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| Name | Class |
|---|---|
| Patient-Centered Outcomes Research Institute | OTHER |
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In 2012, the FDA Center for Devices and Radiological Health (CDRH) issued guidance to clarify the principal benefit-risk factors FDA considers during the reviews for premarket approval applications and de novo classification requests. In addition to a detailed description of benefits and risks, CDRH listed "patient tolerance for risk and perspective on benefit" as a factor that CDRH may consider in regulatory reviews. It underlined the need for developing methods to measure patient preference and incorporate it into regulatory decision-making. The purpose of this study is to advance methods for patient and community engagement in patient-centered outcome research (PCOR) and has three objectives.
First, demonstrate good practices for patient and community involvement in PCOR projects by applying principles of community-based participatory research (CBPR).
Second, address methodological gaps pertaining to the use of stated-preference methods in studying preferences in PCOR. These include identifying the best methods for designing a preference study and strategies for analyzing variation in preferences. The investigators also seek to assess the relevance of stated-preference methods to patients and stakeholders using both qualitative and quantitative methods.
Third, demonstrate good practices for applying stated-preference methods by studying the preferences of patients with type II diabetes. While type II diabetes provides an important case study, this research will advance approaches and methods that will be broadly generalizable to other diseases, and to diverse patient and stakeholder groups.
Clinical Significance:
This project will illustrate and advance methods for assessing the values of patients and stakeholders. It will demonstrate how CBPR methods apply to PCOR studies and the value of stated-preference methods in measuring the preferences of patients and stakeholders and directing health care.
This study will apply the principles of CBPR to involve patients and stakeholders associated with a local community board and a national diabetes advisory board in key decisions in the project. During year 1, the investigators will utilize mixed methods to develop, pretest, and pilot the survey instruments to assess the preferences of patients with type II diabetes. In year 2, the investigators plan further engagement to finalize the survey instruments, and will implement a nationally representative, racially/ethnically diverse sample of patients with type II diabetes. Based on further consultation, the investigators will conduct statistical analysis, including stratified analyses and segmentation of patients with similar preferences. In year 3, mixed methods will be applied to assess beliefs of patients and other consumers about the relevance of this work and its generalizability to other PCOR topics. Finally, lay language reports will be developed to highlight patient and stakeholder engagement and the application of stated-preference methods to the study of the preferences of patients with type II diabetes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Best-Worst Scaling (Case 2) | Preference measured by best-worst scaling (case 2) |
| |
| Discrete Choice Experiment | Preference measured by discrete choice experiment |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Best-Worst Scaling (Case 2) | Other | Respondents receive questions asking them to choose the best and worst features of a hypothetical medication. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Patient Medication Preference as Estimated by a Choice Model | Preference estimate for each medicine attribute level from a conditional logit regression analysis. For each arm, there were six attributes of the medication, with 3 levels each. Within each attribute the parameter estimates for each of the levels sum to 0. If a parameter estimate for a level is above (below) 0 then the parameter is higher (lower) than average for that medication attribute. | One-time survey |
| Weight Respondents Assign to Medication Attribute (Relative Attribute Importance) Assessed by a Choice Model | Relative attribute importance (RAI) for each attribute in each arm measures the overall importance of that attribute. It is estimated by subtracting the lowest parameter estimate from the highest parameter estimate within each attribute. The RAI was then re-scaled on a 0 to 10 scale with 0 demonstrating no importance and 10 reflecting the most important attribute in each arm. | One-time survey |
| Measure | Description | Time Frame |
|---|---|---|
| Self-reported Difficulty in Understanding and Answering the Survey Questions | Questions that asked the respondents to evaluate if the Best-Worst Scaling (BWS) or Discrete Choice Experiment (DCE tasks were easy to understand and answer. | One-time survey |
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Inclusion Criteria:
Exclusion Criteria:
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Adults with type II diabetes.
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| Name | Affiliation | Role |
|---|---|---|
| John Bridges, PhD | Johns Hopkins University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Johns Hopkins Bloomberg School of Public Health | Baltimore | Maryland | 21205 | United States |
638 respondents (34%) did not respond to the survey and 139 people among those who responded (11%) were excluded based on the screening questions.
The survey was conducted through GfK KnowledgePanel. Eligible members were invited by email to participate in the survey. All participants were required to be 18 years or older with self-reported physician-diagnosed type 2 diabetes and able to read English or Spanish. African Americans and Latinos were oversampled.
