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患者对转移性结直肠癌治疗的偏好:使用离散选择实验和最佳-最差缩放的多方法方法方法

Carina Oedingen¹, Karen V MacDonald¹, Barry D Stein²

¹Department of Community Health Sciences, Cumming School of Medicine, Health Research Innovation Centre (HRIC) - 3C56, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.

|July 29, 2025

概括

患有转移性结直肠癌 (mCRC) 的患者优先考虑生存和生活质量. 对治疗属性的偏好各不相同,这凸显了在医疗技术评估 (HTA) 中以患者为中心的决策的需要.

科学领域:

在瘤学瘤学.
卫生经济学卫生经济学
患者报告的结果

背景情况:

转移性结直肠癌 (mCRC) 治疗决策涉及平衡生存时间,生活质量 (HRQoL) 和副作用.
患者的定量偏好至关重要,但尚未被纳入医疗技术评估 (HTA) 中,用于药物报销.

研究的目的:

探索将患者的定量偏好纳入癌症治疗的HTA决策.
通过多方法方法,在加拿大的mCRC患者中引起治疗偏好和风险耐受性.

主要方法:

开发了一项采用离散选择实验 (DCE) 和最佳-最差缩放 (BWS-1) 的调查.
DCE评估了对HRQoL,生存,施用,频率和副作用的偏好.
BWS-1评估了对25种潜在的mCRC治疗副作用的耐受性.
对加拿大127名mCRC患者进行了调查;使用混合logit,潜伏类和计数模型分析数据.

主要成果:

患者对整体存活率和HRQoL的估值几乎相同.
喜欢更好的结果 (更长的无进展生存期,没有副作用),而不是更糟糕的结果.
与静脉注射相比,口服囊的表达不实用性.
根据患者的经验和健康状况观察到显著的偏好异质性.
最能容忍的副作用包括疲劳和活动限制;最不能容忍的包括严重的症状,如吐和疼痛,需要协助.

结论:

一个多方法方法有效地评估患者的偏好和风险承受能力在mCRC.
这些发现为将患者的观点纳入加拿大HTA框架提供了坚实的基础.
结果将为未来的努力提供信息,将患者的偏好纳入癌症治疗HTA决策.

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