https://www.rcpjournals.org/content/clinmedicine/3/6/589.full.pdf

The autonomous patient: ending paternalism in medical care

Consumer desires and perceptions of lactose-free milk.

In recent years, there has been a growing interest in obtaining patients’ preferences for healthcare treatments that are deemed ‘preference sensitive’. In particular, the use of stated-preference studies (including discrete-choice experiments (DCE), conjoint analysis, and best–worst scaling) has markedly increased [1]. Preference-sensitive treatments are those in which there are trade-offs between health benefits and risks and the patient’s consideration of these factors is of utmost importance in the eventual utilization of such services. Stated-preference studies originated in marketing as a means of better understanding the wants and needs of the consumer. A main assumption of DCE is that a treatment can be broken down into its attributes (such as effectiveness, side effects and mode of administration) and that the utility a person receives from the treatment is a combination of these attributes. In such studies, respondents (generally patients) are asked to repeatedly choose between two or more hypothetical treatments that differ according to attributes of interest. DCEs can quantify the relative importance of the various attributes that characterize a treatment by quantifying the trade-offs that respondents make from their choices. Given the significant challenges and lack of therapeutic options for osteoarthritis (OA), it is not surprising that several stated-preference studies have been conducted to elicit preferences for OA treatment. Preference-sensitive decisions are mainly adapted for non-urgent, non-fatal diseases and, therefore, particularly adapted to OA. OA is the most common form of arthritis and most frequently affects the knee, hand, and/or hip. OA is predominantly characterized by pain and has been shown to substantially reduce the patient’s mobility and quality of life and to represent

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Patients’ preferences for osteoarthritis treatment: the value of stated-preference studies

Introduction
To explore how adaptive choice-based conjoint (ACBC) analysis could contribute to shared decision-making in the treatment of individual patients with osteoarthritis (OA).

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Generating Individual Patient Preferences for the Treatment of Osteoarthritis Using Adaptive Choice-Based Conjoint (ACBC) Analysis.

Walking is one mode of active transportation that cities around the world promote not only to increase public health, but also to fight climate change. The goal of the present study is to assess the relevance of air quality, noise, green environment, and traffic as well as time and distance considerations on individuals stated walking preferences. In total, 501 US residents participated in an adaptive choice based conjoint study. The following seven attributes were considered (with three levels each): air pollution level, air pollution source, noise level, noise source, natural environment, traffic, as well as walking time and distance. Part-worth utility and relative importance scores were estimated using hierarchical Bayes analyses. Air pollution level was the most important attribute, followed by traffic, noise level, and the natural environment. The findings help identify burdens for walking in urban areas, particularly with regard to air pollution levels and traffic condition (which have a combined relative importance of 41%). Pro-environmentalists select their routes based on both air pollution and noise levels, thus they might be particularly interested in informing themselves about, and monitoring, these attributes. City planners should create opportunities for active routes that offer clean air, some greenery, natural sound, and low traffic, and inform city residents better about these attributes.

Recreational walking decisions in urban away-from-home environments: The relevance of air quality, noise, traffic, and the natural environment

Two-photon fluorescence microscopy (2PFM) emerged as a powerful alternative to conventional one-photon microscopy. 2PFM typically uses two near-infrared (NIR) photons to excite fluorescent dyes, which minimizes light scattering in biological samples. Multiphoton absorption also suppresses background signal and autofluorescence from tissues and allows to achieve higher 3D resolution images with low photodamage and photobleaching. Fluorene dyes possess distinct properties that meet the strict criteria of probes used for 2PFM such as enhanced solubility, photostability, and two-photon absorption cross-section. The fluorene molecule also includes many active positions that allow versatile synthesis, selective functionalization, bioconjugation, and tuning solubility. These properties have led to reporting several fluorene probes including monomers, polymers, and dendrimers with important uses in understanding molecular dynamics and bioimaging. The current review presents a compact summary of fluorene-based fluorophores for 2PFM bioimaging applications, shedding light on structure-photophysical property relationships in fluorenes and polyaromatic probe designs. 

