Older Americansʼ Risk-benefit Preferences for Modifying the Course of Alzheimer Disease

RTI International, RTI HealthSolutions, 3040 Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709-2194, USA.
Alzheimer disease and associated disorders (Impact Factor: 2.44). 09/2008; 23(1):23-32. DOI: 10.1097/WAD.0b013e318181e4c7
Source: PubMed


Alzheimer disease (AD) is a progressive, ultimately fatal neurodegenerative illness affecting millions of patients, families, and caregivers. Effective disease-modifying therapies for AD are desperately needed, but none currently exist on the market. Thus, accelerating the discovery, development, and approval of new disease-modifying drugs for AD is a high priority for individuals, physicians, and medical decision makers. Potentially disease-modifying drugs likely will have significant therapeutic benefits but also may have treatment-related risks. We quantified older Americans' treatment-related risk tolerance by eliciting their willingness to accept the risk of treatment-related death or permanent severe disability in exchange for modifying the course of AD. A stated-choice survey instrument was administered to 2146 American residents 60 years of age and older. On average, subjects were willing to accept a 1-year risk of treatment-related death or permanent severe disability from stroke of over 30% for a treatment that prevents AD from progressing beyond the mild stage. Thus, most people in this age cohort are willing to accept considerable risks in return for disease-modifying benefits of new AD drugs. These results are consistent with other studies indicating that individuals view AD as a serious, life threatening illness that imposes heavy burdens on both patients and caregivers.

Download full-text


Available from: Ateesha Farah Mohamed, May 15, 2014
1 Follower
25 Reads
  • Source
  • [Show abstract] [Hide abstract]
    ABSTRACT: The study of IN/Internet interworking occurred initially in the PSTN/Internet interworking (PINT) working group of the IETF. Subsequently, the ITU-T has recognized its importance. During their SG11 plenary in September of 1997, an ad hoc study group was established for studying how the PSTN/Internet interworking can be supported by the intelligent network (IN). The study includes the aspects of services, architectures, management and security. Currently, there are some architectures of the IN/Internet interworking proposed for discussion, mainly in IETF and ITU-T. However, they are still premature and several deficiencies can be found. Therefore, after a discussion of these proposals, the authors propose a new interworking scheme.
    Communication Technology Proceedings, 1998. ICCT '98. 1998 International Conference on; 11/1998
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Evidence that long-term hormone therapy (HT) may increase the risk of serious adverse events led to a sharp reduction in all HT use, including short-term use for vasomotor symptom relief. We estimated women's willingness to accept adverse event risks in exchange for vasomotor symptom relief when risks are communicated in absolute vs. relative terms. We developed a conjoint survey to elicit preferences across benefit and risk attributes of HT. The survey was administered via the Internet to 523 U.S. women aged 46-60 years. Participants evaluated pairs of hypothetical treatments and indicated preferences using a Likert-based scale. Risks were presented in absolute and relative terms. Satisfaction scores for HT risks and benefits were estimated using random-effects, ordered-probit regression. Maximum acceptable risk (MAR) was calculated as the increase in risk that reduces the satisfaction score for a given level of HT benefit to 0. For both risk versions, the least important attribute (smallest difference in satisfaction scores) was night sweat frequency; heart attack risk was the most important (largest difference in scores). Participants were more willing to accept risks in return for symptom relief when shown absolute vs. relative risks, although differences in MAR were statistically significant only for breast cancer risk. MARs for breast cancer and heart attack exceeded reported rates in most cases. Many women may be willing to accept risks to control vasomotor symptoms. However, describing risks in different, but technically equivalent, ways affects women's willingness to trade risks for benefits.
    Journal of Women's Health 10/2007; 16(7):1028-40. DOI:10.1089/jwh.2006.0218 · 2.05 Impact Factor
Show more