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Caregiver preferences for increasing patient survival in advanced melanoma.

Publication ,  Conference
Hauber, AB; González, JM; Posner, J; Lees, M
Published in: Journal of Clinical Oncology
February 10, 2017

185 Background: Patients with advanced cancer and their caregivers may often accept shorter life expectancy to ensure higher quality of remaining months of life. Our objective was to elicit caregiver preferences for quality-adjusted survival associated with treatments for advanced melanoma using a discrete-choice experiment. Methods: Adults in Germany and Sweden caring for people with diagnoses of advanced melanoma completed a web-enabled, discrete-choice experiment. The survey presented caregivers with a series of 10 choice questions, each including three profiles – a pair of hypothetical melanoma treatments and standard of care. Each profile was defined by survival time (24 months, 12 months, 6 months), severity (mild, moderate, severe) of melanoma symptoms, nausea and vomiting, diarrhea, skin problems, and out-of-pocket cost. Treatment profile pairs in choice questions were based on an experimental design with known statistical properties. Standard of care was constant across all choice questions. Regression analysis related respondents’ choice to treatment characteristics and estimate preference weights in each country. Results: 188 respondents in Germany and 202 in Sweden completed the survey. Caregivers choices were consistent with accepting tradeoffs among efficacy, symptom severity, severity of toxicities and cost. Severity of melanoma symptoms was the most important outcome for Swedish caregivers and was approximately as important as survival time for German caregivers. German caregivers placed positive value on each additional month of survival regardless of symptom severity. In Sweden, additional months of survival were of positive value to caregivers except when melanoma symptoms were severe or patients experienced severe nausea, vomiting, and diarrhea concurrently. In all cases where additional months of survival had positive value, the incremental value of each additional month diminished as overall survival increased. Conclusions: Additional months of life with severe symptoms or toxicities may not be viewed as unambiguously good outcomes. Quality of survival is not only a key consideration, but may determine whether a given treatment for melanoma is considered better or worse than standard of care.

Duke Scholars

Published In

Journal of Clinical Oncology

DOI

EISSN

1527-7755

ISSN

0732-183X

Publication Date

February 10, 2017

Volume

35

Issue

5_suppl

Start / End Page

185 / 185

Publisher

American Society of Clinical Oncology (ASCO)

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hauber, A. B., González, J. M., Posner, J., & Lees, M. (2017). Caregiver preferences for increasing patient survival in advanced melanoma. In Journal of Clinical Oncology (Vol. 35, pp. 185–185). American Society of Clinical Oncology (ASCO). https://doi.org/10.1200/jco.2017.35.5_suppl.185
Hauber, A Brett, Juan M. González, Joshua Posner, and Michael Lees. “Caregiver preferences for increasing patient survival in advanced melanoma.” In Journal of Clinical Oncology, 35:185–185. American Society of Clinical Oncology (ASCO), 2017. https://doi.org/10.1200/jco.2017.35.5_suppl.185.
Hauber AB, González JM, Posner J, Lees M. Caregiver preferences for increasing patient survival in advanced melanoma. In: Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO); 2017. p. 185–185.
Hauber, A. Brett, et al. “Caregiver preferences for increasing patient survival in advanced melanoma.Journal of Clinical Oncology, vol. 35, no. 5_suppl, American Society of Clinical Oncology (ASCO), 2017, pp. 185–185. Crossref, doi:10.1200/jco.2017.35.5_suppl.185.
Hauber AB, González JM, Posner J, Lees M. Caregiver preferences for increasing patient survival in advanced melanoma. Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO); 2017. p. 185–185.

Published In

Journal of Clinical Oncology

DOI

EISSN

1527-7755

ISSN

0732-183X

Publication Date

February 10, 2017

Volume

35

Issue

5_suppl

Start / End Page

185 / 185

Publisher

American Society of Clinical Oncology (ASCO)

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences