Embedding patients' values and preferences in guideline development for allergic diseases: The case study of Allergic Rhinitis and its Impact on Asthma 2024

Autores da FMUP

• Rafael José Monteiro Da Silva Vieira

  Autor

• Bernardo Manuel De Sousa Pinto

  Autor

• Ana Isabel Alves De Sá E Sousa

  Autor

Participantes de fora da FMUP

• Bognanni, A
• Yepes-Nu?ez, JJ
• Zhang, Y
• Litynska, J
• Sadowska, E
• Borowiack, E
• Togias, A
• Zuberbier, T
• Bousquet, J
• Sch?nemann, HJ

Unidades de investigação

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina da Comunidade, Informação e Decisão em Saúde

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Recommendations for or against the use of interventions need to consider both desirable and undesirable effects as well as patients values and preferences (VP). In the decision-making context, patients VP represent the relative importance people place on the outcomes resulting from a decision. Therefore, the balance between desirable and undesirable effects from an intervention should depend not only on the difference between benefits and harms but also on the value that patients place on them. VP are therefore one of the criteria to be considered when formulating guideline recommendations in the Evidence-to-Decision framework developed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) Working Group. Patients VP may be quantified through utilities, which can be elicited using direct methods (e.g., standard gamble or time trade-off) or indirect methods (using validated instruments to measure health-related quality of life, such as EQ-5D). The GRADE approach recommends conducting systematic reviews to summarise all the available evidence and assess the degree of certainty on VP. In this article, we discuss the importance of considering patients VP and provide examples of how they are considered in the 2024 person-centred Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines.

Keywords

• allergic rhinitis; GRADE; guidelines; utility; values and preferences