Preference Weights Research Articles

The impact of different care dependencies on people’s willingness to provide informal care: a discrete choice experiment in Germany

BackgroundInformal care provided by family members, friends, or neighbors is a major pillar in the German long-term care system. As the number of care-dependent older adults grow, ensuring their future care still relies on the willingness of family members, friends, or neighbors to assume the role of an informal caregiver. This study aimed to investigate the impact on people’s willingness to provide informal care to a close relative with predominately cognitive compared to physical impairments.MethodsAn online survey was distributed to the general population in Germany, which resulted in 260 participants. A discrete choice experiment was created to elicit and quantify people’s preferences. A conditional logit model was used to investigate preferences and marginal willingness-to-accept values were estimated for one hour of informal caregiving.ResultsIncreased care time per day (hours) and expected duration of caregiving were negatively valued by the participants and reduced willingness to care. Descriptions of the two care dependencies had a significant impact on participants’ decisions. Having to provide care to a close relative with cognitive impairments was slightly preferred over caring for a relative with physical impairments.ConclusionsOur study results show the impact of different factors on the willingness to provide informal care to a close relative. How far the preference weights as well as the high willingness-to-accept values for an hour of caregiving can be explained by the sociodemographic structure of our cohort needs to be investigated by further research. Participants slightly preferred caring for a close relative with cognitive impairments, which might be explained by fear or discomfort with providing personal care to a relative with physical impairments or feelings of sympathy and pity towards people with dementia. Future qualitative research designs can help understand these motivations.

P.013 Patient preferences for selection of preventive migraine therapies in Canada: results from a discrete choice experiment

Background: This study assessed the importance of mode of administration relative to other treatment attributes when selecting a preventive migraine therapy. Methods: Cross-sectional study among Canadian adults diagnosed with migraine with ≥5 monthly migraine days and tried ≥2 prescription migraine treatments (any kind/duration). Preferences for treatments varying in the following attributes were evaluated via a discrete choice experiment: speed of efficacy (effective in 24hr/1wk/3mo), duration of efficacy (wears off never/1wk/2 wks before next dose), mode of administration (infusion/auto-injection/cranial injections), administration setting (clinic/home), and administration frequency (1mo/3mo). Attribute-level preference weights were estimated using Hierarchical Bayes modeling. Results: Of 200 respondents, 142 experienced episodic migraine and 58 experienced chronic migraine. Preference weights confirmed that respondents’ most preferred treatments were those that provided fast and long-lasting efficacy (effective in 24hr = 0.59; wears off never = 1.07) and were offered via infusion (0.58) or auto-injection (0.47) over intracranial injection (-1.04). Respondents reported being moderately willing to receive infusions in either a home or clinic setting (1-6 Likert scale from “not at all” to extremely” willing). Conclusions: Second to speed and duration of efficacy, respondents were most concerned with mode of administration when selecting their preferred migraine preventive, suggesting that physicians should consider patient preferences in treatment decision-making.

