Evidence map›Paper›PMID 29247126›Full record

ArticleAnnals of the rheumatic diseases2018

Preference phenotypes to facilitate shared decision-making in rheumatoid arthritis.

Liana Fraenkel, W Benjamin Nowell, George Michel, Carole Wiedmeyer

Abstract read
In one paragraph

Article in Annals of the rheumatic diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  13. Incorporating Patient Preferences into a Decision-Making Model of Hand Trauma Reconstruction.International journal of environmental research and public health · 2021
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  18. Shared Decision Making: From Decision Science to Data Science.Medical decision making : an international journal of the Society for Medical Decision Making · 2020
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Liana FraenkelSchool of Medicine, Yale University, New Haven, Connecticut, USA.
W Benjamin NowellCreakyJoints, Global Healthy Living Foundation, New York City, New York, USA.
George MichelSchool of Medicine, Yale University, New Haven, Connecticut, USA.
Carole WiedmeyerCreakyJoints, Global Healthy Living Foundation, New York City, New York, USA.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Improving Decision Making in Patients with Rheumatic DiseaseK24AR060231 · NIAMS · YALE UNIVERSITY · PI FRAENKEL, LIANA · 2011 to 2018
$1.2M
NCATS NIH HHS UL1 TR001863NIAMS NIH HHS K24 AR060231
6 · The paper itself

Abstract

objectiveImplementing treat-to-target (TTT) strategies requires that patients with rheumatoid arthritis (RA) and their rheumatologists decide on how best to escalate care when indicated. The objective of this study was to develop preference phenotypes to facilitate shared decision-making at the point of care for patients failing methotrexate monotherapy.

methodsWe developed a conjoint analysis survey to measure the preferences of patient with RA for triple therapy, biologics and Janus kinase (JAK) inhibitors. The survey included seven attributes: administration, onset, bothersome side effects, serious infection, very rare side effects, amount of information and cost. Each choice set (n=12) included three hypothetical profiles. Preference phenotypes were identified by applying latent class analysis to the conjoint data.

results1273 participants completed the survey. A five-group solution was chosen based on progressively lower values of the Akaike and Bayesian information criteria. Members of the largest group (group 3: 38.4%) were most strongly impacted by the cost of the medication. The next largest group (group 1: 25.8%) was most strongly influenced by the risk of bothersome side effects. Members of group 2 (11.2%) were also risk averse, but were most concerned with the risk of very rare side effects. Group 4 (6.6%) strongly preferred oral over parenteral medications. Members of group 5 (18.0%) were most strongly and equally influenced by onset of action and the risk of serious infections.

conclusionsTreatment preferences of patients with RA can be measured and represented by distinct phenotypes. Our results underscore the variability in patients' values and the importance of using a shared decision-making approach to implement TTT.

Indexed as

Decision MakingPatient PreferenceAdolescentAdultAgedAged, 80 and overAntirheumatic AgentsArthritis, RheumatoidBayes TheoremBiological ProductsChoice BehaviorFemaleHumansLatent Class AnalysisMaleMiddle AgedAntirheumatic AgentsBiological Productsdmards (biologic)dmards (synthetic)patient perspectiverheumatoid arthritis

Identifiers

PMID29247126
PMCPMC5898982

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.