USING OUTCOME DATA TO INFORM HEALTHCARE PROFESSIONAL – PATIENT DISCUSSION- A DATABASE OF TREATMENT EFFECTS

Author(s)

Gilbert J
National Guideline Centre, London, UK

INTRODUCTION: Healthcare professionals (HCPs) are expected to discuss benefits and harms of treatment decisions with their patients to allow for shared decision-making. Ideally, these discussions involve a neutral presentation of the magnitude of expected benefits and harms for each treatment option. These discussions are rarely, if ever, feasible particularly because estimates of treatment effect are not readily available to HCPs. NICE (National Institute for Health and Care Excellence) produce predominantly single condition guidelines that make recommendations based on systematic literature reviews. Estimates of benefit and harm from interventions are available in NICE guidelines, although not presented in the final recommendations. This information allows for condition specific decision aids but patients rarely make decisions in the context of a single condition. CURRENT WORK: The National Guideline Centre (NGC), commissioned by NICE, recently developed a guideline on multimorbidity. As part of this guideline, the NGC produced a Database of Treatment Effects (DoTE), designed to support patients and HCPs faced with these challenging decisions. We identified all currently available NICE guidelines that include efficacy estimates of common treatments aimed at prognostic benefit. We extracted point estimates (and confidence intervals) of efficacy for each treatment, control group risks and the duration of the source trials. This information was compiled into a tool, DoTE, that allows for the comparison of relative and absolute expected effects of the relevant treatments. The associated NICE recommendations, trial populations and uncertainty of each result can be presented alongside the effect estimate. CONCLUSIONS: DoTE is a tool that provides information for unbiased discussions around the expected benefits and harms of treatment choices. Compiling DoTE was not simple and it is important that users fully appreciate the methods involved and their limitations. However, without a resource like DoTE, many HCPs are left facing an impossible task on a daily basis.

Conference/Value in Health Info

2017-11, ISPOR Europe 2017, Glasgow, Scotland

Value in Health, Vol. 20, No. 9 (October 2017)

Code

CP2

Topic

Health Policy & Regulatory

Disease

Multiple Diseases

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