Patient preferences for reducing bowel adverse events following prostate radiotherapy.

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  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
      Patient Preference*; Intestines/*radiation effects ; Prostatic Neoplasms/*radiotherapy ; Radiotherapy/*adverse effects; Aged ; Cohort Studies ; Humans ; Intestines/pathology ; Intestines/physiopathology ; Male ; Quality of Life
    • Abstract:
      Background: The Extended Prostate Cancer Index Composite (EPIC) instrument is a commonly used patient reported outcome (PRO) tool in prostate cancer clinical trials. Summary scores for EPIC subscales are calculated by averaging patient scores for attributes (e.g., side effects), implying equal weighting of the attributes in the absence of evidence showing otherwise.
      Methods: We estimated patient preferences for each of the attributes included in the bowel subscale of the EPIC instrument using best-worst (B-W) scaling among a cohort of men with prostate cancer. Patients were presented with multiple tasks in which they were asked to indicate which attribute they would find most and least bothersome at different levels of severity. Analysis utilized both (simple) B-W counts and scores to estimate patient preferences for each attribute as well as attribute levels.
      Results: A total of 174 respondents from two institutions participated in the survey. Preference estimates for each of the five attributes included in the EPIC-26 bowel subscale showed wide variation preferences: 'losing control of bowel movements' was found to be the most bothersome attribute, with a B-W score of -0.48, followed by bowel urgency which also had negative B-W score (-0.04). Increased frequency of bowel movements was the least bothersome attribute, with a B-W score of +0.33, followed by bloody stools (+0.12), and pelvic/rectal pain (+0.06). Analysis of preference weights for attribute bother levels showed preference estimates be linear.
      Conclusions: We provide novel evidence on patient preferences for side effect reduction following prostate radiotherapy. Within the bowel sub-scale of the EPIC-26 short form, we found that bowel incontinence was perceived to be the most bothersome treatment effect, while increased bowel frequency was least bothersome to patients.
      Competing Interests: Dr. Mishra reports receiving an honorarium from Varian Medical Systems, outside of the scope and unrelated to the content of this manuscript. All other authors have declared that no competing interests exist.
    • References:
      Oncologist. 2014 Feb;19(2):127-34. (PMID: 24473225)
      Patient. 2010 Dec 1;3(4):217-27. (PMID: 22273431)
      J Clin Oncol. 2019 Apr 20;37(12):964-973. (PMID: 30860943)
      Int J Radiat Oncol Biol Phys. 2017 Feb 1;97(2):228-235. (PMID: 28068231)
      BMC Dermatol. 2012 Oct 04;12:19. (PMID: 23035730)
      Urology. 2000 Dec 20;56(6):899-905. (PMID: 11113727)
      Cancer. 2015 Jul 15;121(14):2422-30. (PMID: 25847819)
      J Clin Oncol. 2012 Dec 1;30(34):4249-55. (PMID: 23071244)
      Value Health. 2016 Jun;19(4):300-15. (PMID: 27325321)
      Am J Clin Oncol. 2018 Nov;41(11):1069-1075. (PMID: 29462124)
      Cancer. 2014 Apr 1;120(7):1076-82. (PMID: 24382757)
      Value Health. 2011 Jun;14(4):403-13. (PMID: 21669364)
      Pharmacoeconomics. 2016 Dec;34(12):1195-1209. (PMID: 27402349)
      J Clin Oncol. 2018 Jun 20;36(18):1823-1830. (PMID: 29561693)
      CA Cancer J Clin. 2019 Jan;69(1):7-34. (PMID: 30620402)
      Value Health. 2013 Jan-Feb;16(1):3-13. (PMID: 23337210)
      Patient Educ Couns. 2012 Jun;87(3):369-74. (PMID: 22177658)
      Patient Prefer Adherence. 2015 Jul 02;9:899-911. (PMID: 26170640)
      Breast Cancer Res Treat. 2013 Nov;142(1):101-7. (PMID: 24129976)
      Qual Life Res. 2006 Mar;15(2):285-98. (PMID: 16468083)
      N Engl J Med. 2016 Oct 13;375(15):1425-1437. (PMID: 27626365)
      N Engl J Med. 2016 Oct 13;375(15):1415-1424. (PMID: 27626136)
    • Publication Date:
      Date Created: 20200709 Date Completed: 20200914 Latest Revision: 20200914
    • Publication Date:
      20240829
    • Accession Number:
      PMC7343167
    • Accession Number:
      10.1371/journal.pone.0235616
    • Accession Number:
      32639983