Evidence map›Paper›PMID 31856842›Full record

ArticleHealth and quality of life outcomes2019

Outcome preferences of older people with multiple chronic conditions and hypertension: a cross-sectional survey using best-worst scaling.

Hélène E Aschmann, Milo A Puhan, Craig W Robbins, Elizabeth A Bayliss, Wiley V Chan, Richard A Mularski, Renée F Wilson, Wendy L Bennett, Orla C Sheehan, Tsung Yu and 8 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Health and quality of life outcomes, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
2.2field-weighted citation impact, top 8% of its field
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

14 citing papers in PubMed, 28 citations in OpenAlex.

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  10. Assessing patient information needs for new antidiabetic medications to inform shared decision-making: A best-worst scaling experiment in China.Health expectations : an international journal of public participation in health care and health policy · 2024
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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

18 authors at 5 institutions in 3 countries.

Hélène E AschmannEpidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Milo A PuhanEpidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Craig W RobbinsCenter for Clinical Information Services, Kaiser Permanente Care Management Institute, Oakland, CA, USA.
Elizabeth A BaylissInstitute for Health Research, Kaiser Permanente, Denver, CO, USA.
Wiley V ChanKaiser Permanente Northwest, National Guideline Program, Portland, OR, USA.
Richard A MularskiThe Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA.
Renée F WilsonDepartment of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Wendy L BennettDivision of General Internal Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
Orla C SheehanDivision of Geriatrics and Gerontology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
Tsung YuDepartment of Public Health College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Henock G YebyoEpidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Bruce LeffDivision of Geriatrics and Gerontology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
Heather TabanoInstitute for Health Research, Kaiser Permanente, Denver, CO, USA.
Karen ArmacostDivision of Geriatrics and Gerontology, Patient and Caregiver Partner Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Carol GloverDivision of Geriatrics and Gerontology, Patient and Caregiver Partner Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Katie MaslowDivision of Geriatrics and Gerontology, Patient and Caregiver Partner Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Suzanne MintzDivision of Geriatrics and Gerontology, Patient and Caregiver Partner Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Cynthia M BoydDivision of Geriatrics and Gerontology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA. cyboyd@jhmi.edu.ORCID http://orcid.org/0000-0001-5642-9015
Johns Hopkins University · USKaiser Permanente · USUniversity of Zurich · CHNational Cheng Kung University · TWOregon Health & Science University · US

Funding

Patient-Centered Outcomes Research Institute ME-1310-07619
6 · The paper itself

Abstract

backgroundOlder people with hypertension and multiple chronic conditions (MCC) receive complex treatments and face challenging trade-offs. Patients' preferences for different health outcomes can impact multiple treatment decisions. Since evidence about outcome preferences is especially scarce among people with MCC our aim was to elicit preferences of people with MCC for outcomes related to hypertension, and to determine how these outcomes should be weighed when benefits and harms are assessed for patient-centered clinical practice guidelines and health economic assessments.

methodsWe sent a best-worst scaling preference survey to a random sample identified from a primary care network of Kaiser Permanente (Colorado, USA). The sample included individuals age 60 or greater with hypertension and at least two other chronic conditions. We assessed average ranking of patient-important outcomes using conditional logit regression (stroke, heart attack, heart failure, dialysis, cognitive impairment, chronic kidney disease, acute kidney injury, fainting, injurious falls, low blood pressure with dizziness, treatment burden) and studied variation across individuals.

resultsOf 450 invited participants, 217 (48%) completed the survey, and we excluded 10 respondents who had more than two missing choices, resulting in a final sample of 207 respondents. Participants ranked stroke as the most worrisome outcome and treatment burden as the least worrisome outcome (conditional logit parameters: 3.19 (standard error 0.09) for stroke, 0 for treatment burden). None of the outcomes were always chosen as the most or least worrisome by more than 25% of respondents, indicating that all outcomes were somewhat worrisome to respondents. Predefined subgroup analyses according to age, self-reported life-expectancy, degree of comorbidity, number of medications and antihypertensive treatment did not reveal meaningful differences.

conclusionsAlthough some outcomes were more worrisome to patients than others, our results indicate that none of the outcomes should be disregarded for clinical practice guidelines and health economic assessments.

Indexed as

Decision MakingAgedAged, 80 and overCross-Sectional StudiesFemaleHumansHypertensionMaleMiddle AgedMultiple Chronic ConditionsPatient PreferenceQuality of LifeSurveys and QuestionnairesBest-worst scalingHypertensionMultiple chronic conditionsOutcome preferencesPatient preferences

Identifiers

PMID31856842
PMCPMC6924040
OpenAlexW2996275081

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.