PATIENT PREFERENCES IN PHARMACEUTICAL AND DEVICE-BASED TREATMENTS FOR UNCONTROLLED HYPERTENSION

Objective: Radiofrequency renal denervation (RDN) safely reduces high blood pressure (BP) in hypertensive (HTN) patients. Patient preference regarding such a treatment over antihypertensive (AH) drugs for uncontrolled HTN is poorly understood. Design and method: A recent discrete choice experiment (DCE) study in patients with uncontrolled HTN identified the reduction in systolic BP as the most important driver of patient preference between interventional treatments (e.g. RDN) or drugs. Using a predictive model consisting of the preference weights for safety and efficacy attributes from the DCE study, we calculated patients’ treatment preferences in 3 typical clinical scenarios in HTN management. Each scenario presented a choice to either initiate/increase AH drugs, or to have interventional treatment such as RDN: (1) AH drug naïve: initiate AH drugs vs. interventional treatment (2) mild-moderate HTN, 1-3 AH drugs: increasing AH drugs vs. intervention with no drug changes, (3) severe HTN (systolic BP >150mmHg, >3 AH drugs): increasing AH drugs vs. intervention with no drug changes. In each scenario, the average predicted probability of choosing one treatment over the other was calculated based on a benefit-risk profile from the sum of preference-weighted treatment attributes (type of treatment, changes in AH drugs, office systolic BP reducing efficacy, effect duration, risk of drug side effects, interventional treatment adverse events). Values of the treatment attributes were derived from the literature, expert opinion, and published RDN studies (SPYRAL HTN OFF-MED, ON-MED, Global SYMPLICITY Registry). Results: In (1), 17% preferred interventional treatment without drugs vs 83% preferred initiation of drugs. In (2), 24% preferred interventional treatment without increasing drugs vs 76% preferred increasing drugs. In (3), 45% preferred interventional treatment without increasing drugs vs 55% preferred increasing drugs. Preference differences were driven by the magnitude of office systolic BP reductions with each treatment. Risks of treatment-related adverse events were less important to treatment choices. Conclusions: Preference for RDN ranged from one-fifth to one-half of patients depending on clinical scenario. The increase mirrored the extent of prior treatment with AH drugs and HTN severity on drugs. Patient preference was driven predominantly by efficacy and minimally by safety of treatment.

Prospective study on the clinical and economic burden of venous leg ulcers in the tropics

ObjectiveVenous leg ulcers (VLUs) are both chronic and recurrent. The treatment of such ulcers often require multiple outpatient visits and dressing changes. Several reports on the costs of treating such VLUs have been reported in the west. We prospectively evaluated the clinical and economic burden of VLUs in a population of Asian patients in the tropics. MethodsPatients from a prospective two-center study conducted at two tertiary hospitals in Singapore, as a part of the Wound Care Innovation in the Tropics program, between August 2018 and September 2021 were recruited. The patients were followed up for 12 weeks (visit 1 to visit 12), until index ulcer healing, death, or lost to follow-up (whichever came first). These patients were then followed up 12 weeks later to determine the longer term outcome of the wound (healed, recurrence, remained unhealed). The itemized costs derived from the medical service were retrieved from the relevant departments of the study sites. The patients' health-related quality of life was assessed at baseline and the last visit of the 12-week follow-up period (or until index ulcer healing), using the official Singapore version of the EuroQol five-dimension-5L questionnaire, which also includes a visual analog scale (EQ-VAS). ResultsA total of 116 patients were enrolled; 63% were men, and the mean patient age was 64.7 years. Of the 116 patients, 85 (73%) had a healed ulcer at 24 weeks (mean duration to ulcer healing, 49 days), and 11 (12.9%) had experienced ulcer recurrence within the study period. Within the 6-month follow-up period, the mean direct healthcare cost per patient was USD$1998. The patients with healed ulcers had significantly lower costs per patient compared with those with unhealed ulcers (USD$1713 vs USD$2780). Regarding health-related quality of life, 71% of the patients had a lower quality of life at baseline, which had improved at 12 weeks of follow-up, with only 58% of the patients reported to have a lower quality of life. Also, the patients with healed ulcers scored higher for both utilities (societal preference weights) and EQ-VAS at follow-up (P < .001). In contrast, patients with unhealed ulcers only scored higher EQ-VAS at follow-up (P = .003). ConclusionsThe findings from this exploratory study provide information on the clinical, quality of life, and economic burden of VLUs in an Asian population and suggest the importance of healing VLUs to reduce the effects on patients. The present study provides data as a basis for economic evaluation as a consideration for the treatment of VLUs.

Drivers of Purchase Decisions Among Consumers of Dried Flower Cannabis Products - A Discrete Choice Experiment.

Cannabis was legalized for non-medical use in Canada in 2018. However, with a long-established illegal market, it is important to understand cannabis consumers preferences in order to create a market that encourages purchasing cannabis through legalized channels. A survey including a discrete choice experiment was conducted to estimate preference weights for seven attributes of dried flower cannabis purchases (price, packaging, moisture level, potency, product recommendations, package information and regulation by Health Canada). Participants were at least 19 years of age, lived in Canada, and purchased cannabis in the last 12 months. A multinomial logit (MNL) model was used for the base model, and latent class analyses to identify sub-groups preference profiles. 891 participants completed the survey. The MNL model showed that all attributes significantly influenced choice, except product recommendations. Potency and package information were most important. A three-group latent class model showed that ~30% of the sample were most concerned with potency, while two groups, jointly making up the remaining ~70% were most concerned with package type ( ~40% preferred bulk packaging, ~30% preferred pre-rolled joints). Consumer purchase preferences for dried flower cannabis was influenced by different attributes. Preference patterns can be grouped into three groups. About 30% of the population appeared to have their preferences met by the legalized market, while another 30% appeared to be more loyal to the unlicensed market. The remaining 40% represented a group that may be influenced through regulatory changes to simplify packaging and increasing availability of product information.

