Developing a Novel Values Elicitation Measure for Clinical Use in Older Adults with Hematologic Malignancies:...

Introduction. The recent expansion of treatment options for older adults with blood cancers has increased the necessity for understanding patient preferences and values to inform treatment decision making. Currently, no values elicitation measures have been validated for clinical use in this population. Values-HM (Values elicitation measure for Hematologic Malignancies) is a novel values elicitation measure based on best-worst scaling. It was developed specifically for older adults with blood cancers involving multiple stakeholders including patients, caregivers, and clinicians. Objective. The objective of this study was to test the preliminary validity, reliability, and acceptability of this measure for clinical use based on US Food and Drug Administration and International Society for Pharmacoeconomics and Outcomes Research guidance. Results. Twenty-nine adults aged ≥60 y with newly diagnosed lymphoma, leukemia, myelodysplastic syndrome, and multiple myeloma were enrolled. Most patients were White (97%). Most patients (88%) felt that the measure was relevant to them, showed their real preferences (73%), and was acceptable to clarify their preferences (68%). The measure demonstrated discriminant validity of importance scores and convergent validity for most patients (77%) with a ranking exercise of the treatment values. Cognitive interviews with 10 participants suggested question comprehension, outcome understanding, and appropriate judgment. Data from 18 participants who completed the measure more than once provide some evidence for the reliability of the measure to capture repeated values over time. Conclusions. These initial data suggest that Values-HM may be acceptable to patients and valid and reliable to capture patient values. Additional data are needed to confirm these findings in a larger and more diverse sample. This trial was registered at www.clinicaltrials.gov as #NCT05061095.

Values-HM is a novel values elicitation measure designed based on best-worst scaling for adults with blood cancers.Values-HM appears to be acceptable to patients and may be valid and reliable to capture patient values in clinical care.