PSS30 - Patient Preferences In The Treatment of Periodontal Disease: Multi-Dimensionality and Validity

Abstract

Parodontopathies refer to all inflammatory diseases of the tooth retaining apparatus. Various treatments are available for therapy. So far, it is unclear which patient-relevant endpoints determine the benefit of treatments. The aim of the study is to document the relative importance of patient-relevant endpoints for therapies in periodontal disease. In addition, it will be examined to what extent changing decision criteria influence the validity of Discrete Choice Experiments (DCE). Two randomized online-supported DCEs with different decision models were performed. For each model, six patient-relevant endpoints were considered as attributes for morbidity and side effects of the therapy. "Tooth loosening/tooth loss" was presented as a multi-dimensional attribute with varying severity and the number of teeth concerned. The data were analyzed by Random Parameter Logit (RPL) model and Latent Class (LC) model. Data from N=627 participants (Model1:N=309, Model2:N=318) were evaluated. The results of the RPL-model show in both DCEs that decisions were significantly influenced from "tooth loosening/tooth loss" (Model1:Koef.:0.827; Model2:Coef.:0.885). In the two questionnaire versions, the attributes "tooth loosening/tooth loss", "gum bleeding", "pain in everyday life" and "pain by the therapy" occupied the front ranks and influenced the patients benefit most. Significant standard deviations (p<0.01) for "tooth loosening/tooth loss", "pain" and "performing the treatment" were indicative of heterogeneity in the sample. The study analyzed patients' preferences in the treatment of periodontal disease. From the perspective of patients, avoidance of tooth loosening/tooth loss and pain are the most important criteria in the treatment. It was also shown that the side effects as well as the performance of the therapy influence the evaluation of the patients to a lesser degree. The LC model revealed preference differences in the subgroups. In both DCEs, one class whose decisions were mainly influenced by the "tooth loosening/tooth loss" was identified. In each other class „pain“ was more important.