Skip to main content Accessibility help
×
Home

QUANTITATIVE PATIENT PREFERENCE EVIDENCE FOR HEALTH TECHNOLOGY ASSESSMENT: A CASE STUDY

  • Ann-Sylvia Brooker (a1), Steven Carcone (a1), William Witteman (a1) and Murray Krahn (a1)

Abstract

Objectives: We conducted a systematic review of quantitative research regarding patients’ preferences, perspectives and values for ventilation among chronic obstructive pulmonary disease (COPD) patients. Our objective was to explore the feasibility and desirability of incorporating patient preferences within the health technology assessment (HTA) process by working through a case study.

Methods: Medical and economic databases were searched for studies published in English from 1990 through March 4, 2011. Studies were selected based on title and abstract. Due to the heterogeneity of the studies, data were analyzed using a narrative synthesis approach.

Results: Among 1833 identified citations, twelve studies met our inclusion criteria. Ten of these studies pertained to COPD patient preferences for ventilation. Results indicate that a significant proportion of COPD patients are willing to forgo ventilation, particularly when it is expressed as “indefinite life support” (60–78 percent) rather than as temporary modality. Results indicate that patient preferences for mechanical or noninvasive ventilation cannot be predicted by covariates (e.g., age, quality of life) or by others who are frequently called upon to make decisions are their behalf.

Conclusions: We found that it is indeed feasible to conduct a systematic review of quantitative preference-related evidence for an HTA topic. However, the process of conducting this preference-related case study also revealed several challenges because there is a high degree of variation in taxonomy, instrumentation, and study design. Therefore, we do not recommend it as a routine part of the HTA process, but we suggest that it is a promising area to pursue for preference-sensitive technological decisions.

Copyright

References

Hide All
1.Facey, K, Boivin, A, Gracia, J, et al.Patients’ perspectives in health technology assessment: A route to robust evidence and fair deliberation. Int J Technol Assess Health Care. 2010;26:334340.
2.Boivin, A, Green, J, van der Meulen, J, Légaré, F, Nolte, E. Why consider patients’ preferences? A discourse analysis of clinical practice guideline developers. Med Care. 2009;47:908915.
3.Bridges, JF, Jones, C. Patient-based health technology assessment: A vision of the future. Int J Technol Assess Health Care. 2007;23:3035.
4.Krahn, M, Naglie, G. The next step in guideline development: Incorporating patient preferences. JAMA. 2008;300:436438.
5.Barham, L. Public and patient involvement at the UK National Institute for Health and Clinical Excellence. Patient. 2011;4:110.
6.Gagnon, M-P, Lepage-Savary, D, Gagnon, J, et al.Introducing patient perspective in health technology assessment at the local level. BMC Health Serv Res. 2009;9:54.
7.Lee, A, Skott, LS, Hansen, HP. Organizational and patient-related assessments in HTAs: State of the art. Int J Technol Assess Health Care. 2009;25:530536.
8.Hansen, HP, Lee, A, van Randwijk, CB. Patient aspects: A review of fifty-eight Danish HTA reports. Int J Technol Assess Health Care. 2011;27:330336.
9.Messina, J, Grainger, DL. A pilot study to identify areas for further improvements in patient and public involvement in health technology assessments for medicines. Patient. 2012;5:199211.
10.Giacomini, M, DeJean, D, Simeonov, D, Smith, A. Experiences of living and dying with COPD: A systematic review and synthesis of the qualitative empirical literature. Ont Health Technol Assess Ser. 2012;12:147.
11.Norris, WM, Nielsen, EL, Engelberg, RA, Curtis, JR. Treatment preferences for resuscitation and critical care among homeless persons. Chest. 2005;127:21802187.
12.Wilson, KG, Aaron, SD, Vandemheen, KL, et al.Evaluation of a decision aid for making choices about intubation and mechanical ventilation in chronic obstructive pulmonary disease. Patient Educ Couns. 2005;57:8895.
13.Mays, N, Pope, C, Popay, J. Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field. J Health Serv Res Policy. 2005;10(Suppl 1):620.
14.Chakrabarti, B, Sulaiman, MI, Davies, L, Calverley, PMA, Warburton, CJ, Angus, RM. A study of patient attitudes in the United Kingdom toward ventilatory support in chronic obstructive pulmonary disease. J Palliat Med. 2009;12:10291035.
15.Gaber, KA, Barnett, M, McGavin, CR, Planchant, Y. Attitudes of 100 patients with chronic obstructive pulmonary disease to artificial ventilation and cardiopulmonary resuscitation. J Palliat Med. 2004;18:626629.
16.Rocker, GM, Dodek, PM, Heyland, DK, Canadian Researchers at the End of Life N. Toward optimal end-of-life care for patients with advanced chronic obstructive pulmonary disease: Insights from a multicentre study. Can Respir J. 2008;15:249254.
17.Lynn, J, Ely, EW, Zhong, Z, et al.Living and dying with chronic obstructive pulmonary disease. J Am Geriatr Soc. 2000;48:S91100.
18.Goldstein, RS, Psek, JA, Gort, EH. Home mechanical ventilation: Demographics and user perspectives. Chest. 1995;108:15811586.
19.Jones, SE, Packham, S, Hebden, M, Smith, AP. Domiciliary nocturnal intermittent positive pressure ventilation in patients with respiratory failure due to severe COPD: Long-term follow up and effect on survival. Thorax. 1998;53:495498.
20.Claessens, MT, Lynn, J, Zhong, Z, et al.Dying with lung cancer or chronic obstructive pulmonary disease: Insights from SUPPORT. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. J Am Geriatr Soc. 2000;48:S146S153.
21.Stapleton, RD, Nielsen, EL, Engelberg, RA, Patrick, DL, Curtis, JR. Association of depression and life-sustaining treatment preferences in patients with COPD. Chest. 2005;127:328334.
22.Levin, I, Schneider, S, Gaeth, G. All frames are not created equal: A typology and Critical Analysis of Framing Effects. Organ Behav Hum Decis Process. 1998;76:149188.
23.Travaline, JM, Silverman, HJ. Discussions with outpatients with chronic obstructive pulmonary disease regarding mechanical ventilation as life-sustaining therapy. South Med J. 1995;88:10341038.
24.Dales, RE, O'Connor, A, Hebert, P, Sullivan, K, McKim, D, Llewellyn-Thomas, H. Intubation and mechanical ventilation for COPD: Development of an instrument to elicit patient preferences. Chest. 1999;116:792800.

Keywords

Type Description Title
WORD
Supplementary materials

Brooker et al. supplementary material
Supplementary table

 Word (223 KB)
223 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed