide the clinical accuracy and relevance of the survey instrument. A community stakeholder committee, consisting of patients with AML and caregivers (n=15), provided information about their experiences with AML and various treatments. They also engaged in pretest interviews to test comprehension and ensure it captured the patient experience. A discrete-choice experiment (DCE) was developed spanning 5 benefits and risks, including event-free survival (EFS), complete remission (CR), time in hospital, short-term side effects, and long-term side effects. This DCE consisted of 16 pairs of hypothetical treatments, with participants being asked to identify which treatment they would prefer in each pair. Results of a pilot study with AML patients and caregivers were assessed by Z-score that were derived from a conditional logistic model regressing each attribute upon their choices. Results: The pilot included 18 patients and 8 caregivers with a mean age of 50 years (range=24-81). Most participants were college educated (n=22), Caucasian (n=19), privately insured (n=21), and employed (n=13). Participants valued CR the most (Z-score=7.95, p<0.001), followed by EFS (5.32, p<0.001). They were most averse to time in hospital (-3.41, p=0.001), followed by long-term side effects (-3.03, p=0.002) and short-term side effects (-1.99, p=0.047), which was marginally significant. Conclusions: This study demonstrates the value of rigorous community engagement in developing survey instruments to measure patient preferences. The results of this pilot study demonstrate the ability of our DCE to measure treatment preferences of AML patients and caregivers. Given this success, we are currently engaged in a nationally study where we will recruit a larger and more diverse sample. The results of this national study will inform drug developers and regulatory decision makers. Disclosures Seo: The Leukemia & Lymphoma Society: Research Funding. Voyard:The Leukemia & Lymphoma Society: Employment. O'Donoghue:The Leukemia & Lymphoma Society: Employment. Bridges:The Leukemia & Lymphoma Society: Research Funding.

An Innovative Approach to Clinical Communication in Schizophrenia: The Approaches to Schizophrenia Communication Checklists

CNS Spectrums ◽  
2001 ◽  
Vol 6 (4) ◽  
pp. 333-338 ◽  
Author(s):  
Sharon G. Dott ◽  
Peter Weiden ◽  
Penelope Hopwood ◽  
A. George Awad ◽  
Jonathan S.E. Hellewell ◽  
...  
Keyword(s):  
Pilot Study ◽  
Side Effects ◽  
Side Effect ◽  
Treatment Compliance ◽  
Structured Interview ◽  
Self Report ◽  
Antipsychotic Treatment ◽  
Healthcare Team ◽  
Preliminary Evaluation ◽  
Busy Clinical Setting

ABSTRACTSide effects from antipsychotic medications can have a profound effect on patients' lives and may adversely affect their willingness to comply with treatment. Identification of side effects through improved communication between psychiatrists, other members of the healthcare team, and their patients might increase treatment compliance. The Approaches to Schizophrenia Communication (ASC) Steering Group developed two simple, practical checklists for use in the busy clinical setting. The ASC–Self-Report (ASC-SR) checklist is completed by the patient and comprises a list of the more common or clinically important side effects of antipsychotic treatment. The ASC-Clinic (ASC-C) checklist is completed by both clinician and patient together, being used as the basis for a semi-structured interview. In a multicenter pilot study set up to evaluate the utility of checklists, 86% of patients responding considered the ASC-SR to be useful in communicating their problems to psychiatrists and other members of the healthcare team. All healthcare team respondents found both checklists to be helpful when discussing side effect problems with their patients. Moreover, 41% and 47% of healthcare team respondents reported that the ASC-SR and ASC-C, respectively, had assisted them in identifying side-effect problems not previously acknowledged. Preliminary evaluation of the ASC-SR and ASC-C in this multicenter pilot study suggests that both tools were user-friendly, encouraged communication between patients and healthcare professionals about antipsychotic drug side effects, and could readily integrated into everyday clinical practice.

scholarly journals Understanding children’s preference for park features that encourage physical activity: an adaptive choice based conjoint analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jenny Veitch ◽  
Kylie Ball ◽  
Elise Rivera ◽  
Venurs Loh ◽  
Benedicte Deforche ◽  
...  
Keyword(s):  
Physical Activity ◽  
Conjoint Analysis ◽  
Primary Schools ◽  
Open Space ◽  
Hierarchical Bayes ◽  
Relative Importance ◽  
Importance Score ◽  
Adaptive Choice ◽  
Large Round ◽  
Flying Fox

Abstract Background Parks are a key setting for physical activity for children. However, little is known about which park features children prefer and which features are most likely to encourage them to be active in parks. This study examined the relative importance of park features among children for influencing their choice of park for engaging in park-based physical activity. Methods Children (n = 252; 8-12 years, 42% male) attending three primary schools in Melbourne, Australia completed a survey at school. They were required to complete a series of Adaptive Choice-Based Conjoint analysis tasks, with responses used to identify the part-worth utilities and relative importance scores of selected park features using Hierarchical Bayes analyses within Sawtooth Software. Results For the overall sample and both boys and girls, the most important driver of choice for a park that would encourage them to be active was presence of a flying fox (overall conjoint analysis relative importance score: 15.8%; 95%CI = 14.5, 17.1), followed by a playground (13.5%; 95%CI = 11.9, 15.2). For the overall sample, trees for climbing had the third highest importance score (10.2%; 95%CI = 8.9, 11.6); however, swings had 3rd highest importance for girls (11.1, 95%CI = 9.3, 12.9) and an obstacle course/parkour area had the 3rd highest importance score for boys (10.7, 95%CI = 9.0, 12.4). For features with two levels, part-worth utility scores showed that the presence of a feature was always preferred over the absence of a feature. For features with multiple levels, long flying foxes, large adventure playgrounds, lots of trees for climbing, large round swings, large climbing equipment, and large grassy open space were the preferred levels. Conclusion To ensure parks appeal as a setting that encourages children to engage in physical activity, park planners and local authorities and organisations involved in park design should prioritise the inclusion of a long flying fox, large adventure playgrounds, lots of trees for climbing, large round swings and obstacle courses/parkour areas.

Adjustment of the UKU Side Effect Rating Scale for adults with intellectual disabilities. A pilot study

2014 ◽  
Vol 8 (4) ◽  
pp. 260-267 ◽  
Author(s):  
Anne Louise Tveter ◽  
Trine Lise Bakken ◽  
Jørgen G. Bramness ◽  
Jan Ivar Røssberg
Keyword(s):  
Pilot Study ◽  
Side Effects ◽  
Intellectual Disabilities ◽  
Psychotropic Medication ◽  
Side Effect ◽  
Patient Population ◽  
Rating Scale ◽  
Expert Panel ◽  
Subjective Experiences ◽  
Content Type

Purpose – Patients with intellectual disabilities (ID) and additional psychiatric disorders are often treated with psychotropic medication. However, examinations of side effects among these patients are scarce. The purpose of this pilot study is to examine the most frequently used side effect scale, UKU Side Effect Rating Scale (UKU-SERS), in this patient population. Design/methodology/approach – The aim of the present study is to explore whether the UKU-SERS is feasible for patients with ID. The UKU-SERS consists originally of 48 items, measuring side effects of psychotropic medication. In the study, UKU-SERS was used to score a group of 13 adults with ID admitted to a specialised inpatient psychiatric unit. First, an expert panel of seven psychiatrists and five psychiatric nurses independently evaluated the UKU-SERS and decided which items they considered possible to score after observation alone. Second, a total of 26 staff members, based on observation, scored the 13 patients on the ward. These results were used as the basis for recommending items from UKU-SERS to be used. Items scored differently by the two groups were examined more thoroughly. Findings – The expert panel and the ward staff agreed on 24 of the original 48 UKU-SERS items. The other 24 items were examined more thoroughly based on clinical meaningfulness. Consequently, 11 more items were included despite disagreement in the scorer groups. As expected, items that are based on observations seem more feasible than items based on the patients’ subjective experiences. Originality/value – The revised checklist comprises 35 items and seems applicable for further research and for use in clinical settings for this patient population. It is possible to observe important side effects using the UKU Side Effect Scale, but adjustment of the scale is desirable to make it more appropriate for the specific purpose and target group.

scholarly journals Platelet polyphosphate and SARS-Cov-2 mRNA-vaccine-induced inflammatory side-effects: a pilot study

2021 ◽  
Author(s):  
Takashi Uematsu ◽  
Atsushi Sato ◽  
Hachidai Aizawa ◽  
Tetsuhiro Tsujino ◽  
Taisuke Watanabe ◽  
...  
Keyword(s):  
Pilot Study ◽  
Side Effects ◽  
Immune Cells ◽  
Initial Dose ◽  
Side Effect ◽  
White Blood Cells ◽  
Small Sample ◽  
Continuous Treatment ◽  
Female Group ◽  
Male Group

Abstract Background: Platelets have recently been recognized as immune cells. Platelets first contact invading pathogens and then induce immune reactions in cooperation with white blood cells. Platelet polyphosphate (polyP), which is classically recognized as a thrombotic and hemostatic biomolecule, has recently attracted attention as a cytokine that modulates inflammation and is involved in intercellular communication between platelets and major immune cells. Objective: To determine the involvement of polyP in SARS-Cov-2-mRNA vaccine-induced immune responses, this pilot study examined the effects of mRNA vaccines on platelet polyP levels. Methods: Before and after vaccination (BNT162b2), blood samples were obtained from healthy, non-smoking individuals (relatively older male group, n=6 vs. younger female group, n=23), who did not have systemic diseases that required continuous treatment. Washed platelets were prepared and subjected to a fluorometric determination of platelet polyP levels using 4',6-diamidino-2-phenylindole. The side effects of vaccination were recorded as scores. Results: Compared with the male group, platelet polyP levels decreased in the relatively younger female group after the initial dose, while the side effect score increased in the female group after the second dose. Moderate correlation coefficients were observed between the reduction in polyP levels and the side effect scores or the original polyP levels. Conclusions: Despite being a pilot study using a small sample size, this study suggests the possibility that platelet polyP may suppress the side effects induced by the mRNA vaccines after the initial dose, but not the second dose, in relatively young female subjects who generally have high immune responsiveness.

Cutaneous ulcers following hydroxyurea therapy

Phlebologie ◽  
2004 ◽  
Vol 33 (06) ◽  
pp. 202-205 ◽  
Author(s):  
K. Hartmann ◽  
S. Nagel ◽  
T. Erichsen ◽  
E. Rabe ◽  
K. H. Grips ◽  
...  
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Antineoplastic Agent ◽  
Limited Time ◽  
Myeloproliferative Diseases ◽  
Dermatological Side Effects ◽  
Chronic Myeloproliferative Diseases ◽  
Hydroxyurea Therapy

SummaryHydroxyurea (HU) is usually a well tolerated antineoplastic agent and is commonly used in the treatment of chronic myeloproliferative diseases. Dermatological side effects are frequently seen in patients receiving longterm HU therapy. Cutaneous ulcers have been reported occasionally.We report on four patients with cutaneous ulcers whilst on long-term hydroxyurea therapy for myeloproliferative diseases. In all patients we were able to reduce the dose, or stop HU altogether and their ulcers markedly improved. Our observations suggest that cutaneous ulcers should be considered as possible side effect of long-term HU therapy and healing of the ulcers can be achieved not only by cessation of the HU treatment, but also by reducing the dose of hydroxyurea for a limited time.

scholarly journals Side effects of the metacognitive training for depression compared to a cognitive remediation training in patients with depression

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mona Dietrichkeit ◽  
Marion Hagemann-Goebel ◽  
Yvonne Nestoriuc ◽  
Steffen Moritz ◽  
Lena Jelinek
Keyword(s):  
Side Effects ◽  
Side Effect ◽  
Statistical Power ◽  
Controlled Trial ◽  
Treatment Options ◽  
Cognitive Remediation ◽  
Negative Effects ◽  
Metacognitive Training ◽  
To Receive

AbstractAlthough awareness of side effects over the course of psychotherapy is growing, side effects are still not always reported. The purpose of the present study was to examine side effects in a randomized controlled trial comparing Metacognitive Training for Depression (D-MCT) and a cognitive remediation training in patients with depression. 84 patients were randomized to receive either D-MCT or cognitive remediation training (MyBrainTraining) for 8 weeks. Side effects were assessed after the completion of each intervention (post) using the Short Inventory of the Assessment of Negative Effects (SIAN) and again 6 months later (follow-up) using the Negative Effects Questionnaire (NEQ). D-MCT and MyBrainTraining did not differ significantly in the number of side effects. At post assessment, 50% of the D-MCT group and 59% of the MyBrainTraining group reported at least one side effect in the SIAN. The most frequently reported side effect was disappointment in subjective benefit of study treatment. At follow-up, 52% reported at least one side effect related to MyBrainTraining, while 34% reported at least one side effect related to the D-MCT in the NEQ. The most frequently reported side effects fell into the categories of “symptoms” and “quality”. Our NEQ version was missing one item due to a technical error. Also, allegiance effects should be considered. The sample size resulted in low statistical power. The relatively tolerable number of side effects suggests D-MCT and MyBrainTraining are safe and well-received treatment options for people with depression. Future studies should also measure negative effects to corroborate our results.

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