BACKGROUND This study aimed to address the current limitations of the use of composite endpoints in orthopaedic trauma research by quantifying the relative importance of clinical outcomes common to orthopaedic trauma patients and use those values to develop a patient-centered composite endpoint weighting technique. METHODS A Best-Worst Scaling choice experiment was administered to 396 adult surgically-treated fracture patients. Respondents were presented with ten choice sets, each consisting of three out of ten plausible clinical outcomes. Hierarchical Bayesian modeling was used to determine the utilities associated with the outcomes. RESULTS Death was the outcome of greatest importance (mean utility = - 8.91), followed by above knee amputation (- 7.66), below knee amputation (- 6.97), severe pain (- 5.90), deep surgical site infection (SSI) (- 5.69), bone healing complications (- 5.20), and moderate pain (- 4.59). Mild pain (- 3.30) and superficial SSI (- 3.29), on the other hand, were the outcomes of least importance to respondents. CONCLUSION This study revealed that patients' relative importance towards clinical outcomes followed a logical gradient, with distinct and quantifiable preferences for each possible component outcome. These findings were incorporated into a novel composite endpoint weighting technique.

中文翻译：

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以患者为中心的复合终点加权技术，用于骨科创伤研究。

背景技术本研究旨在通过量化骨科创伤患者常见的临床结果的相对重要性，并利用这些值来开发以患者为中心的复合终点加权技术，来解决骨科创伤研究中使用复合终点的当前局限性。方法对396例经外科手术治疗的成人骨折患者进行了最差规模选择试验。为受访者提供了十个选择集，每个选择集由十个合理的临床结果中的三个组成。贝叶斯分层建模用于确定与结果相关的效用。结果死亡是最重要的结果（平均效用=-8.91），其次是膝盖以上截肢（-7.66），膝盖以下截肢（-6.97），严重疼痛（-5.90），深部手术部位感染（SSI）（-5.69），骨愈合并发症（-5.20）和中度疼痛（-4.59）。另一方面，轻度疼痛（-3.30）和浅表性SSI（-3.29）是对受访者最不重要的结果。结论这项研究表明，患者对临床结局的相对重要性遵循逻辑梯度，并且对每种可能的成分结局具有独特且可量化的偏好。这些发现被并入了一种新颖的复合终点加权技术。对每种可能的成分结果具有独特且可量化的偏好。这些发现被并入了一种新颖的复合终点加权技术。对每种可能的成分结果具有独特且可量化的偏好。这些发现被并入了一种新颖的复合终点加权技术。