The influence of product digital visual presentation on purchase willingness: effects of roundedness axes and degree

The research examines the influence of digital visual product package presentations on perceived purchase willingness. Subjects pairwise compared the graphical stimuli displayed on a computer monitor. Gathered purchase willingness preference weights were calculated by means of the Analytic Hierarchy Process technique. Two studies focused on the package edge roundedness effect applied along different axes are reported. The first one included the following factors: Roundedness axis defined on three levels (X, Y, Z) and Roundedness degree also specified on three levels (Small, Medium, Large). The second involved Roundedness type (two levels: All edges rounded, Only sides rounded – along one axis) and Roundedness degree (Tiny, Small, Medium, Large). Both package Roundedness axis and Roundedness degree influenced perception and purchase willingness. This research extends existing knowledge by presenting empirical evidence on how a variety of product digital forms influences visual perception and purchase willingness. The results deliver useful and detailed information for practitioners and the outcomes may be applied as guidelines for computer graphics designers preparing visual appearance for articles in electronic shops, websites, banners, or advertisements displayed in networked screens.

Multi-objective two-stage stochastic unit commitment model for wind-integrated power systems: A compromise programming approach

In this paper, we introduce a compromise programming (CP) framework for solving a multi-objective two-stage stochastic unit commitment problem characterized by high penetration of wind power. The proposed framework aims at finding best-compromise Pareto efficient on/off schedules, accounting for wind and power demand uncertainties: such solutions must trade off the three objectives of operating cost, CO2 emissions, and wind power curtailment in accordance to the decision maker preferences. To achieve this, we introduce a practical procedure to compute the ideal and Nadir points associated to the multi-objective two-stage stochastic unit commitment problem and propose a linearized ℓ1 norm-based compromise program to design best-compromise on/off schedules that correspondingly minimize and maximize their weighted distances to the ideal point and to the Nadir point, considering the preference weights assigned by the decision maker to each of the three objective functions. The proposed CP framework is applied to a case study related to the New England IEEE-39 bus test system. The results show that, compared to the schedule obtained through the traditional minimization of operating cost, the designed best-compromised schedules considerably improve CO2 emissions reduction and wind power curtailment performance by conservatively sacrificing operating cost performance.

The impact of population screening for cardiovascular disease on quality of life.

To examine the impact of population screening-generated events on quality of life: invitation, positive test result, initiation of preventive medication, enrolment in follow-up at the surgical department, and preventive surgical repair. A difference-in-difference design based on data collected alongside two randomized controlled trials where general population men were randomized to screening for cardiovascular disease or to no screening. Repeated measurements of health-related quality of life (HRQoL) were conducted up to 3 years after inclusion using all relevant scales of the EuroQol instrument: the anxiety/depression dimension, the EuroQol 5-dimension profile index (using Danish preference weights), and the visual analogue scale for global health. We compare the mean change scores from before to after events for groups experiencing vs. not experiencing the events. Propensity score matching is additionally used to provide both unmatched and matched results. Invitees reported to be marginally better off than non-invitees on all scales of the EuroQol. For events of receiving the test result, initiating preventive medication, being enrolled in surveillance, and undergoing surgical repair, we observed no impact on overall HRQoL but a minor impact of being enrolled in surveillance on emotional distress, which did not persist after matching. The often-claimed detrimental consequences of screening to HRQoL could not be generally confirmed. Amongst the screening events assessed, only two possible consequences were revealed: a reassurance effect after a negative screening test and a minor negative impact to emotional distress of being enrolled in surveillance that did not spill over to overall HRQoL.

