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Ivo Abraham,1 Mickael Hiligsmann,2 Kenneth KC Lee,3 Leslie Citrome,4 Giorgio Lorenzo Colombo,5 Mike Gregg6 1University of Arizona, Tucson, AZ, USA; 2Maastricht University, Maastricht, the Netherlands; 3Taylor’s University, Selangor, Malaysia; 4New York Medical College, Valhalla, New York, NY, USA; 5University of Pavia, Pavia, Italy; 6Taylor & Francis, London, SE1 8BF, UKCorrespondence: Mike Gregg, Email mike.gregg@tandf.co.uk

Anna Tichler,1,2 Dorijn FL Hertroijs,1,2 Dirk Ruwaard,1,2 Martijn CGJ Brouwers,2,3 Mickaël Hiligsmann,1,2 Judith D de Jong,1,2,4 Arianne MJ Elissen1,2 1Department of Health Services Research, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, the Netherlands; 2Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; 3Department of Internal Medicine, Division of Endocrinology and Metabolic Disease, Maastricht University Medical Center+, Maastricht, the Netherlands; 4The Netherlands Institute for Health Services Research (NIVEL), Utrecht, the NetherlandsCorrespondence: Anna Tichler, Department of Health Services Research, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, P.O. Box 616, Maastricht, 6200 MD, the Netherlands, Tel +31433882193, Email a.tichler@maastrichtuniversity.nlPurpose: Greater knowledge of individuals’ needs and preferences can enhance shared decision-making, which is associated with improved quality of decisions and increased satisfaction. This study aimed to identify and prioritize the attributes (ie conversation topics) that individuals with type 2 diabetes find it most important to discuss with their healthcare provider regarding treatment decisions.Patients and Methods: First, small group interviews were organized with adults with type 2 diabetes (N=8) treated in primary care to identify the attributes that they find important to discuss regarding treatment decisions. A five-step nominal group technique was applied during the interviews. An object best-worst scaling (BWS) survey was subsequently distributed to individuals with self-reported diabetes participating in the Dutch Health Care Consumer Panel of the Netherlands Institute for Health Services Research (N=600) to determine the relative importance score (RIS) of the identified attributes. A higher RIS indicates a higher level of perceived importance. Subgroup and latent class analyses were performed to explore whether individuals’ demographic and disease characteristics influenced their attribute preferences.Results: A total of 21 attributes were identified during three small group interviews with individuals with type 2 diabetes. Respondents in the BWS survey (N=285) viewed “quality of life” (RIS=11.97), “clinical outcomes” (RIS=10.40), “long-term diabetes complications” (RIS=9.83) and “short-term adverse medication” (RIS=7.72) as the most important in the decision-making process for the treatment of type 2 diabetes. Some differences in attribute preferences were identified according to demographic and disease characteristics.Conclusion: In general, individuals with type 2 diabetes not only want to discuss the biological effects of treatments, but also the impact of treatment on their quality of life. Healthcare providers should be aware that attributes are viewed differently by different individuals. This emphasizes the need for tailor-made healthcare decisions, which means eliciting and responding to individual preferences in the decision-making process.Keywords: shared decision-making, person-centered care, patient preferences, diabetes type 2

UnlabelledThe Committee of Scientific Advisors of International Osteoporosis Foundation (IOF) recommends that papers describing the descriptive epidemiology of osteoporosis using bone mineral density (BMD) at the femoral neck include T-scores derived from an international reference standard.IntroductionThe prevalence of osteoporosis as defined by the T-score is inconsistently reported in the literature which makes comparisons between studies problematic.MethodsThe Epidemiology and Quality of Life Working Group of IOF convened to make its recommendations and endorsement sought thereafter from the Committee of Scientific Advisors of IOF.ResultsThe Committee of Scientific Advisors of IOF recommends that papers describing the descriptive epidemiology of osteoporosis using BMD at the femoral neck include T-scores derived from the National Health and Nutrition Examination Survey III reference database for femoral neck measurements in Caucasian women aged 20-29 years.ConclusionsIt is expected that the use of the reference standard will help resolve difficulties in the comparison of results between studies and the comparative assessment of new technologies.

