title: The use of a decision board to elicit Brazilian patients' and physicians' preferences for treatment: the case of lupus nephritis.
abstract: OBJECTIVE
  To find preferences for treatment expressed by lupus patients and physicians (who were asked to assume they have lupus) and to explore if certain variables explain these preferences.
  
  
  METHODS
  One hundred seventy-two patients and 202 physicians were interviewed using a lupus nephritis decision board that describes the treatment options and their potential benefits and risks. Clinical and sociodemographic variables were collected. Participants were asked to indicate their preferred treatment and provide justification for their choice. Descriptive statistics, t tests, and Pearson's chi-square tests were used to determine the significance of differences in the decisions made by the two groups. A logistic regression model determined which factors contributed to treatment decisions.
  
  
  RESULTS
  The average age of study participants was 34 ± 8 years for patients and 31 ± 7 years for physicians. Sixty-eight percent of patients and 96% of physicians (P < 0.001) selected the oral option. Patients and physicians justified their choice of treatment using different arguments (P < 0.001 in each case). Logistic regression showed that risk potential (P < 0.001) and a history of joint involvement (P = 0.011) were the arguments used most often to explain a patient's decision and the risk of side effects was most relevant among physicians (P < 0.001).
  
  
  CONCLUSIONS
  Using a decision board, patients and physicians were found to have different preferences for treatment when faced with the same treatment options. Further, the variables that influence their preferences are different.
authors.affiliation: Federal University of São Carlos, Medicine Department, São Carlos, SP, Brazil. mirhelen@ufscar.br
authors.forename: Mirhelen Mendes
authors.initials: MM
authors.lastname: de Abreu
authors.forename: Amiran
authors.initials: A
authors.lastname: Gafni
authors.forename: Marcos Bosi
authors.initials: MB
authors.lastname: Ferraz
mesh_terms: D000328:Adult; D001938:Brazil; D016009:Chi-Square Distribution; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016015:Logistic Models; D008181:Lupus Nephritis / Q000175:diagnosis / Q000188:drug therapy*; D010358:Patient Participation / Q000706:statistics & numerical data; D057240:Patient Preference / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents