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Are Adult Patients More Tolerant Of Treatment Risks Than Parents Of Juvenile Patients?

机译：成年患者比未成年患者的父母更能容忍治疗风险吗？

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Understanding patient-specific differences in risk tolerance for new treatments that offer improved efficacy can assist in making difficult regulatory and clinical decisions for new treatments that offer both the potential for greater effectiveness in relieving disease symptoms, but also risks of disabling or fatal side effects. The aim of this study is to elicit benefit-risk trade-off preferences for hypothetical treatments with varying efficacy and risk levels using a stated-choice (SC) survey. We derive estimates of "maximum acceptable risk" (MAR) that can help decisionmakers identify welfare-enhancing alternatives. In the case of children, parent caregivers are responsible for treatment decisions and their risk tolerance may be quite different than adult patients' own tolerance for treatment-related risks. We estimated and compared the willingness of Crohn's disease (CD) patients and parents of juvenile CD patients to accept serious adverse event (SAE) risks in exchange for symptom relief. The analyzed data were from 345 patients over the age of 18 and 150 parents of children under the age of 18. The estimation results provide strong evidence that adult patients and parents of juvenile patients are willing to accept tradeoffs between treatment efficacy and risks of SAEs. Parents of juvenile CD patients are about as risk tolerant for their children as adult CD patients are for themselves for improved treatment efficacy. SC surveys provide a systematic method for eliciting preferences for benefit-risk tradeoffs. Understanding patients' own risk perceptions and their willingness to accept risks in return for treatment benefits can help inform risk management decision making.
机译：了解针对特定患者的新疗法在风险耐受性方面的差异，这些新疗法可提供更高的疗效，这有助于制定新的疗法难于进行法规和临床决策，从而为缓解疾病症状提供更大的疗效，同时也具有致残或致命副作用的风险。这项研究的目的是通过陈述选择（SC）调查，针对具有不同功效和风险水平的假设治疗方法，得出利益与风险之间的权衡偏好。我们得出“最大可接受风险”（MAR）的估计值，可以帮助决策者确定增强福利的替代方案。对于儿童，父母的照顾者负责治疗决策，他们的风险承受能力可能与成年患者对治疗相关风险的承受能力大不相同。我们估计并比较了克罗恩病（CD）患者和CD青少年患者的父母愿意接受严重不良事件（SAE）风险以换取症状的意愿。分析的数据来自345名18岁以上的患者和150名18岁以下的儿童的父母。估计结果提供了有力的证据，表明成年患者和未成年患者的父母愿意接受治疗功效与SAE风险之间的权衡。少年CD患者的父母对孩子的风险承受能力与成人CD患者对自身的风险承受能力差不多。供应链调查提供了一种系统的方法来引起利益风险权衡的偏好。了解患者自己的风险观念以及他们愿意接受风险以换取治疗益处的意愿可以帮助指导风险管理决策。

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