Author(s)
Mukamel DB1, Wenzel L1, Ladd H1, Osann K1, Sparks L2, Havrilesky L3, Wright AA4, Walker J5, Robison K6, Alvarez R7, Van Le L8, Wakabayashi M9, Randall L10, Wahi A1, Hsieh S11, Lipscomb J12, Cohn D13
1University of California, Irvine, Irvine, CA, USA, 2Chapman University, Orange, CA, USA, 3Duke University, Durham, NC, USA, 4Dana-Farber Cancer Institute, Boston, MA, USA, 5Stephenson Cancer Center, Oklahoma City, OK, USA, 6Brown University, Providence, RI, USA, 7Vanderbilt University, Nashville, TN, USA, 8University of North Carolina, Chapel Hill, NC, USA, 9City of Hope, Duarte, CA, USA, 10University of California, Irvine, Orange, CA, USA, 11VA Health Care Systems, Livermore, CA, USA, 12Emory University, Atlanta, GA, USA, 13The Ohio State University, Columbus, OH, USA
OBJECTIVES: To identify a quantifiable, latent patient characteristic associated with a propensity to view the side-effects of chemotherapy treatment as minimally bothersome and to investigate its properties with respect to patient reported quality-of-life (QoL) and satisfaction with treatment choice. METHODS: 64 women diagnosed with stage 3 or 4 ovarian cancer (a rare cancer) were given access to a web-based decision-aid, which includes educational modules and a preference elicitation exercise, and is designed to help patients choose between routes of chemotherapy administration. Patients provided QoL data and preferences about side-effects before starting treatment. Preferences were measured using a visual analog scale for 4 side effects, each with 3 possible severity levels, for a total of 12 side-effect/severity dyads. Following chemotherapy choice, satisfaction with treatment choice was measured. Item response theory (IRT) was used to identify a latent “optimism” characteristic of patients based on their tendency to rank all side-effects/severities as likely to be either of little bother or a lot. Regression techniques were used to test the relationships between QoL, its component subscales, “optimism”, and satisfaction with the treatment choice. RESULTS: Lower scores assigned by the IRT analysis indicate the patient’s higher propensity to rank all side-effects/severities as of little concern. Sensitivity analysis suggested a score of 0.2 as the cut-off between “optimistic” and “non-optimistic” patients. Patients who had a higher QoL at baseline were found to be more “optimistic” (OR=1.06 p<0.05). “Optimism” had a large effect size (of about 0.75 standard deviation p<0.001) on being satisfied with the chemotherapy treatment choice. CONCLUSIONS: This study found that ovarian cancer patients exhibited consistent preferences over 12 side-effects/severities and that these are associated with other attitudes towards the disease. Further studies to evaluate this phenomenon for other cancer patients and with respect to other attitudes which may affect care, is indicated.
Conference/Value in Health Info
2017-05, ISPOR 2017, Boston, MA, USA
Value in Health, Vol. 20, No. 5 (May 2017)
Code
PP3
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes, Stated Preference & Patient Satisfaction
Disease
Oncology
