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A novel measure of drug benefit–risk assessment based on Scale Loss Score

Quantitative methods have been proposed to assess and compare the benefit-risk balance of treatments. Among them, multicriteria decision analysis (MCDA) is a popular decision tool as it permits to summarise the benefits and the risks of a drug in a single utility score, accounting for the preference...

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Autores principales: Saint-Hilary, Gaelle, Robert, Veronique, Gasparini, Mauro, Jaki, Thomas, Mozgunov, Pavel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6728751/
https://www.ncbi.nlm.nih.gov/pubmed/30025499
http://dx.doi.org/10.1177/0962280218786526
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author Saint-Hilary, Gaelle
Robert, Veronique
Gasparini, Mauro
Jaki, Thomas
Mozgunov, Pavel
author_facet Saint-Hilary, Gaelle
Robert, Veronique
Gasparini, Mauro
Jaki, Thomas
Mozgunov, Pavel
author_sort Saint-Hilary, Gaelle
collection PubMed
description Quantitative methods have been proposed to assess and compare the benefit-risk balance of treatments. Among them, multicriteria decision analysis (MCDA) is a popular decision tool as it permits to summarise the benefits and the risks of a drug in a single utility score, accounting for the preferences of the decision-makers. However, the utility score is often derived using a linear model which might lead to counter-intuitive conclusions; for example, drugs with no benefit or extreme risk could be recommended. Moreover, it assumes that the relative importance of benefits against risks is constant for all levels of benefit or risk, which might not hold for all drugs. We propose Scale Loss Score (SLoS) as a new tool for the benefit–risk assessment, which offers the same advantages as the linear multicriteria decision analysis utility score but has, in addition, desirable properties permitting to avoid recommendations of non-effective or extremely unsafe treatments, and to tolerate larger increases in risk for a given increase in benefit when the amount of benefit is small than when it is high. We present an application to a real case study on telithromycin in Community Acquired Pneumonia and Acute Bacterial Sinusitis, and we investigated the patterns of behaviour of Scale Loss Score, as compared to the linear multicriteria decision analysis, in a comprehensive simulation study.
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spelling pubmed-67287512019-10-03 A novel measure of drug benefit–risk assessment based on Scale Loss Score Saint-Hilary, Gaelle Robert, Veronique Gasparini, Mauro Jaki, Thomas Mozgunov, Pavel Stat Methods Med Res Regular Articles Quantitative methods have been proposed to assess and compare the benefit-risk balance of treatments. Among them, multicriteria decision analysis (MCDA) is a popular decision tool as it permits to summarise the benefits and the risks of a drug in a single utility score, accounting for the preferences of the decision-makers. However, the utility score is often derived using a linear model which might lead to counter-intuitive conclusions; for example, drugs with no benefit or extreme risk could be recommended. Moreover, it assumes that the relative importance of benefits against risks is constant for all levels of benefit or risk, which might not hold for all drugs. We propose Scale Loss Score (SLoS) as a new tool for the benefit–risk assessment, which offers the same advantages as the linear multicriteria decision analysis utility score but has, in addition, desirable properties permitting to avoid recommendations of non-effective or extremely unsafe treatments, and to tolerate larger increases in risk for a given increase in benefit when the amount of benefit is small than when it is high. We present an application to a real case study on telithromycin in Community Acquired Pneumonia and Acute Bacterial Sinusitis, and we investigated the patterns of behaviour of Scale Loss Score, as compared to the linear multicriteria decision analysis, in a comprehensive simulation study. SAGE Publications 2018-07-20 2019-09 /pmc/articles/PMC6728751/ /pubmed/30025499 http://dx.doi.org/10.1177/0962280218786526 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Regular Articles
Saint-Hilary, Gaelle
Robert, Veronique
Gasparini, Mauro
Jaki, Thomas
Mozgunov, Pavel
A novel measure of drug benefit–risk assessment based on Scale Loss Score
title A novel measure of drug benefit–risk assessment based on Scale Loss Score
title_full A novel measure of drug benefit–risk assessment based on Scale Loss Score
title_fullStr A novel measure of drug benefit–risk assessment based on Scale Loss Score
title_full_unstemmed A novel measure of drug benefit–risk assessment based on Scale Loss Score
title_short A novel measure of drug benefit–risk assessment based on Scale Loss Score
title_sort novel measure of drug benefit–risk assessment based on scale loss score
topic Regular Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6728751/
https://www.ncbi.nlm.nih.gov/pubmed/30025499
http://dx.doi.org/10.1177/0962280218786526
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