Outcome Preferences in Patients With Noninfectious Uveitis: Results of a Best-Worst Scaling Study.
OBJECTIVE
To estimate patient preferences regarding potential adverse outcomes of local versus systemic corticosteroid therapies for noninfectious uveitis by using a best-worst scaling (BWS) approach.


METHODS
Local and systemic therapies are alternatives for noninfectious uveitis that have different potential adverse outcomes. Patients participating in the Multicenter Uveitis Steroid Treatment Trial Follow-up Study (MUST FS) and additional patients with a history of noninfectious uveitis treated at two academic medical centers (Johns Hopkins University and University of Pennsylvania) were surveyed about their preferences regarding six adverse outcomes deemed important to patients. Using "case 1" BWS, patients were asked to repeatedly select the most and least worrying from a list of outcomes (in the survey three outcomes per task).


RESULTS
Eighty-two patients in the MUST FS and 100 patients treated at the academic medical centers completed the survey. According to BWS, patients were more likely to select vision not meeting the requirement for driving (individual BWS score: median = 3, interquartile range, 0-5), development of glaucoma (2, 1-4), and needing eye surgery (1, 0-3) as the most worrying outcomes as compared to needing medicine for high blood pressure/cholesterol (-2, -4 to 0), development of cataracts (-2, -3 to -1), or infection (sinusitis) (-3, -5 to 0). Larger BWS scores indicated the outcomes were more worrying to patients.


CONCLUSIONS
Patients with noninfectious uveitis considered impaired vision, development of glaucoma, and need for eye surgery worrying adverse outcomes, which suggests that it is especially desirable to avoid these outcomes if possible. (ClinicalTrials.gov number, NCT00132691.)
Department of Epidemiology The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States 2Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland.
Tsung
T
Yu
Department of Epidemiology The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States.
Janet T
JT
Holbrook
Department of Epidemiology The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States 3Department of Ophthalmology/Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United S.
Jennifer E
JE
Thorne
Centre for Research Ethics and Bioethics, Uppsala University, Sweden.
Terry N
TN
Flynn
Department of Epidemiology The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States.
Mark L
ML
Van Natta
Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland.
Milo A
MA
Puhan
D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014605:Uveitis / Q000150:complications / Q000188:drug therapy / Q000523:psychology*