Design, Photophysical Properties, and Applications of Fluorene-Based Fluorophores in Two-Photon Fluorescence Bioimaging: a Review

Simple Summary Cancer is the leading cause of death worldwide and responsible for killing approximately 10 million people per year. Fused heterocyclic ring systems such as benzofuran have emerged as important scaffolds with many biological properties. Furthermore, derivatives of benzofurans demonstrate a wide range of biological and pharmacological activities, including anticancer properties. The main aim of this review is to highlight and discuss the contribution of benzofuran derivatives as anticancer agents by considering and discussing the chemical structure of 20 different compounds. Evaluating the chemical structure of these compounds will guide future medicinal chemists in designing new drugs for cancer therapy that might give excellent results in in vivo/in vitro applications. Abstract Benzofuran is a heterocyclic compound found naturally in plants and it can also be obtained through synthetic reactions. Multiple physicochemical characteristics and versatile features distinguish benzofuran, and its chemical structure is composed of fused benzene and furan rings. Benzofuran derivatives are essential compounds that hold vital biological activities to design novel therapies with enhanced efficacy compared to conventional treatments. Therefore, medicinal chemists used its core to synthesize new derivatives that can be applied to a variety of disorders. Benzofuran exhibited potential effectiveness in chronic diseases such as hypertension, neurodegenerative and oxidative conditions, and dyslipidemia. In acute infections, benzofuran revealed anti-infective properties against microorganisms like viruses, bacteria, and parasites. In recent years, the complex nature and the number of acquired or resistant cancer cases have been largely increasing. Benzofuran derivatives revealed potential anticancer activity with lower incidence or severity of adverse events normally encountered during chemotherapeutic treatments. This review discusses the structure–activity relationship (SAR) of several benzofuran derivatives in order to elucidate the possible substitution alternatives and structural requirements for a highly potent and selective anticancer activity.

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Structure–Activity Relationship of Benzofuran Derivatives with Potential Anticancer Activity

Podophyllotoxin and its derivatives: Potential anticancer agents of natural origin in cancer chemotherapy.

Rationale, aims and objectives Patient preferences are an important part of optimizing the pharmacological treatment of osteoarthritis (OA). Recent choice experiments have explored this issue using two types of conjoint analysis: choice-based conjoint analysis (CBCA) and adaptive conjoint analysis (ACA). The aim of this study was to examine the feasibility of using adaptive choice-based conjoint analysis (ACBCA) methods to determine patient preferences for pharmacological treatment of OA. The specific outcomes were patient evaluations of a) eight attributes in an ACBCA task, b) the computer skills required to complete the task, and c) the perceived utility of the results. Method Participants were drawn from members of a Research Users’ Group (RUG) who had been diagnosed with osteoarthritis. Participants took part in two feasibility studies. In the first feasibility study, four RUG members critically examined the implementation of a computerized ACBCA task. In the second feasibility study, 11 RUG members completed an ACBCA task on medication preferences for osteoarthritis. The ACBCA task was evaluated by a set of self-completed questions and through semi-structured interviews. Results The first feasibility study helped to shape the design and contents of the ACBCA task. In the second feasibility study, no participants reported the ACBCA task to be hard to read or understand. Most participants agreed that the task was adjusting appropriately as the session proceeded and that it helped them in making decisions about preferences. Older patients and patients with little computer experience appeared to find no substantial challenges in using this interactive computer-based technique. Conclusions These studies indicate that, with the involvement of patients, face and content validity of an ACBCA task can be achieved through a developmental process taking account of participants’ requirements.

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Basem Al-Omari

Papers

Design, Photophysical Properties, and Applications of Fluorene-Based Fluorophores in Two-Photon Fluorescence Bioimaging: a Review

Generating Individual Patient Preferences for the Treatment of Osteoarthritis Using Adaptive Choice-Based Conjoint (ACBC) Analysis.

Structure–Activity Relationship of Benzofuran Derivatives with Potential Anticancer Activity

Podophyllotoxin and its derivatives: Potential anticancer agents of natural origin in cancer chemotherapy.

Patient preferences for the pharmacological treatment of osteoarthritis: a feasibility study using adaptive choice-based conjoint analysis (ACBCA)