Post on 26-Mar-2023
THE GROWING ROLE OF QUALITATIVE
INTERVIEWS IN HEALTH OUTCOMES
RESEARCH GUILLEMOT J1, GAUTHIER A1, HASS B2, BASSO F3, COGNET M1
1Amaris, London, UK 2Boehringer Ingelheim GmbH, Ingelheim, Germany 3Boehringer Ingelheim GmbH, Vienna, Austria
ISPOR 2013 DUBLIN - CP3 PODIUM
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QUALITATIVE INTERVIEWS: INFORMING OUTCOMES
RESEARCH DECISIONS
Traditionally, health outcomes research tends to
use quantitative research methods.
Quantitative research methods provide statistically
measurable outcomes.
Qualitative research is usually associated with market
research and social sciences.
With the increasing complexity of outcomes research, the
influences of human behaviour is becoming more
prominent.
Qualitative interviewing as a method of capturing health
related human behaviour is proving to be a valuable tool.
Green, J. & Britten, N. Qualitative Research and Evidence Based Medicine. BMJ. Volume 316. 1998.
Greenhalgh, T & Taylor, R. Papers that Go Beyond Numbers (Qualitative Research). BMJ. Volume 315. 1998.
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Context Preference study
Disease Hepatitis C (HCV)
Population Physicians and HCV patients
Objective
Identify HCV treatment characteristics most
important to the population
Quantify the relative importance of the
treatment characteristics
Methods Discrete Choice Experiment (DCE)
UNDERSTANDING PATIENT TREATMENT
PREFERENCES IN HCV
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DCE METHODOLOGY
DCE assumes that treatments can be fully described by a set
of characteristics or attributes and that individual preferences
depend solely on the level of each attribute
The first step of a DCE consists of identifying these attributes
Systematic
literature review
Treatment profiles
development
Experts validation Draft treatment
attributes
Interviews
Final treatment
attributes
DCE
(Discrete Choice
Experiment)
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DRAFT TREATMENT ATTRIBUTES LIST
Efficacy
Treatment duration
Treatment administration
Anaemia/fatigue
Dermatological problems
Gastro-intestinal problems
Food requirements
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QUALITATIVE INTERVIEWING APPROACH
Review the selection of treatment attributes
Assess comprehensibility of the questionnaire
• List of themes/topics which must be discussed
• Semi direct: leaves the respondent free to discuss aspects
related to the theme, most relevant to him/her
Topic guide for
semi-direct
interview
• Apply codes to the transcript
• Descriptive, e.g. history of diagnosis experience
• Analytical, e.g. ‘importance of efficacy in treatment choice’
Coding
(qualitative
research)
• Descriptive analytics associated with the appearance of codes
across database
• More complex analysis: across codes
Qualitative
analysis
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FINDINGS ON TREATMENT ATTRIBUTES
The findings confirmed most of the treatment attributes
Patients highlighted neuropsychological problems as a critical aspect
of treatment preferences
The analysis revealed the importance of synergetic effects of treatment
attributes
e.g. Longer treatment duration became less acceptable with high
levels of adverse events.
Data suggested that ‘food requirements’ were the treatment attribute
that mattered the least
Patient 2: ‘In a short duration, you can handle the side effects a
lot more than if it’s just grinding you down.’
Five patients and two physicians were interviewed.
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FINDINGS ON COMPREHENSIBILITY
The interviews revealed the need to clarify some terms intended
to be used in the survey
e.g. Interviewees were asked about their views on receiving
injections. Patients with experience of interferon interpreted
the term 'injection' as ‘interferon injection'
Some respondents were treatment-experienced former
injecting drug users or tattoo enthusiasts: Phobia of needles
were small but great for interferon side effects
Interviewer: What about injecting?
Patient 1: Yeah, that is completely off; I wouldn’t do that and I don’t
want do that. I mean if it was injecting protease inhibitors, I might
do it but as far as interferon is concerned I wouldn’t; I don’t want to
do an interferon-based regime.
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IMPACT OF FINDINGS
On treatment attributes, the findings supported
The inclusion of “neuropsychological problems“ as a treatment
attribute replacing “food requirements”
On comprehensibility, the findings supported
That “treatment administration” needed to be explicitly
explained, i.e. different from the treatment itself
That each treatment attribute needed to be supported with an
extensive explanation
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LIMITATIONS
The qualitative interviews were conducted on a small
population sample
Patients were recruited via HCV patient associations
Interviewees were likely to be more knowledgeable than the
target population
Patients displayed advanced educational backgrounds,
which might have affected the research outcomes
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CONCLUSION
Qualitative interviews were beneficial in order to best
possibly prepare the actual DCE
Patients and physicians explained in detail their preferences
which improved our understanding
The interviews contributed to the selection of treatment
attributes
The question of interdependence between treatment
attributes will be further investigated during the
quantitative phase
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TAKE AWAY MESSAGES
Qualitative research follows strict and valuable methods: a
scientific approach providing worthy outcomes
The approach used is probably extendable to other types
of quantitative projects, e.g. qualitative interviews to ensure
the quality of survey-based research
Barbour, RS. The Role of Qualitative Research in Broadening the ‘Evidence base’ for Clinical Practice. Journal of Evaluation in
Clinical Practice, 6, 2, 1555-163.
Giacomini, MK. The Rocky Road: Qualitative Research as Evidence. EBM. Volume 4. 2001
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TAKE AWAY MESSAGES
Using qualitative interviews
helped better aim the DCE,
therefore improving the quality
of the specificity of the DCE.
Qualitative methods such as
qualitative interviews and
quantitative research can be
used complementarily
Barbour, RS. The Role of Qualitative Research in Broadening the ‘Evidence base’ for Clinical Practice. Journal of Evaluation in
Clinical Practice, 6, 2, 1555-163.
Giacomini, MK. The Rocky Road: Qualitative Research as Evidence. EBM. Volume 4. 2001
A quantitative
approach
captures less
data with
greater precision
A qualitative
approach
captures more
data with less
precision