Patient Preferences for Attributes of Advanced Migraine Prevention Medications: Findings from a Discrete Choice Experiment (P7-12.004)

Patient Preferences for Attributes of Advanced Migraine Prevention Medications: Findings from a Discrete Choice Experiment (P7-12.004)

Cost-effectiveness of flexible take-home buprenorphine-naloxone versus methadone for treatment of prescription-type opioid use disorder

BackgroundOur objective was to examine the cost-effectiveness of flexible take-home buprenorphine-naloxone (BNX) versus methadone alongside the OPTIMA trial in Canada. MethodsThe OPTIMA study was a pragmatic, open-label, noninferiority, two-arm randomized controlled trial, to assess the comparative effectiveness of flexible take-home BNX vs. methadone in routine clinical care for individuals with prescription-type opioid use disorder. We evaluated cost-effectiveness using a semi-Markov cohort model. Probabilities of overdose were calibrated, accounting for fentanyl prevalence and other overdose risk factors such as naloxone availability. We considered health sector and societal cost perspectives, including costs (2020 CAD) for treatment, health resource use, criminal activity, and health state-specific preference weights as outcomes to calculate incremental cost-effectiveness ratios. Six-month and lifetime (3% annual discount rate) time-horizons were explored. ResultsOver a lifetime time horizon, individuals accumulated −0.144 [CI: −0.302, −0.025] incremental quality-adjusted life years (QALYs) in BNX compared with methadone. Incremental costs were -$2047 [CI: -$39,197, $24,250] from a societal perspective, and -$4549 [CI: -$6332, -$3001] from a health sector perspective. Over a six-month time-horizon, individuals accumulated 0.002 [credible interval (CI): −0.011, 0.016] incremental QALYs in BNX compared with methadone. Incremental costs were -$307 [CI: -$10,385, $8466] from a societal perspective and -$1111 [CI: -$1517, -$631] from a health sector perspective. BNX was dominated (costlier, less effective) in 49.7% of simulations when adopting a societal perspective over a lifetime time horizon. ConclusionsFlexible take-home BNX was not cost-effective versus methadone over a lifetime time horizon, resulting from better treatment retention in methadone compared to BNX.

Selection of infill parameters considering their effects on operational and mechanical performance for material extrusion of CFR-PEEK

PurposeAs newer high performance polymers in mechanical properties become available for material extrusion-based additive manufacturing, determining infill parameter settings becomes more important to achieve both operational and mechanical performance of printed outputs. For the material extrusion of carbon fiber reinforced poly-ether-ether-ketone (CFR-PEEK), this study aims not only to identify the effects of infill parameters on both operational and mechanical performance but also to derive appropriate infill settings through a multicriteria decision-making process considering the conflicting effects.Design/methodology/approachA full-factorial experimental design to investigate the effects of two major infill parameters (i.e. infill pattern and density) on each performance measure (i.e. printing time, sample mass, energy consumption and maximum tensile load) is separately performed to derive the best infill settings for each measure. Focusing on energy consumption for operational performance and maximum tensile load for mechanical performance, the technique for order preference by similarity to ideal solution is further used to identify the most appropriate infill settings given relative preferences on the conflicting performance measures.FindingsThe results show that the honeycomb pattern type with 25% density is consistently identified as the best for the operational performance measures, while the triangular pattern with 100% density is the best for the mechanical performance measure. Moreover, it is suggested that certain ranges of preference weights on operational and mechanical performance can guide the best parameter settings for the overall material extrusion performance of CFR-PEEK.Originality/valueThe findings from this study can help practitioners selectively decide on infill parameters by considering both operational and mechanical aspects and their possible trade-offs.

MP11-03 PREFERENCES FOR KEY ATTRIBUTES OF CLINICALLY AVAILABLE ANDROGEN DEPRIVATION THERAPIES AMONG MEN WITH PROSTATE CANCER

You have accessJournal of UrologyCME1 Apr 2023MP11-03 PREFERENCES FOR KEY ATTRIBUTES OF CLINICALLY AVAILABLE ANDROGEN DEPRIVATION THERAPIES AMONG MEN WITH PROSTATE CANCER Sean P. Collins, Kathleen Beusterien, Brett Hauber, Elke Hunsche, Lewis Kopenhafer, Esmond Nwokeji, and Martine C. Maculaitis Sean P. CollinsSean P. Collins More articles by this author , Kathleen BeusterienKathleen Beusterien More articles by this author , Brett HauberBrett Hauber More articles by this author , Elke HunscheElke Hunsche More articles by this author , Lewis KopenhaferLewis Kopenhafer More articles by this author , Esmond NwokejiEsmond Nwokeji More articles by this author , and Martine C. MaculaitisMartine C. Maculaitis More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003226.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Androgen deprivation therapies (ADTs) have evolved to include several options varying in administration, adverse event profiles, speed of testosterone (T) recovery and onset, and costs. This study assessed preferences for key attributes of ADTs for prostate cancer (PC). METHODS: US men aged >40 years who self-reported a PC diagnosis and had healthcare coverage for the past 3 years were recruited via healthcare research panels to complete a cross-sectional survey. Men who did not know/recall whether ADT was received or who were unable to complete the survey independently were ineligible. A discrete choice experiment assessed ADT attribute preferences. Hierarchical Bayes models estimated attribute level preference weights; relative importance (RI) was computed using the difference between preference weights of most and least favorable levels of each attribute standardized to 0–100 scale. RI was compared by subgroup (ADT experience, age, race/ethnicity, PC location, and cardiovascular [CV] comorbidities) with 2-sample t-tests. RESULTS: Of 304 men with PC (65.1% White), mean age was 64.4 years. Mean time from diagnosis was 5.4 years; 55.3% reported organ-confined PC and 49.0% had prior ADT use. Reducing out-of-pocket (OOP) costs from $350 to $5 per month (RI=32.7) and change from once-monthly injection to daily pill (RI=21.6) were more important than each of the other attributes (Table 1). Improvements in impact on sexual activity (RI=17.5) and time to T recovery after discontinuation (RI=16.3) were 2- to 4-fold as important as reduced CV event risk (RI=7.4) and T surge after initialization (RI=4.5). Change from once-monthly injection to daily pill was more important to non-White men, men with CV conditions, and those whose PC had spread (p<0.05). Preferences for improvements in impact on sexual activity and time to T recovery after discontinuation, and reduced OOP cost differed between age groups (p<0.05). RI did not vary between ADT-experienced and ADT-naïve men. CONCLUSIONS: When selecting ADT, OOP cost had the most impact, overall and across subgroups. Given the variations in salience of ADT attributes, especially mode of administration, shared-decision making should take individuals’ preferences into account. Source of Funding: Myovant GmbH in collaboration with Pfizer © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e124 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sean P. Collins More articles by this author Kathleen Beusterien More articles by this author Brett Hauber More articles by this author Elke Hunsche More articles by this author Lewis Kopenhafer More articles by this author Esmond Nwokeji More articles by this author Martine C. Maculaitis More articles by this author Expand All Advertisement PDF downloadLoading ...

Quantitative Benefit-Risk Assessment in Medical Product Decision Making: A Good Practices Report of an ISPOR Task Force

Benefit-risk assessment is commonly conducted by drug and medical device developers and regulators, to evaluate and communicate issues around benefit-risk balance of medical products. Quantitative benefit-risk assessment (qBRA) is a set of techniques that incorporate explicit outcome weighting within a formal analysis to evaluate the benefit-risk balance. This report describes emerging good practices for the 5 main steps of developing qBRAs based on the multicriteria decision analysis process. First, research question formulation needs to identify the needs of decision makers and requirements for preference data and specify the role of external experts. Second, the formal analysis model should be developed by selecting benefit and safety endpoints while eliminating double counting and considering attribute value dependence. Third, preference elicitation method needs to be chosen, attributes framed appropriately within the elicitation instrument, and quality of the data should be evaluated. Fourth, analysis may need to normalize the preference weights, base-case and sensitivity analyses should be conducted, and the effect of preference heterogeneity analyzed. Finally, results should be communicated efficiently to decision makers and other stakeholders. In addition to detailed recommendations, we provide a checklist for reporting qBRAs developed through a Delphi process conducted with 34 experts.

