Exploring what matters most to patients in relapsed refractory multiple myeloma treatment: a Canadian discrete choice experiment with patients, caregivers and physicians
Bibliographic record
Abstract
BACKGROUND: Relapsed/refractory multiple myeloma (RRMM) significantly impacts patients' quality of life. This study investigated treatment characteristic preferences for RRMM in Canada, comparing attributes of conventional treatments to those of Chimeric antigen receptor (CAR) T-cell therapy. It aimed to understand patient preferences and how caregivers and healthcare professionals (HCPs) perceive these preferences. METHODS: A discrete choice experiment (DCE) was conducted with 101 RRMM patients, 46 caregivers, and 49 HCPs. Five attributes were explored: progression-free survival (PFS), 10-year survival chance, risk of serious side effects, risk of long-term moderate side effects, and treatment administration. Participants were asked to choose between two hypothetical treatments in a series of 12 questions. Hypothetical treatments included CAR-T-administered treatments and alternative treatments administered by conventional means ("conventional treatments") with varying levels of performance across remaining attributes. RESULTS: Prolonged PFS and 10-year survival chance were the most critical factors in treatment decisions across all groups. Long-term moderate side effects were more concerning than serious short-term side effects, while treatment administration was least important. Patients were willing to accept higher side effect risks for improved survival. High agreement was found between patients' preferences and caregivers' and HCPs' perceptions of these preferences. CONCLUSIONS: While participants showed no significant preference between the administration profiles of CAR-T therapy and conventional treatments, CAR-T therapy was favored for its clinical benefits of potentially increased survival and lower long-term side effect risks. These findings are valuable for Canadian patient-centered clinical and reimbursement decision-making, highlighting the potential role of CAR-T therapy in addressing patient needs.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".