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| ID | Title | Description |
|---|---|---|
| FG000 | Best-Worst Scaling (Case 2) | Preference measured by best-worst scaling (case 2) Best-Worst Scaling (Case 2): Respondents receive questions asking them to choose the best and worst features of a hypothetical medication. |
| FG001 | Discrete Choice Experiment | Preference measured by discrete choice experiment Discrete Choice Experiment: Respondents receive questions asking them to choose the medication they prefer between a pair of hypothetical medications. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
Respondents who completed the survey.
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| ID | Title | Description |
|---|---|---|
| BG000 | Best-Worst Scaling (BWS) (Case 2) | Preference measured by best-worst scaling (case 2) Best-Worst Scaling (Case 2): Respondents receive questions asking them to choose the best and worst features of a hypothetical medication. |
| BG001 | Discrete Choice Experiment (DCE) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Patient Medication Preference as Estimated by a Choice Model | Preference estimate for each medicine attribute level from a conditional logit regression analysis. For each arm, there were six attributes of the medication, with 3 levels each. Within each attribute the parameter estimates for each of the levels sum to 0. If a parameter estimate for a level is above (below) 0 then the parameter is higher (lower) than average for that medication attribute. | Respondents who completed the survey. | Posted | Mean | 95% Confidence Interval | utility of | One-time survey |
|
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Adverse events were not collected
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Best-Worst Scaling (Case 2) | Preference measured by best-worst scaling (case 2) Best-Worst Scaling (Case 2): Respondents receive questions asking them to choose the best and worst features of a hypothetical medication. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| John FP Bridges | Johns Hopkins Bloomberg School of Public Health | 614-685-2543 | john.bridges@osumc.edu |
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| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| D057240 | Patient Preference |
| D003920 | Diabetes Mellitus |
| ID | Term |
|---|---|
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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| Discrete Choice Experiment | Other | Respondents receive questions asking them to choose the medication they prefer between a pair of hypothetical medications. |
|
Preference measured by discrete choice experiment Discrete Choice Experiment: Respondents receive questions asking them to choose the medication they prefer between a pair of hypothetical medications. |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| Education | Count of Participants | Participants |
|
| Income | Count of Participants | Participants |
|
| Years of diagnosis | Mean | Standard Deviation | years |
|
| Self-reported health | Count of Participants | Participants |
|
| No. of hypoglycemic events in the past 6 months | Count of Participants | Participants |
|
| No. of HbA1c level measured in past 6 months | Count of Participants | Participants |
|
| Most recent HbA1c level | Count of Participants | Participants |
|
| Type of diabetes medicine used | Count of Participants | Participants |
|
| Complications | Count of Participants | Participants |
|
| Other chronic conditions | Count of Participants | Participants |
|
| OG001 |
| Discrete Choice Experiment |
Preference measured by discrete choice experiment Discrete Choice Experiment: Respondents receive questions asking them to choose the medication they prefer between a pair of hypothetical medications. |
|
|
| Primary | Weight Respondents Assign to Medication Attribute (Relative Attribute Importance) Assessed by a Choice Model | Relative attribute importance (RAI) for each attribute in each arm measures the overall importance of that attribute. It is estimated by subtracting the lowest parameter estimate from the highest parameter estimate within each attribute. The RAI was then re-scaled on a 0 to 10 scale with 0 demonstrating no importance and 10 reflecting the most important attribute in each arm. | Respondents who completed the survey. | Posted | Mean | 95% Confidence Interval | units on a scale | One-time survey |
|
|
|
| Secondary | Self-reported Difficulty in Understanding and Answering the Survey Questions | Questions that asked the respondents to evaluate if the Best-Worst Scaling (BWS) or Discrete Choice Experiment (DCE tasks were easy to understand and answer. | Respondents who completed the survey. | Posted | Count of Participants | Participants | One-time survey |
|
|
|
| 0 |
| 0 |
| 0 |
| 0 |
| 0 |
| 0 |
| EG001 | Discrete Choice Experiment | Preference measured by discrete choice experiment Discrete Choice Experiment: Respondents receive questions asking them to choose the medication they prefer between a pair of hypothetical medications. | 0 | 0 | 0 | 0 | 0 | 0 |
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| D017060 | Patient Satisfaction |
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
| D001519 | Behavior |
| Frequency of hypoglycemia |
|
| Duration of nausea |
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| Treatment burden |
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| Out-of-pocket cost |
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| Neither agree nor disagree |
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| Agree |
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| Strongly agree |
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| Refused |
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| I found it easy to answer all the questions |
|
| My answers are consistent with my preferences |
|