Describing the health-related quality of life of Māori adults in Aotearoa me Te Waipounamu (New Zealand)

PurposeIn Aotearoa me Te Waipounamu (New Zealand; NZ) there are considerable inequities in health status and outcomes for Māori, the Indigenous peoples of NZ. It is therefore important that the health status and preferences of Māori are specifically considered in healthcare policy and decision making. This paper describes the health-related quality of life of 390 Māori adults who took part in the NZ EQ-5D-5L valuation study.MethodsResponses on the five dimensions of the EQ-5D-5L were dichotomised into “no problems” and “any problems”, summarised and disaggregated by age group. Mean preference weights were reported by age group and overall. Mean utility values (calculated by applying each participant’s preference weights to their EQ-5D-5L profile) were summed and respective means and standard deviations reported by age, chronic disease status and disability.ResultsThe EQ-5D-5L dimensions with the highest proportion of participants reporting any problems were pain/discomfort (61.5%) and anxiety/depression (50%). The most commonly-reported chronic disease was mental illness/distress (24.6%). Anxiety/depression ranked as the most important dimension, with usual activities, the least important. The mean utility value was 0.83 with the lowest value (0.79) found in the 18–24 and 45–54 age groups. For participants with at least one chronic disease the mean utility value was 0.76 compared to 0.91 for those with none.ConclusionTo reduce inequities experienced by Māori it is crucial that the health status of Māori and the values Māori place on health-related quality of life are properly understood. This can only be achieved using Māori-specific data.

Economic and health impacts of the Change4Life Food Scanner app: Findings from a randomized pilot and feasibility study.

The UK Government developed the Change4Life Food Scanner app to provide families with engaging feedback on the nutritional content of packaged foods. There is a lack of research exploring the cost-effectiveness of dietary health promotion apps. Through stakeholder engagement, a conceptual model was developed, outlining the pathway by which the Food Scanner app leads to proximal and distal outcomes. The conceptual model informed the development of a pilot randomized controlled trial which investigated the feasibility and acceptability of evaluating clinical outcomes in children and economic effectiveness of the Food Scanner app through a cost-consequence analysis. Parents of 4-11 years-olds (n = 126) were randomized into an app exposure condition (n = 62), or no intervention control (n = 64). Parent-reported Child Health Utility 9 Dimension (CHU9D) outcomes were collected alongside child healthcare resource use and associated costs, school absenteeism and parent productivity losses at baseline and 3 months follow up. Results for the CHU9D were converted into utility scores based on UK adult preference weights. Sensitivity analysis accounted for outliers and multiple imputation methods were adopted for the handling of missing data. 64 participants (51%) completed the study (intervention: n = 29; control: n = 35). There was a mean reduction in quality adjusted life years between groups over the trial period of -0.004 (SD = 0.024, 95% CI: -0.005; 0.012). There was a mean reduction in healthcare costs of -£30.77 (SD = 230.97; 95% CI: -£113.80; £52.26) and a mean reduction in workplace productivity losses of -£64.24 (SD = 241.66, 95% CI: -£147.54; £19.07) within the intervention arm, compared to the control arm, over the data collection period. Similar findings were apparent after multiple imputation. Modest mean differences between study arms may have been due to the exploration of distal outcomes over a short follow-up period. The study was also disrupted due to the coronavirus pandemic, which may have confounded healthcare resource data. Although measures adopted were deemed feasible, the study highlighted difficulties in obtaining data on app development and maintenance costs, as well as the importance of economic modeling to predict long-term outcomes that may not be reliably captured over the short-term. https://osf.io/, identifier 62hzt.

