Portal de investigação
Empirical estimation of disutilities and decision thresholds for composite endpoints
Autores da FMUP
Participantes de fora da FMUP
- Bognanni, Antonio
- Gil-Mata, Sara
- Xie, Feng
- Bonovas, Stefanos
- Piovani, Daniele
- Morgano, Gian Paolo
- Lourenco-Silva, Nuno
- Piggott, Thomas
- Wiercioch, Wojtek
- Neumann, Ignacio
- Bedbrook, Anna
- Yepes-Nunez, Juan Jose
- Klimek, Ludger
- Zuberbier, Torsten
- Fonseca, Joao A.
- Bousquet, Jean
- Schuenemann, Holger J.
Unidades de investigação
Abstract
Objectives: The evaluation of health benefits and harms of an intervention with GRADE Evidence to Decision (EtD) frameworks includes judgments if the effects are ``trivial,''''small,''''moderate,''or ``large.''Such judgments ideally require the a priori establishment of decision thresholds (DTs), whose empirical derivation for single outcomes has been previously described. In this article, we provide a methodological approach to estimate DTs for composite endpoints based on disutilities. Study Design and Setting: We generated an approach that involves the computation of pooled disutilities, in which the disutility of each outcome comprised in the composite endpoint is weighted by the respective relative frequency. We also applied a modeling approach based on probability distributions to account for uncertainty in the estimates. We present a practical example of the determination of DTs associated with the development of at least one adverse event following treatment with intranasal medications for rhinitis that we used in the Allergic Rhinitis and its Impact on Asthma guidelines. Results: We provide the methodological steps of a modeling-based approach to compute pooled disutilities and, as a result, DTs for composite endpoints. We have developed a webtool (https://compositedt.med.up.pt/) that allows for a simple implementation of the proposed approach. Applying our approach to a practical example, we concluded that rhinitis nasal medications, compared to placebo, were associated with a trivial harm from adverse events. Conclusion: We propose an approach for estimating DTs for composite endpoints, which may be particularly valuable whenever composite endpoints are used for clinical research, clinical practice, and decision-making. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
Dados da publicação
- ISSN/ISSNe:
- 0895-4356, 1878-5921
- Tipo:
- Article
- Páginas:
- -
- Link para outro recurso:
- www.scopus.com
Journal of Clinical Epidemiology Elsevier USA
Documentos
- Não há documentos
Filiações
Keywords
- Composite endpoints; Decision thresholds; Disutilities; GRADE; Guidelines; Meta-analysis
Campos de estudo
Proyectos asociados
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Investigador Principal: Renato Ivo Ferreira da Silva
Estudo Observacional Académico (ESOA-19) . 2022
Seroprevalence of SARS-CoV-2 and assessment of epidemiologic determinants in Portuguese municipal workers
Investigador Principal: Bernardo Manuel De Sousa Pinto
Estudo Clínico Académico (SARS-CoV-2) . 2021
Citar a publicação
Sousa B,Bognanni A,Gil S,Vieira RJ,Xie F,Bonovas S,Piovani D,Morgano GP,Ferreira R,Ferreira A,Cardoso A,Lourenco N,Piggott T,Wiercioch W,Neumann I,Bedbrook A,Yepes JJ,Klimek L,Zuberbier T,Fonseca JA,Bousquet J,Schuenemann HJ. Empirical estimation of disutilities and decision thresholds for composite endpoints. J. Clin. Epidemiol. 2025. 179. 111638. IF:7,200. (1).
