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Are Component Endpoints Equal? : Use of Best-worst Scaling to Assess Patients’ Perceptions Regarding the Use of Composite Endpoints in Clinical Trials.

Vaanholt, M.C.W. (2016) Are Component Endpoints Equal? : Use of Best-worst Scaling to Assess Patients’ Perceptions Regarding the Use of Composite Endpoints in Clinical Trials.

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Abstract:Clinical trials comparing revascularization treatments generally use composite endpoints in order to increase statistical precision and efficiency. However, the use of composite endpoints is questioned because it assumes that all unfavourable outcomes of treatment are equally important to patients. We aimed to examine patients’ perspectives regarding the use of composite endpoints and the utility patients put on possible unfavourable outcomes of treatment. In this single-centre, observational PRECORE (PReference of COronary REvascularization) study, 160 patients with coronary artery disease, who underwent either a Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Grafting (CABG) at the Thoraxcentrum Twente (Enschede, the Netherlands) between May 2016 and June 2016, participated in this study. Patients considered repeat PCI, minor stroke, minor MI, angina, repeat CABG, and major MI, less severe than death (p<0.001), but considered major stroke worse than death (p<0.001). Subgroup differences can be found for the relative weights attributed to component endpoints. Patients do not consider the individual component endpoints equal. The fact that patients weigh the individual components differentially has significant implications for trial statistics. Patient preference data should be applied more often to trial data, in order to give a better reflection of patient preference values for treatment outcomes.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/70689
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