P516 Discrete choice experiment to examine patient preferences for surgical interventions in patients with Crohn’s perianal fistulas: results from a global burden of illness study
Notice bibliographique
Résumé
Abstract Background Perianal fistulas (PAF) are a common complication of Crohn’s disease (CD) and patients with Crohn’s perianal fistulas (CPF) experience low health-related quality of life and a higher burden of symptoms than patients with CD without PAF (non-PAF CD). Treatment options for PAF, including medical and surgical interventions, are associated with high rates of relapse or failure. This global study assessed the burden of illness in patients with CPF compared with patients with non-PAF CD. Here, we present data on patient satisfaction with currently available PAF treatments and the attributes that drive treatment choice for patients with CPF. Methods This cross-sectional study was conducted in seven countries (France, Germany, Spain, UK, Canada, Australia and Japan) in patients aged ≥21 and ≤90 years with self-reported physician-diagnosed CD. Patients were classified as non-PAF CD (cohort 1) or CPF without PAF-related surgery (cohort 2) or CPF with PAF-related surgery (cohort 3). Using a web-enabled questionnaire, patient satisfaction with current PAF treatment options was recorded using a 1–9 scale and relative treatment attribute preferences were assessed via a discrete choice experiment (DCE) that included six attributes (Figure 1). Patients evaluated two treatment profiles at a time (“choice tasks”) to identify their most preferred treatment of the choices available. Data were analysed using descriptive statistics. Results A total of 929 patients were recruited, 620 with non-PAF CD and 309 with CPF. Of those with CPF (cohort 2, n=174; cohort 3, n=135), 68% were male, 65% were aged 21–40 years and 83% were currently taking CD-related medication. The median number of PAF was the same in cohorts 2 and 3 (both 2.0), although cohort 3 had a higher proportion of patients with active PAF (119/135 [88%]) compared with cohort 2 (136/174 [78%]; p =0.022). In cohort 3, 105/135 (78%) patients had ≥3 PAF-related procedures/surgeries, and ≥1 and >3 post-operative complications were experienced by 117/135 (87%) and 34/135 (25%) patients, respectively. Mean satisfaction scores were moderate for the majority of PAF treatment options and similar in both cohorts (range 6.2–6.9), although cohort 3 had significantly less satisfaction with long-term seton placement than cohort 2 (6.2 vs 6.7, respectively; p =0.035). Among the tested attributes, post-operative discomfort and fistula healing rate were the most important attributes influencing treatment choice (Figure 1). Conclusion In this study, patients with CPF had moderate satisfaction with PAF treatment options, regardless of surgical intervention. The DCE demonstrated that patients preferred interventions with better healing rates and lower post-operative discomfort compared to other attributes tested.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,008 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».