Using Patient Preferences to Determine Noninferiority Margins in Trials—Reply

Using Patient Preferences to Determine Noninferiority Margins in Trials—Reply Letters Fourth, Kemble and colleagues referenced flat or declin- Using Patient Preferences to Determine ing revenues for the majority of physicians in 3PC. However, Noninferiority Margins in Trials according to the HMSA (Emily Oshima Lee, verbal communi- To the Editor A 2016 systematic review of noninferiority trials cation, August 27, 2019), it increased aggregate payments to showed that most provided ambiguous or limited informa- PCPs by 20% in the 3PC’s first 3 years. Consequently, a signifi- tion to justify the noninferiority margins used to size them. cant majority have increased their revenues. Dr Acuna and colleagues advocated incorporating patient Fifth, that the HMSA model did not drive year-1 cost sav- preferences in designing noninferiority deimplementation ings is testament to the transitional process the HMSA devel- trials using probability trade-off techniques. For example, an oped with the PCPs and physician organizations. The lack of early-stage breast cancer trial considering forgoing axillary savings cannot be an indictment of a model that provided only lymph node dissection (ALND) would lessen adverse effects bonuses, not penalties, to physicians to protect them as they (eg, lymphedema) at the cost of slightly worse survival. transitioned to 3PC. Patients would be presented with probability trade-off situa- http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Using Patient Preferences to Determine Noninferiority Margins in Trials—Reply

JAMA, Volume 322 (21) – Dec 3, 2019

Loading next page...
 
/lp/american-medical-association/using-patient-preferences-to-determine-noninferiority-margins-in-CWWgNM6eyZ
Publisher
American Medical Association
Copyright
Copyright 2019 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2019.16345
Publisher site
See Article on Publisher Site

Abstract

Letters Fourth, Kemble and colleagues referenced flat or declin- Using Patient Preferences to Determine ing revenues for the majority of physicians in 3PC. However, Noninferiority Margins in Trials according to the HMSA (Emily Oshima Lee, verbal communi- To the Editor A 2016 systematic review of noninferiority trials cation, August 27, 2019), it increased aggregate payments to showed that most provided ambiguous or limited informa- PCPs by 20% in the 3PC’s first 3 years. Consequently, a signifi- tion to justify the noninferiority margins used to size them. cant majority have increased their revenues. Dr Acuna and colleagues advocated incorporating patient Fifth, that the HMSA model did not drive year-1 cost sav- preferences in designing noninferiority deimplementation ings is testament to the transitional process the HMSA devel- trials using probability trade-off techniques. For example, an oped with the PCPs and physician organizations. The lack of early-stage breast cancer trial considering forgoing axillary savings cannot be an indictment of a model that provided only lymph node dissection (ALND) would lessen adverse effects bonuses, not penalties, to physicians to protect them as they (eg, lymphedema) at the cost of slightly worse survival. transitioned to 3PC. Patients would be presented with probability trade-off situa-

Journal

JAMAAmerican Medical Association

Published: Dec 3, 2019

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create folders to
organize your research

Export folders, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off