Smartest Doc
Patient preferences for chemotherapies used in breast cancer Full Text
International Journal of Women's Health, 06/29/2012
Clinical Article
Beusterien K et al. – Breast cancer patients place high value on small incremental survival advantages associated with treatment despite the risk of serious toxicities.
Methods- This was a cross–sectional study of 121 patients with stage I–IV breast cancer who completed an internet–based conjoint survey that assessed the following attributes: ten grade III/IV toxicities, survival advantage, and administration regimen.
- Literature and expert input were used to identify descriptions for each attribute and respective levels (eg, different risks of toxicities).
- Subjects rated the attribute levels on a series of scales and indicated preferences in pair–wise comparisons of two hypothetical treatments differing in attribute levels.
- Ordinary least–squares regression was used to calculate utilities (preference weights) for each attribute level.
- Of the twelve attributes, survival was the most important; specifically, a survival advantage of 3 months versus no survival advantage was most influential in the perceived value of chemotherapy.
- Among toxicities, the differences in the risks of neutropenia with hospitalization, diarrhea, nausea, and fatigue had the most impact on preferences; the risk differences of myalgia, stomatitis, and hand–foot syndrome had the least.
- In general, a more convenient administration regimen was less important than a 13% chance or more of severe toxicities, but more important than a 10%–12% chance of severe toxicities.