title: Dimensions of patient needs in dermatology: subscales of the patient benefit index.
abstract: Evaluation of patient-relevant treatment benefit gains importance for approval and reimbursement of therapeutic strategies. The 'Patient Benefit Index' (PBI) is the first questionnaire to measure patient-relevant treatment benefit in dermatology. Its global score is the average of benefits achieved after treatment, weighted by the individual importance of treatment needs. This study aimed to establish subscales of the PBI on the basis of independent and consistent treatment need dimensions. The PBI was used in a cross-sectional study involving n = 500 patients with ten distinct skin diseases, and in a longitudinal acne therapy study (n = 925). PBI dimensions were extracted by factor analysis and varimax rotation in both studies independently, using the longitudinal study data for replication. Factor analysis revealed largely similar need dimensions in both studies. The five-dimensional solution found in the cross-sectional study explained 63.0% of the variance. The need dimensions were named as reducing psychological impairments, reducing social impairments, reducing impairments due to therapy, reducing physical impairments, and building confidence into therapy. Using this factor solution, different patterns of need were found amongst the ten dermatological diseases. The PBI allows for a differential benefit assessment on five well distinguishable and interpretable subscales. The use of subscales as shown refines the interpretation of needs and benefits in dermatologic treatment.
authors: CVderm-German Center for Health Services Research in Dermatology, Institute for Health Services Research in Dermatology, University Clinics of Hamburg, Germany. c.blome@uke.uni-hamburg.de
authors: Christine
authors: C
authors: Blome
authors: Matthias
authors: M
authors: Augustin
authors: Julia
authors: J
authors: Behechtnejad
authors: Stephan Jeff
authors: SJ
authors: Rustenbach
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D017063:Outcome Assessment, Health Care; D012871:Skin Diseases / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome