Treatment preferences of patients, caregivers, and physicians in follicular lymphoma (FL): A global discrete-choice experiment (DCE) study.
Bibliographic record
Abstract
11109 Background: While recent FL therapy advances offer various treatment options, data are limited on FL treatment preferences in the shared decision-making process. A comprehensive survey with a DCE design was conducted to assess preferences of patients, caregivers, and physicians for different attributes that impact treatment choice. Methods: A web-based DCE survey available in English and Spanish was administered in Oct-Nov 2024 to patients with FL, caregivers, and physicians recruited in the US, the UK, Spain, Australia, and Canada through the Follicular Lymphoma Foundation (FLF). FL treatment attributes were selected based on targeted literature review, clinical inputs, and review with FLF patient and caregiver advisors. Attributes included efficacy (progression-free survival [PFS]), safety (impact of adverse events [AEs], including fatigue, cytokine release syndrome [CRS], and neurologic events [NE], on quality of life [QOL]), and convenience (mode of administration, treatment duration and frequency of visits, time needed to travel to treatment center). Survey responses were analyzed by patient, caregiver, and physician groups. Preference weights were generated from conditional logistic regression models and used to calculate the relative importance of attributes and willingness to trade off. Results: A total of 337 patients, 37 caregivers, and 29 physicians (median age: 59, 45, and 51 y, respectively) from 25 countries (>75% from US, UK, and Spain) responded to the DCE survey. The majority (93.7%) of patients reported having experienced ≥1 AE from previous treatment. Patients preferred treatments with longer PFS; mild or no impact of fatigue, CRS, and NEs on QOL during treatment; oral tablets vs infusions; a 3-mo duration with twice-weekly visits vs continuous duration with visits once every 3 mo; and <30 min of travel time vs >2 h (all P <.05). PFS was ranked as the most important attribute across patients, caregivers, and physicians. Following efficacy, treatment convenience attributes were ranked higher by patients and caregivers while safety attributes were more important to physicians. On average, patients were willing to accept reductions of 1 y of PFS for treatment requiring <30 min of travel vs >2 h, 0.7-1 y to receive treatments with less impact of AEs on QOL, 0.6 y for oral tablets vs blood collection and intravenous infusion, and 0.5 y for 3-mo treatment vs continuous duration. Conclusions: Efficacy is the most important attribute in treatment choice for patients, caregivers, and physicians. Following efficacy, patients and caregivers prioritize convenience and reduced impact of AEs, while physicians prioritize safety over convenience. Insights on differences between preferences highlight the importance of informed discussion and a balanced, individualized approach to treatment selection.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".