Implementasi Algoritma Simple Additive Weighting dalam pemilihan penerima Beasiswa di UIN Ar-Raniry

The cost of education at tertiary institutions in Indonesia is relatively high for some groups of people. Indonesian government agencies are trying to reduce this problem. One of the ways is by providing scholarships. The large number of scholarship enthusiasts becomes a challenge for the scholarship manager in making decisions on scholarship recipients. Scholarship selection at UIN Ar-Raniry is undertaken manually, so it is less efficient in making decisions on scholarship recipients. Hence, Decision Support System is required in the selection of scholarship recipients so that it fits with the criteria. With the existence of predetermined criteria, the Simple Additive Weighting (SAW) method is employed in which this method is simple, the algorithm is not difficult, and produces precise and accurate analysis based on the specified criteria values and preference weights. This study aims to analyze the SAW algorithm in selecting KIP scholarships at UIN Ar-Raniry so that it can facilitate the selection process. This test is carried out by calculating the weight of the SAW method with the concept of the weighted sum of each alternative and all its attributes. Calculation of the best value ranking results obtained from all the alternatives used that are eligible to become KIP-College scholarship recipients. Hence, it can be concluded that by applying the SAW method in determining scholarship acceptance at UIN Ar-Raniry, it can help facilitate the selection of scholarships efficiently and effectively.

Higher diet quality is associated with short and long-term benefits on SF-6D health state utilities: a 5-year cohort study in an international sample of people with multiple sclerosis

Background/PurposeHealth state utilities (HSU) are a subjective measure of an individual's health-related quality of life (HRQoL), adjusted by societal or patient relative preference weights for living in different states of health-related quality of life (HRQoL), derived from patient-reported responses to multi-attribute utility instrument (MAUI), and can be used as inputs for cost-utility analyses and in clinical assessment. This research assessed associations of diet with subsequent HSU in a large international cohort of people living with multiple sclerosis (MS), a progressive autoimmune condition of the central nervous system.MethodsHSUs were generated from responses to Short-Form Six-Dimension (SF-6D) MAUI, and quality-of-the-diet by Diet Habits Questionnaire (DHQ). Cross-sectional, and short- and long-term prospective associations of DHQ with HSU evaluated by linear regression at 2.5- and 5-years. Pooled prospective associations between DHQ and HSU evaluated using linear and quantile regression. Analyses adjusted for relevant demographic and clinical covariates.ResultsAmong 839 participants, baseline DHQ scores showed short- and long-term associations with subsequent HSU, each 10-unit increase in total DHQ score associated with 0.008–0.012 higher HSU (out of 1.00). These associations were dose-dependent, those in the top two quartiles of baseline DHQ scores having 0.01–0.03 higher HSU at follow-up, 0.03 being the threshold for a minimally clinically important difference. Fat, fiber, and fruit/vegetable DHQ subscores were most strongly and consistently associated with better HSU outcomes. However, baseline meat and dairy consumption were associated with 0.01–0.02 lower HSU at subsequent follow-up.ConclusionsA higher quality-of-the-diet showed robust prospective relationships with higher HSUs 2.5- and 5-years later, substantiating previous cross-sectional relationships in this cohort. Subject to replication, these results suggest interventions to improve the quality-of-the-diet may be effective to improve HRQoL in people living with MS.

Heterogeneity in physician and patient preferences for the treatment of renal cell carcinoma: Evidence from latent class analysis.

661 Background: To inform shared decision-making, it is important to learn how patients or physicians trade off the features of adjuvant treatments and whether there is heterogeneity within preferences. Methods: An online discrete-choice experiment survey was administered to patients with physician-confirmed renal cell carcinoma (RCC) and physician-defined intermediate high/high risk of recurrence and physicians who treat such patients. Hypothetical treatment choices were defined by median disease-free survival (DFS); 5-year overall survival (OS) rate; mode and frequency of administration; need for concomitant daily pill; treatment duration; and the risks of severe diarrhea, fatigue, and dizziness. After making an adjuvant treatment choice, respondents were presented with the opportunity to opt out of treatment. Patient and physician choice data were analyzed separately using latent class (LC) models, which identify clusters within patients and physicians making similar choices. Each class’ preference weights were used to calculate the conditional relative attribute importance. Results: LC analysis identified three classes among the 250 patients (% respondents) that placed greater relative importance on: 1) 5-year OS and opting into treatment (37.5%), 2) median DFS and opting into treatment (26.9%), and 3) treatment duration and opting out of treatment (35.5%) (Table). Among the 250 physicians, the LC analysis identified three classes that placed greater relative importance on: 1) 5-year OS and recommending treatment (37.5%), 2) median DFS and recommending treatment (37.8%), and 3) not recommending treatment (24.7%). Additionally, each LC analysis showed that the other treatment attributes evaluated were less important, but the importance varied by LC (Table). Conclusions: Heterogeneity in physician and patient preferences for RCC adjuvant therapy was found, highlighting a need for shared decision-making. Discordance within patients and physicians in the propensity to opt out of adjuvant treatment suggests patient-physician dialogue is important. [Table: see text]

Physician preferences for nonmetastatic castration-resistant prostate cancer treatments: A discrete choice experiment among men in mainland China.

