Table 3.
Summary of findings: nonutility results for VTE management
| Health state/outcome (categories of values and preferences) | Estimates | Certainty in evidence |
|---|---|---|
| No. of participants/studies | ||
| Prophylaxis | ||
| VTE risk reduction (Haac et al,49 Quante et al,56 Westrich et al38) | Patients highly value the benefits of VTE risk reduction of VTE prophylaxis. Preferences changed in favor of subcutaneous injections with an absolute risk reduction of only 1.27% in VTE, also with the assumption of a generally better effectivity (47.4% of patients). VAS for the importance of VTE prevention with mechanical devices: 7.09 (scale, 1-9). | ⊕⊕⊕⊕ High certainty due to serious RoB |
| 510 participants from 1 RCT and 2 cross-sectional studies | ||
| Treatment | ||
| VTE risk reduction (Lutsey et al52) | Patients held the greatest concern for recurrent VTE (33% of them being extremely concerned) and mortality (29%), regardless of which treatment they were prescribed | ⊕⊕⊕○ Moderate certainty due to RoB* |
| 519 participants from 1 cross-sectional study | ||
| Adverse events (Barcellona et al,42 Keita et al,29 Lutsey et al,52 O’Meara et al35) | Patients considered adverse events burdensome, and the majority would like to avoid them. Some patients are fearful of hemorrhagic events (21%-25%), although most patients (87%) who have had a negative episode are “not afraid of” negative consequences. | ⊕⊕⊕○ Moderate certainty due to RoB† |
| 1019 participants from 4 cross-sectional studies | ||
| Cancer | ||
| VTE risk reduction and adverse events (Cajfinger et al,46 Noble et al54) | Patients place more importance on decreased risks for new or recurring blood clot than on decreased risks for minor and major bleeding | ⊕⊕⊕○ Moderate certainty due to RoB‡ |
| 509 participants from 2 cross-sectional studies |
High certainty in evidence: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty in evidence: We are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
RCT, randomized controlled trial; VAS, visual analog scale.
Lutsey et al52 directly asked which administration type the participants preferred.
Only 1 study (O’Meara et al35) judged as an overall low RoB. Two studies (Barcellona et al,42 O’Meara et al35) showed unclear response rates, and another study (Lutsey et al52) used unclear sampling methods. Two studies (Barcellona et al,42 Lutsey et al52) directly asked which administration route the participants preferred, without describing the possible consequence of the treatment. Therefore, the measurement instrument was judged to be at serious RoB for both studies, in addition to health state presentation for 1 of them (Barcellona et al42).
Cajfinger et al46 directly asked which administration route the participants would prefer, without describing the possible consequence of the treatment; the response rate was unknown in both studies.