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How to weight patient-relevant treatment goals for assessing treatment benefit in psoriasis: preference elicitation methods vs. rating scales

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Abstract

In psoriasis, several patient-relevant treatment goals must be met to be able to consider a treatment beneficial. To assess treatment benefit, the validated questionnaire Patient Benefit Index (PBI) can be used. Its global score summarizes the degree of patient-relevant treatment goals achieved after treatment, weighted by their individual importance on rating scales. These treatment goals have empirically been assigned to five dimensions. While the weighting procedure of the PBI provides information about the importance patients attach to treatment goals on a rating scale from 0 to 4, methods of preference elicitation provide information on how patients would trade off certain treatment goals against each other. However, since the treatment goals defined in the PBI often overlap conceptually, the dimensions of the PBI might be more suitable for exploration in preference elicitation methods. We used an analytic hierarchy process (AHP) and a discrete choice experiment (DCE) to generate preference-based importance weights for the PBI dimensions, and compared these weights to those derived from the rating scales. We were further interested in the effect of importance weights on the calculation of the PBI score. A total of 120 patients with psoriasis completed a questionnaire at baseline, including AHP, DCE and the rating scales, and at follow-up, regarding the attainment of treatment goals, to calculate the PBI score. In contrast to the results derived from the average rating scores, use of AHP and DCE resulted in both similar importance weights and rankings of dimensions. Presumably, patients rated treatment goals differently than the respective dimension they belong to. However, the differently calculated importance weights led to similar values of the PBI score. Our findings nevertheless provide clear evidence that, regardless of the method used, the importance of treatment goals differs between psoriasis patients, and this should be reflected in treatment decisions.

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Funding

This study was not supported by a grant.

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Authors and Affiliations

  1. German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany

    Mandy Gutknecht, Marthe-Lisa Schaarschmidt, Marina Otten & Matthias Augustin

  2. Department of Dermatology, University Medical Center Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Marthe-Lisa Schaarschmidt

  3. Institute for Health Economics and Clinical Epidemiology (IGKE), University Hospital of Cologne, Gleueler Str. 176-178, 50935, Cologne, Germany

    Marion Danner

Authors
  1. Mandy Gutknecht
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  2. Marthe-Lisa Schaarschmidt
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  3. Marion Danner
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  4. Marina Otten
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  5. Matthias Augustin
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Corresponding author

Correspondence to Mandy Gutknecht.

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Conflict of interest

M. Gutknecht received financial support for participation in conferences from AbbVie and obtained honoraria from Novartis. M.-L. Schaarschmidt conducted clinical trials for AbbVie, Boehringer Ingelheim, Celgene, Eli Lilly, Janssen-Cilag, Merck, Novartis and UCB Pharma; obtained honoraria from Janssen-Cilag and Novartis; and received financial support for participation in conferences from AbbVie, ALK-Abello, Biogen Inc., Janssen-Cilag and MSD. M. Danner has no conflict of interest. M. Otten received financial support for participation in conferences from Celgene. M. Augustin has served as consultant and/or paid speaker for and/or has received research grants and/or honoraria for consulting and/or scientific lectures for and/or got travel expenses reimbursed and/or participated in clinical trials sponsored by companies that manufacture drugs used for the treatment of psoriasis including AbbVie, Almirall, Amgen, Biogen Idec, Boehringer Ingelheim, Celgene, Centocor, Eli Lilly, Janssen-Cilag, Leo, Medac, MSD (formerly Essex, Schering-Plough), Mundipharma, Novartis, Pfizer (formerly Wyeth), Pohl Boskamp, Sandoz and Xenoport.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Gutknecht, M., Schaarschmidt, ML., Danner, M. et al. How to weight patient-relevant treatment goals for assessing treatment benefit in psoriasis: preference elicitation methods vs. rating scales. Arch Dermatol Res 310, 567–577 (2018). https://doi.org/10.1007/s00403-018-1846-4

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  • DOI: https://doi.org/10.1007/s00403-018-1846-4

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