88 Background: A range of medication options are available for non-metastatic castration-resistant prostate cancer (nmCRPC), with varying efficacy and safety profiles. We used a discrete choice experiment (DCE) to explore how physicians make treatment decisions between adverse events (AEs) and survival gains in nmCRPC in mainland China. Methods: Physicians’ preferences for medication attributes were assessed through an online survey including 14 treatment choice questions, each comparing 2 hypothetical treatment profiles, which varied safety (fatigue, skin rash, cognitive problems, falls, and fractures) in terms of severity and frequency and efficacy (overall survival [OS] and time to pain progression [TPP]) in terms of duration of effect. Preference weights and importance scores for each attribute were estimated using random parameters logit models. The amount of survival gain physicians were willing to trade off for a reduction in specific AEs was also estimated. Results: In total, 80 physicians who had experience in treating nmCRPC patients were involved in this study. Physicians’ duration of clinical practice was about 18.4±7.39 years. In addition, 57.6% of participants were from regions with more developed economics, including North, East and South China. The results indicated that physician preferences were logically ordered, with higher efficacy and lower risks for AEs being favored over lower efficacy and higher risks for AEs. The most important attributes for treatment decision were OS (Relative importance, RI = 29.2%), serious fracture (RI = 24.4%), serious fall (RI =15.4%) and TPP (RI =10.6%). Comparing non-serious AEs including fatigue, skin rash and cognitive problems, physicians emphasized the risk reduction of fatigue the most. The trade-off analysis between OS and adverse events suggested that physicians were willing to trade 7.5 and 4.7 months of OS to reduce the risk of severe fracture from 8% to none, and the risk of serious fall from 8% to none. In an exploratory subgroup analysis, it was found that physicians with more than 15 years of clinical practice put more emphasis on overall survival, risk of serious fracture, and risk of serious fall compared to less experienced physicians (≤15 years). Physicians from regions with more developed economics tended to put more value on reduction of AEs as compared to physicians from the rest regions. Conclusions: OS is the most important attribute for physicians when treating nmCRPC patients. Physicians were willing to trade the duration of OS to reduce the risk of serious adverse events. These results emphasize the importance of carefully balancing therapies’ benefits and risks to ultimately optimize the overall quality of nmCRPC patients’ survival.

A discrete choice experiment on oral and injection treatment preferences among moderate-to-severe psoriasis patients inJapan.

Long-term psoriasis (PsO) management remains challenging. With growing variation in treatment efficacy, cost, and modes of administration, patient preferences for different treatment characteristics are not well understood. A discrete choice experiment (DCE), informed by qualitative patient interviews, was conducted to assess patient preferences for different attributes of PsO treatments; 222 adult patients with moderate-to-severe PsO receiving systemic therapy participated in the DCE web survey. Better long-term efficacy and lower cost were preferred (preference weights p < 0.05). Long-term efficacy had the highest relative importance (RI) and mode of administration was as important as the outcome attributes (efficacy and safety). Patients also preferred oral to injectable administration. In subgroup analyses by disease severity, residence, psoriatic arthritis as a comorbidity, and gender, the trends for each subgroup were the same as the overall population although the extent of RI for administration mode varied. Mode of administration was more important for patients with moderate versus severe disease, or rural versus urban residence. This DCE utilized attributes related to both oral and injectable treatment as well as a broad study population of systemic treatment users. Preferences were further stratified by patient characteristics to explore trends in different subgroups. Understanding the RI of treatment attributes and the attribute trade-offs acceptable to patients helps inform moderate-to-severe PsO systemic treatments decisions.