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Identifying the primary outcome for a randomised controlled trial in rheumatoid arthritis: the role of a discrete choice experiment

Overview of attention for article published in Journal of Foot and Ankle Research, December 2017
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Title
Identifying the primary outcome for a randomised controlled trial in rheumatoid arthritis: the role of a discrete choice experiment
Published in
Journal of Foot and Ankle Research, December 2017
DOI 10.1186/s13047-017-0240-3
Pubmed ID
Authors

Eugena Stamuli, David Torgerson, Matthew Northgraves, Sarah Ronaldson, Lindsey Cherry

Abstract

This study sought to establish the preferences of people with Rheumatoid Arthritis (RA) about the best outcome measure for a health and fitness intervention randomised controlled trial (RCT). The results of this study were used to inform the choice of the trial primary and secondary outcome measure. A discrete choice experiment (DCE) was used to assess people's preferences regarding a number of outcomes (foot and ankle pain, fatigue, mobility, ability to perform daily activities, choice of footwear) as well as different schedules and frequency of delivery for the health and fitness intervention. The outcomes were chosen based on literature review, clinician recommendation and patients' focus groups. The DCE was constructed in SAS software using the D-efficiency criteria. It compared hypothetical scenarios with varying levels of outcomes severity and intervention schedule. Preference weights were estimated using appropriate econometric models. The partial log-likelihood method was used to assess the attribute importance. One hundred people with RA completed 18 choice sets. Overall, people selected foot and ankle pain as the most important outcome, with mobility being nearly as important. There was no evidence of differential preference between intervention schedules or frequency of delivery. Foot and ankle pain can be considered the patient choice for primary outcome of an RCT relating to a health and fitness intervention. This study demonstrated that, by using the DCE method, it is possible to incorporate patients' preferences at the design stage of a RCT. This approach ensures patient involvement at early stages of health care design.

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Geographical breakdown

Country Count As %
Unknown 68 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 12 18%
Student > Master 8 12%
Researcher 6 9%
Student > Postgraduate 4 6%
Student > Doctoral Student 3 4%
Other 11 16%
Unknown 24 35%
Readers by discipline Count As %
Medicine and Dentistry 15 22%
Nursing and Health Professions 14 21%
Sports and Recreations 2 3%
Social Sciences 2 3%
Psychology 1 1%
Other 6 9%
Unknown 28 41%