Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Feb;19(2):127-34.
doi: 10.1634/theoncologist.2013-0359. Epub 2014 Jan 28.

Use of conjoint analysis to assess breast cancer patient preferences for chemotherapy side effects

Kathleen Beusterien  1 , Jessica Grinspan, Iryna Kuchuk, Sasha Mazzarello, Susan Dent, Stan Gertler, Nathaniel Bouganim, Lisa Vandermeer, Mark Clemons
Affiliations

Use of conjoint analysis to assess breast cancer patient preferences for chemotherapy side effects

Kathleen Beusterien et al. Oncologist. 2014 Feb.

Abstract

Objective: Our objective was to evaluate preferences associated with grade I/II and grade III/IV chemotherapy side effects among breast cancer patients receiving chemotherapy. We also assessed trade-offs that patients are willing to make between treatment side effects and the route and schedule of treatment administration.

Methods: In this cross-sectional study, patients receiving chemotherapy for breast cancer completed a one-time Web survey. Conjoint analysis was used to elicit preferences for 17 grade I/II and III/IV side effects associated with available chemotherapies and regimens. In the analysis, the risk of each side effect was increased by 5%, holding all others constant, and the respective impact on patient preferences was identified.

Results: A total of 102 women participated (mean age 54 ± 11). Among the grade I/II side effects, a 5% reduction in the risk of sensory neuropathy, nausea, and motor neuropathy had the highest impact on preferences. Among grade III/IV side effects, motor neuropathy, nausea/vomiting, and myalgia made the most difference. An oral twice-daily regimen was most preferred; however, patients were willing to receive an intravenous regimen relative to oral to avoid an increased risk of 5% in the majority of side effects. Avoiding an increased chance of grade III/IV motor neuropathy was associated with willingness to tolerate one of the least preferred administration schedules.

Conclusion: This study identified relative preferences among both mild/moderate to severe side effects from the patient perspective. Patients appear to be willing to make trade-offs between side effects and different regimens. These findings may help to inform medical decision-making processes.

Keywords: Breast cancer; Conjoint; Preferences; Side effects; Tradeoffs.

PubMed Disclaimer

Conflict of interest statement

Disclosures of potential conflicts of interest may be found at the end of this article.

Figures

Figure 1.
Figure 1.
Example of paired comparison question.
Figure 2.
Figure 2.
Increase in patient preferences. (A): Increase in percentage of patients preferring treatment with a 5% reduction in each grade I/II side effect. (B): Increase in percentage of patients preferring treatment with a 5% reduction in each grade III/IV side effect.
Figure 3.
Figure 3.
Administration regimen that the majority of patients are willing to tolerate in exchange for a 5% reduction in each side effect.
See this image and copyright information in PMC

References

    1. Chung CT, Carlson RW. Goals and objectives in the management of metastatic breast cancer. The Oncologist. 2003;8:514–520. - PubMed
    1. Young A, Topham C, Moore J, et al. A patient preference study comparing raltitrexed (‘Tomudex’) and bolus or infusional 5-fluorouracil regimens in advanced colorectal cancer: Influence of side-effects and administration attributes. Eur J Cancer Care. 1999;8:154–161. - PubMed
    1. Beusterien KM, Davies J, Leach M, et al. Population preference values for treatment outcomes in chronic lymphocytic leukaemia: A cross-sectional utility study. Health Qual Life Outcomes. 2010;8:50. - PMC - PubMed
    1. Sun CC, Bodurka DC, Weaver CB, et al. Rankings and symptom assessments of side effects from chemotherapy: Insights from experienced patients with ovarian cancer. Support Care Cancer. 2005;13:219–227. - PubMed
    1. Dubey S, Brown RL, Esmond SL, et al. Patient preferences in choosing chemotherapy regimens for advanced non-small cell lung cancer. J Support Oncol. 2005;3:149–154. - PubMed

Publication types

MeSH terms