Patient and General Population Preferences Regarding the Benefits and Harms of Treatment for Metastatic Prostate Cancer: A Discrete Choice Experiment
Background: Patient preferences for treatment outcomes are important to guide decision-making in clinical practice, but little is known about the preferences of patients with metastatic hormone-sensitive prostate cancer (mHSPC). Objective: To evaluate patient preferences regarding the attributed ben...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | European Urology Open Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666168323001258 |
| _version_ | 1797836917050441728 |
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| author | Dominik Menges Michela C. Piatti Aurelius Omlin Richard Cathomas Daniel Benamran Stefanie Fischer Christophe Iselin Marc Küng Anja Lorch Lukas Prause Christian Rothermundt Alix O'Meara Stern Deborah Zihler Max Lippuner Julia Braun Thomas Cerny Milo A. Puhan |
| author_facet | Dominik Menges Michela C. Piatti Aurelius Omlin Richard Cathomas Daniel Benamran Stefanie Fischer Christophe Iselin Marc Küng Anja Lorch Lukas Prause Christian Rothermundt Alix O'Meara Stern Deborah Zihler Max Lippuner Julia Braun Thomas Cerny Milo A. Puhan |
| author_sort | Dominik Menges |
| collection | DOAJ |
| description | Background: Patient preferences for treatment outcomes are important to guide decision-making in clinical practice, but little is known about the preferences of patients with metastatic hormone-sensitive prostate cancer (mHSPC). Objective: To evaluate patient preferences regarding the attributed benefits and harms of systemic treatments for mHSPC and preference heterogeneity between individuals and specific subgroups. Design, setting, and participants: We conducted an online discrete choice experiment (DCE) preference survey among 77 patients with metastatic prostate cancer (mPC) and 311 men from the general population in Switzerland between November 2021 and August 2022. Outcome measurements and statistical analysis: We evaluated preferences and preference heterogeneity related to survival benefits and treatment-related adverse effects using mixed multinomial logit models and estimated the maximum survival time participants were willing to trade to avert specific adverse effects. We further assessed characteristics associated with different preference patterns via subgroup and latent class analyses. Results and limitations: Patients with mPC showed an overall stronger preference for survival benefits in comparison to men from the general population (p = 0.004), with substantial preference heterogeneity between individuals within the two samples (both p < 0.001). There was no evidence of differences in preferences for men aged 45–65 yr versus ≥65 yr, patients with mPC in different disease stages or with different adverse effect experiences, or general population participants with and without experiences with cancer. Latent class analyses suggested the presence of two groups strongly preferring either survival or the absence of adverse effects, with no specific characteristic clearly associated with belonging to either group. Potential biases due to participant selection, cognitive burden, and hypothetical choice scenarios may limit the study results. Conclusions: Given the relevant heterogeneity in participant preferences regarding the benefits and harms of treatment for mHSPC, patient preferences should be explicitly discussed during decision-making in clinical practice and reflected in clinical practice guidelines and regulatory assessment regarding treatment for mHSPC. Patient summary: We examined the preferences (values and perceptions) of patients and men from the general population regarding the benefits and harms of treatment for metastatic prostate cancer. There were large differences between men in how they balanced the expected survival benefits and potential adverse effects. While some men strongly valued survival, others more strongly valued the absence of adverse effects. Therefore, it is important to discuss patient preferences in clinical practice. |
| first_indexed | 2024-04-09T15:16:34Z |
| format | Article |
| id | doaj.art-e0c1e180eac24f009c233291a5887f69 |
| institution | Directory Open Access Journal |
| issn | 2666-1683 |
| language | English |
| last_indexed | 2024-04-09T15:16:34Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Urology Open Science |
| spelling | doaj.art-e0c1e180eac24f009c233291a5887f692023-04-29T14:58:28ZengElsevierEuropean Urology Open Science2666-16832023-05-01512638Patient and General Population Preferences Regarding the Benefits and Harms of Treatment for Metastatic Prostate Cancer: A Discrete Choice ExperimentDominik Menges0Michela C. Piatti1Aurelius Omlin2Richard Cathomas3Daniel Benamran4Stefanie Fischer5Christophe Iselin6Marc Küng7Anja Lorch8Lukas Prause9Christian Rothermundt10Alix O'Meara Stern11Deborah Zihler12Max Lippuner13Julia Braun14Thomas Cerny15Milo A. Puhan16Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; Corresponding author. Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland. Tel. +41 44 6344615.Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, SwitzerlandDepartment of Medical Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Onkozentrum Zürich, Zurich, SwitzerlandDivision of Oncology/Hematology, Kantonsspital Graubünden, Chur, SwitzerlandDepartment of Urology, Hôpitaux Universitaires Genève, Geneva, SwitzerlandDepartment of Medical Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, SwitzerlandDepartment of Urology, Hôpitaux Universitaires Genève, Geneva, SwitzerlandDepartment of Oncology, Hôpital Cantonal Fribourg, Fribourg, SwitzerlandDepartment of Medical Oncology and Hematology, University Hospital Zurich, Zurich, SwitzerlandDepartment of Urology, Kantonsspital Aarau, Aarau, SwitzerlandDepartment of Medical Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, SwitzerlandDepartment of Oncology, Réseau Hospitalier Neuchâtelois, Neuchâtel, SwitzerlandDepartment of Oncology, Hematology and Transfusion Medicine, Kantonsspital Aarau, Aarau, SwitzerlandEuropa Uomo Switzerland, Ehrendingen, SwitzerlandEpidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, SwitzerlandFoundation Board, Cancer Research Switzerland, Bern, Switzerland; Human Medicines Expert Committee, Swissmedic, Bern, SwitzerlandEpidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, SwitzerlandBackground: Patient preferences for treatment outcomes are important to guide decision-making in clinical practice, but little is known about the preferences of patients with metastatic hormone-sensitive prostate cancer (mHSPC). Objective: To evaluate patient preferences regarding the attributed benefits and harms of systemic treatments for mHSPC and preference heterogeneity between individuals and specific subgroups. Design, setting, and participants: We conducted an online discrete choice experiment (DCE) preference survey among 77 patients with metastatic prostate cancer (mPC) and 311 men from the general population in Switzerland between November 2021 and August 2022. Outcome measurements and statistical analysis: We evaluated preferences and preference heterogeneity related to survival benefits and treatment-related adverse effects using mixed multinomial logit models and estimated the maximum survival time participants were willing to trade to avert specific adverse effects. We further assessed characteristics associated with different preference patterns via subgroup and latent class analyses. Results and limitations: Patients with mPC showed an overall stronger preference for survival benefits in comparison to men from the general population (p = 0.004), with substantial preference heterogeneity between individuals within the two samples (both p < 0.001). There was no evidence of differences in preferences for men aged 45–65 yr versus ≥65 yr, patients with mPC in different disease stages or with different adverse effect experiences, or general population participants with and without experiences with cancer. Latent class analyses suggested the presence of two groups strongly preferring either survival or the absence of adverse effects, with no specific characteristic clearly associated with belonging to either group. Potential biases due to participant selection, cognitive burden, and hypothetical choice scenarios may limit the study results. Conclusions: Given the relevant heterogeneity in participant preferences regarding the benefits and harms of treatment for mHSPC, patient preferences should be explicitly discussed during decision-making in clinical practice and reflected in clinical practice guidelines and regulatory assessment regarding treatment for mHSPC. Patient summary: We examined the preferences (values and perceptions) of patients and men from the general population regarding the benefits and harms of treatment for metastatic prostate cancer. There were large differences between men in how they balanced the expected survival benefits and potential adverse effects. While some men strongly valued survival, others more strongly valued the absence of adverse effects. Therefore, it is important to discuss patient preferences in clinical practice.http://www.sciencedirect.com/science/article/pii/S2666168323001258Adverse effectsBenefitBenefit-harm assessmentDiscrete choice experimentHarmMetastasis |
| spellingShingle | Dominik Menges Michela C. Piatti Aurelius Omlin Richard Cathomas Daniel Benamran Stefanie Fischer Christophe Iselin Marc Küng Anja Lorch Lukas Prause Christian Rothermundt Alix O'Meara Stern Deborah Zihler Max Lippuner Julia Braun Thomas Cerny Milo A. Puhan Patient and General Population Preferences Regarding the Benefits and Harms of Treatment for Metastatic Prostate Cancer: A Discrete Choice Experiment European Urology Open Science Adverse effects Benefit Benefit-harm assessment Discrete choice experiment Harm Metastasis |
| title | Patient and General Population Preferences Regarding the Benefits and Harms of Treatment for Metastatic Prostate Cancer: A Discrete Choice Experiment |
| title_full | Patient and General Population Preferences Regarding the Benefits and Harms of Treatment for Metastatic Prostate Cancer: A Discrete Choice Experiment |
| title_fullStr | Patient and General Population Preferences Regarding the Benefits and Harms of Treatment for Metastatic Prostate Cancer: A Discrete Choice Experiment |
| title_full_unstemmed | Patient and General Population Preferences Regarding the Benefits and Harms of Treatment for Metastatic Prostate Cancer: A Discrete Choice Experiment |
| title_short | Patient and General Population Preferences Regarding the Benefits and Harms of Treatment for Metastatic Prostate Cancer: A Discrete Choice Experiment |
| title_sort | patient and general population preferences regarding the benefits and harms of treatment for metastatic prostate cancer a discrete choice experiment |
| topic | Adverse effects Benefit Benefit-harm assessment Discrete choice experiment Harm Metastasis |
| url | http://www.sciencedirect.com/science/article/pii/S2666168323001258 |
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