Restricted mean survival time versus conventional effect summary for treatment decision‐making: A mixed‐methods study

Background Treatment effect is typically summarized in terms of relative risk reduction or number needed to treat (“conventional effect summary”). Restricted mean survival time (RMST) summarizes treatment effect in terms of a gain or loss in event‐free days. Older adults' preference between the...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) 2023-02, Vol.71 (2), p.528-537
Main Authors: Shi, Sandra M., Palmer, Jennifer A., Newmeyer, Natalie, Carroll, Danette, Steinberg, Nessa, Olivieri‐Mui, Brianne, Kim, Dae Hyun
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Blood pressure
Decision making
Decision Support Techniques
Elder care
evidence communication
Female
Humans
hypertension
Hypertension - therapy
mixed methods
Mixed methods research
Older people
Polls & surveys
Preferences
Research Design
restricted mean survival time
Statistical analysis
Surveys
Surveys and Questionnaires
Survival Rate
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Summary:Background Treatment effect is typically summarized in terms of relative risk reduction or number needed to treat (“conventional effect summary”). Restricted mean survival time (RMST) summarizes treatment effect in terms of a gain or loss in event‐free days. Older adults' preference between the two effect summary measures has not been studied. Methods We conducted a mixed methods study using a quantitative survey and qualitative semi‐structured interviews. For the survey, we enrolled 102 residents with hypertension at five senior housing facilities (mean age 81.3 years, 82 female, 95 white race). We randomly assigned respondents to either RMST‐based (n = 49) or conventional decision aid (n = 53) about the benefits and harms of intensive versus standard blood pressure‐lowering strategies and compared decision conflict scale (DCS) responses (range: 0 [no conflict] to 100 [maximum conflict];
ISSN:0002-8614
1532-5415
DOI:10.1111/jgs.18107