个体化终点评估罕见病治疗结果的可行性:scn2a相关发育性癫痫性脑病目标实现量表的初步研究

IF 4.9 2区 医学 Q1 ECONOMICS Value in Health Pub Date : 2024-12-27 DOI:10.1016/j.jval.2024.12.004
Gunes Sevinc, Kari Knox, Michelle George, Lindsey Evans, Ariela Kaiser, Katherine Charlotte Paltell, Leah Schust Myers, Natasha N Ludwig, Mary Wojnaroski, Gabrielle Conecker, JayEtta Hecker, Jenny Downs, Chere A T Chapman, Anne T Berg
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引用次数: 0

摘要

目的:对于患有罕见神经发育障碍的个体,特别是那些处于谱系最严重一端的个体,标准化的结果测量可能缺乏捕捉微小但有意义的变化的敏感性。个性化终点,如目标实现量表(GAS),允许评估不同基线状态和疾病表现的治疗反应,从而提供高度敏感的疗效测量。目前的研究测试了在罕见的scn2a相关的发育性和癫痫性脑病(SCN2A-DEE)中使用GAS的可行性。方法:对10例SCN2A-DEE患者的护理人员(年龄=8.2岁,SD=5.62,范围3.4-20.4;Nmale=8)参加了由4名临床研究人员主持的面对面目标设定和远程随访访谈。通过临床医生培训、患者指导和电子数据采集平台GoalNav®实现了实施的标准化;使用调查来评估执行情况。结果:所有10名护理人员都完成了目标设定访谈,能够设定、衡量三个目标,并在随访访谈中评估实现水平。进行目标设定和随访访谈的平均(SD)时间分别为59.4(14.5)分钟和18.4(10.5)分钟。参与者设定了与交流(n=10)、进食(n=4)、粗大和精细运动能力(n=6)、行为(n=5)、胃肠功能(n=3)、睡眠(n=1)和癫痫发作(n=1)相关的各种目标。数据完整性、访谈时间和高质量目标的存在(29/30)表明在该人群中使用GAS的可行性,而调查结果表明其可接受性。结论:该试点项目提供了证据,支持GAS作为评估罕见神经发育障碍患者治疗结果的方法的可行性。
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The Feasibility of Personalized Endpoints in Assessing Treatment Outcomes for Rare Diseases: A Pilot Study of Goal Attainment Scaling in SCN2A-Associated Developmental Epileptic Encephalopathy.

Objectives: For individuals living with rare neurodevelopmental disorders, particularly those who are at the most severe end of the spectrum, standardized outcome measures may lack the sensitivity to capture small but meaningful changes. Personalized endpoints such as goal attainment scaling (GAS) allow the assessment of treatment response across variable baseline states and disease manifestations and, thus, provide a highly sensitive measure of efficacy. The current study tested the feasibility of using GAS in rare SCN2A-associated developmental and epileptic encephalopathy (SCN2A-DEE).

Methods: The caregivers of 10 individuals with SCN2A-DEE (Mage = 8.2 years, SD = 5.62, range 3.4-20.4; Nmale = 8) took part in in-person goal setting and remote follow-up interviews facilitated by 4 clinical researchers. Implementation was standardized using clinician training, patient orientation, and an electronic data capture platform, GoalNav®; surveys were used to evaluate implementation.

Results: All 10 caregivers completed the goal-setting interviews and were able to set scale 3 goals, and assess attainment levels at follow-up interviews. The mean (SD) times to conduct the goal setting and follow-up interviews were 59.4 (14.5) and 18.4 (10.5) minutes, respectively. Participants set a variety of goals relating to communication (n = 10), feeding (n = 4), gross and fine motor abilities (n = 6), behavior (n = 5), gastrointestinal function (n = 3), sleep (n = 1), and seizures (n = 1). Data completeness, interview time, and the presence of high-quality goals (29/30) indicated the feasibility of using GAS in this population, whereas survey responses indicated its acceptability.

Conclusions: This pilot project provided evidence supporting the feasibility of GAS as a method for assessing treatment outcomes for patients with rare neurodevelopmental disorders.

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来源期刊
Value in Health
Value in Health 医学-卫生保健
CiteScore
6.90
自引率
6.70%
发文量
3064
审稿时长
3-8 weeks
期刊介绍: Value in Health contains original research articles for pharmacoeconomics, health economics, and outcomes research (clinical, economic, and patient-reported outcomes/preference-based research), as well as conceptual and health policy articles that provide valuable information for health care decision-makers as well as the research community. As the official journal of ISPOR, Value in Health provides a forum for researchers, as well as health care decision-makers to translate outcomes research into health care decisions.
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