Vera Vennedey,1 Sonja HM Derman,2 Mickaël Hiligsmann,3 Daniele Civello,1 Anja Schwalm,4 Astrid Seidl,4 Fülöp Scheibler,5 Stephanie Stock,1 Michael J Noack,2 Marion Danner1,5 1Institute for Health Economics and Clinical Epidemiology, University Hospital Cologne (AöR), Cologne, Germany; 2Department of Operative Dentistry and Periodontology, University Hospital Cologne (AöR), Cologne, Germany; 3Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands; 4Department of Health Care and Health Economics, Institute for Quality and Efficiency in Health Care (IQWiG), Cologne, Germany; 5Department of Paediatrics, University Hospital Schleswig-Holstein (UKSH), Kiel, Germany Background and purpose: The German Institute for Quality and Efficiency in Health Care (IQWiG) previously tested two preference elicitation methods in pilot projects and regarded them as generally feasible for prioritizing outcome-specific results of benefit assessment. The present study aimed to investigate the feasibility of completing a discrete choice experiment (DCE) within 3 months and to determine the relative importance of attributes of periodontal disease and its treatment.Patients and methods: This preference elicitation was conducted alongside the IQWiG benefit assessment of systematic treatments of periodontal diseases. Attributes were defined based on the benefit assessment, literature review, and patients’ and periodontologists’ interviews. The DCE survey was completed by patients with a history of periodontal disease. Preferences were elicited for the attributes “tooth loss within next 10 years”, “own costs for treatment, follow-up visits, re-treatment”, “complaints and symptoms”, and “frequency of follow-up visits”. Patients completed a self-administered questionnaire including 12 choice tasks. Data were analyzed using a random parameters logit model. The relative attribute importance was calculated based on level ranges.Results: Within 3 months, survey development, data collection among 267 patients, data analysis, and provision of a study report could be completed. The analysis showed that tooth loss (score 0.73) was the most important attribute in patients’ decisions, followed by complaints and symptoms (0.22), frequency of follow-up visits (0.02), and costs (0.03) (relative importance scores summing up to 1).Conclusion: A preference analysis performing a DCE can be generally feasible within 3 months; however, a good research infrastructure and access to patients is required. Outcomes used in benefit assessments might need to be adapted to be used in preference analyses. Keywords: discrete choice experiment, conjoint analysis, decision making, periodontal disease, reimbursement, health technology assessment

Vera Vennedey,1 Marion Danner,1 Silvia MAA Evers,2,3 Sascha Fauser,4 Stephanie Stock,1 Carmen D Dirksen,5 Mickaël Hiligsmann2 1Institute for Health Economics and Clinical Epidemiology, Cologne University Hospital, Cologne, Germany; 2Department of Health Services Research, School for Primary Care and Public Health (CAPHRI), Maastricht University, Maastricht, the Netherlands; 3Department of Public Mental Health, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands; 4Department of Vitreo-Retinal Surgery, Center of Ophthalmology, Cologne University Hospital, Cologne, Germany; 5Department of Clinical Epidemiology and Medical Technology Assessment, CAPHRI, University Hospital Maastricht, Maastricht, the Netherlands Background: Age-related macular degeneration (AMD) is the leading cause of visual impairment and blindness in industrialized countries. Currently, mainly three treatment options are available, which are all intravitreal injections, but differ with regard to the frequency of injections needed, their approval status, and cost. This study aims to estimate patients’ preferences for characteristics of treatment options for neovascular AMD. Methods: An interviewer-assisted discrete choice experiment was conducted among patients suffering from AMD treated with intravitreal injections. A Bayesian efficient design was used for the development of 12 choice tasks. In each task patients indicated their preference for one out of two treatment scenarios described by the attributes: side effects, approval status, effect on visual function, injection and monitoring frequency. While answering the choice tasks, patients were asked to think aloud and explain the reasons for choosing or rejecting specific characteristics. Quantitative data were analyzed with a mixed multinomial logit model. Results: Eighty-six patients completed the questionnaire. Patients significantly preferred treatments that improve visual function, are approved, are administered in a pro re nata regimen (as needed), and are accompanied by bimonthly monitoring. Patients significantly disliked less frequent monitoring visits (every 4 months) and explained this was due to fear of deterioration being left unnoticed, and in turn experiencing disease deterioration. Significant preference heterogeneity was found for all levels except for bimonthly monitoring visits and severe, rare eye-related side effects. Patients gave clear explanations of their individual preferences during the interviews. Conclusion: Significant preference trends were discernible for the overall sample, despite the preference heterogeneity for most treatment characteristics. Patients like to be monitored and treated regularly, but not too frequently or infrequently. The results of our qualitative research facilitated the interpretation of the quantitative data collected in this study. Keywords: discrete choice experiment, patient preferences, qualitative research, age related macular degeneration, intravitreal injection