Evidence map›Paper›PMID 38684245›Full record

ArticleBMJ open2024

Trade-offs between overall survival and side effects in the treatment of metastatic breast cancer: eliciting preferences of patients with primary and metastatic breast cancer using a discrete choice experiment.

Alistair Bullen, Mandy Ryan, Holly Ennis, Ewan Gray, Luis Enrique Loría-Rebolledo, Morag McIntyre, Peter Hall

Abstract read
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–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

7 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
  4. Review
  5. Oncology's ongoing struggle with evaluating quality of life limiting, treatment-related toxicity.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
  6. Review
  7. Observational
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

7 authors.

Alistair BullenEdinburgh Clinical Trials Unit, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK alistair.bullen@gcu.ac.uk.ORCID 0000-0002-1655-6404
Mandy RyanHealth Economics Research Unit, University of Aberdeen, Aberdeen, UK.
Holly EnnisThe University of Edinburgh, Edinburgh, UK.
Ewan GrayThe University of Edinburgh, Edinburgh, UK.
Luis Enrique Loría-RebolledoHealth Economics Research Unit, University of Aberdeen, Aberdeen, UK.ORCID 0000-0002-1391-6478
Morag McIntyreWestern General Hospital, Edinburgh, UK.
Peter HallThe University of Edinburgh, Edinburgh, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThere has been a recent proliferation in treatment options for patients with metastatic breast cancer. Such treatments often involve trade-offs between overall survival and side effects. Our study aims to estimate the trade-offs that could be used to inform decision-making at the individual and policy level.

designWe designed a discrete choice experiment (DCE) to look at preferences for avoiding severity levels of side effects when choosing treatment for metastatic breast cancer. Treatment attributes were: fatigue, nausea, diarrhoea, other side effects (peripheral neuropathy, hand-foot syndrome and mucositis) and urgent hospital admission and overall survival. Responses were analysed using an error component logit model. We estimated the relative importance of attributes and minimum acceptable survival for improvements in side effects.

settingThe DCE was completed online by UK residents with self-reported diagnoses of breast cancer.

participants105 respondents participated, of which 72 patients had metastatic breast cancer and 33 patients had primary breast cancer.

resultsOverall survival had the largest relative importance, followed by other side effects, diarrhoea, nausea and fatigue. The risk of urgent hospital admission was not significant. While overall survival was the most important attribute, respondents were willing to forgo some absolute probability of overall survival for reductions in all Grade 2 side effects (12.02% for hand-foot syndrome, 11.01% for mucositis, 10.42% for peripheral neuropathy, 6.33% for diarrhoea and 3.62% for nausea). Grade 1 side effects were not significant, suggesting respondents have a general tolerance for them.

conclusionsPatients are willing to forgo overall survival to avoid particular severity levels of side effects. Our results have implications for data collected in research studies and can help inform person-centred care and shared decision-making.

Indexed as

Breast NeoplasmsChoice BehaviorPatient PreferenceAdultAgedFemaleHumansMiddle AgedNeoplasm MetastasisUnited KingdomBreast tumoursDecision MakingHEALTH ECONOMICSQuality of LifeSurveys and Questionnaires

Identifiers

PMID38684245
PMCPMC11057309

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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.