Jahyun Cho

This study aimed to derive a Korean value set for the SF-6Dv2. Following an adapted international protocol, an online discrete choice experiment with duration (DCE_TTO) was conducted among 3800 Korean adults representative of the general population. The experimental design included three components: choice sets from a Core Module, choice sets pairing commonly occurring health states (Common Module), and triplet choice sets with death options (Triplet Module). Preferences were analyzed using conditional and mixed logit models. Model 9 (based on the Core Module) was selected as the preferred model for its superior logical consistency, including monotonicity of coefficients and avoidance of counterintuitive results. The pain dimension had the largest utility decrement at its worst level (- 0.496), followed by physical functioning (- 0.480), mental health (- 0.391), social functioning (- 0.329), vitality (- 0.178), and role limitations (- 0.138). The utility for the worst possible health state (556555) was estimated at - 1.012, with 31.7% of all states valued as worse than dead. Significant preference heterogeneity was observed across dimensions, indicating substantial individual-level variation in health state valuations. While including death comparisons (Triplet Module) produced less-negative worst-state utilities, it was not recommended as the primary value set due to its non-efficient experimental design and logical monotonicity issues necessitating greater level collapsing. We derived the first Korean SF-6Dv2 value set. This enables quality-adjusted life-year calculations from both SF-36v2 and SF-6Dv2 data, supporting economic evaluations in Korea.

Background: Despite standard combination therapy with endothelin receptor antagonists (ERAs) and phosphodiesterase-5 inhibitors (PDE5is), many patients with pulmonary arterial hypertension (PAH) show inadequate therapeutic responses. Riociguat (a soluble guanylate cyclase stimulator) and selexipag (a prostacyclin receptor agonist) are both approved as next-step therapies; however, their comparative effectiveness and safety remain unknown due to the lack of head-to-head trials. We aimed to compare the therapeutic effects of riociguat replacement and selexipag add-on therapy through an indirect treatment comparison. Methods: Randomized controlled trials (RCTs) involving patients with PAH receiving either riociguat or selexipag were identified through a systematic search of PubMed, EMBASE, and the Cochrane Library up to 04 November 2025. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Study quality was assessed with Cochrane's Risk of Bias 2.0 tool. Indirect treatment comparisons using Bucher's method were conducted within a common comparator (ERA + PDE5i) framework. Results: Three RCTs (four publications) were included: REPLACE, GRIPHON (main and post-hoc analyses), and a phase II trial. The overall risk of bias was low, except for the phase II trial, which had unclear risk due to its small sample size. Indirect comparisons showed no significant differences between the therapies for any outcome. The hazard ratio for clinical worsening was 0.167 (95% confidence interval [CI]: 0.0019–1.495, p = 0.1066). Mean differences for 6-min walk distance and N-terminal pro–B-type natriuretic peptide were 10.64 m (95% CI: –9.158 to 30.438, p = 0.2920) and –46.62 pg/mL (95% CI: –307.826 to 214.586, p = 0.7263). The relative risk of overall adverse events was 1.07 (95% CI: 0.90–1.27, p = 0.453). Subgroup analyses of patients receiving baseline ERA + PDE5i therapy and those classified as World Health Organization functional class III also showed no significant differences. Conclusions: We found no significant differences between riociguat replacement and selexipag add-on therapy. These findings provide comparative data to help clinicians and patients make informed treatment decisions. Further head-to-head trials are needed to confirm comparative effectiveness. This review adhered to PRISMA 2020 guidelines. The PROSPERO Registration: CRD42024524391 https://www.crd.york.ac.uk/PROSPERO/view/CRD42024524391.

Despite standard combination therapy with endothelin receptor antagonists (ERAs) and phosphodiesterase-5 inhibitors (PDE5is), many patients with pulmonary arterial hypertension (PAH) show inadequate therapeutic responses. Riociguat (a soluble guanylate cyclase stimulator) and selexipag (a prostacyclin receptor agonist) are both approved as next-step therapies; however, their comparative effectiveness and safety remain unknown due to the lack of head-to-head trials. We aimed to compare the therapeutic effects of riociguat replacement and selexipag add-on therapy through an indirect treatment comparison. Randomized controlled trials (RCTs) involving patients with PAH receiving either riociguat or selexipag were identified through a systematic search of PubMed, EMBASE, and the Cochrane Library up to 04 November 2025. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Study quality was assessed with Cochrane's Risk of Bias 2.0 tool. Indirect treatment comparisons using Bucher's method were conducted within a common comparator (ERA + PDE5i) framework. Three RCTs (four publications) were included: REPLACE, GRIPHON (main and post-hoc analyses), and a phase II trial. The overall risk of bias was low, except for the phase II trial, which had unclear risk due to its small sample size. Indirect comparisons showed no significant differences between the therapies for any outcome. The hazard ratio for clinical worsening was 0.167 (95% confidence interval [CI]: 0.0019–1.495, p = 0.1066). Mean differences for 6-min walk distance and N-terminal pro–B-type natriuretic peptide were 10.64 m (95% CI: –9.158 to 30.438, p = 0.2920) and –46.62 pg/mL (95% CI: –307.826 to 214.586, p = 0.7263). The relative risk of overall adverse events was 1.07 (95% CI: 0.90–1.27, p = 0.453). Subgroup analyses of patients receiving baseline ERA + PDE5i therapy and those classified as World Health Organization functional class III also showed no significant differences. We found no significant differences between riociguat replacement and selexipag add-on therapy. These findings provide comparative data to help clinicians and patients make informed treatment decisions. Further head-to-head trials are needed to confirm comparative effectiveness. This review adhered to PRISMA 2020 guidelines. CRD42024524391 https://www.crd.york.ac.uk/PROSPERO/view/CRD42024524391.

The authors would like to make the following corrections to this published paper

Purpose The SF-6Dv2 health status valuation using the discrete choice experiment (DCE) method requires effective presentation strategies to improve respondents’ overall understanding and reduce bias, particularly in online surveys. This study aimed to determine the optimal presentation formats for DCE choice tasks through qualitative interviews. Methods We conducted cognitive interviews with 40 South Korean adults using the think-aloud and retrospective probing methods. Participants evaluated five presentation formats (non-emphasized, bold-underlined, yellow-highlighted, graphic circle, and color-shaded) and two duration attribute placement options (upfront vs. end). Results Findings revealed that the presentation format influenced three key areas: readability, comprehension, and comparative judgment. The yellow-highlighted format was the most preferred (50%), followed by the bold-underlined (37.5%) and graphic circle formats (25%), with multiple responses allowed. However, the yellow-highlighted format was criticized for being a visual burden and overlooking non-highlighted information, while the graphic format had issues such as scale direction confusion and inappropriate level summation across attributes. Meanwhile, the bold-underlined format was described easy to read, helpful in grasping the meaning quickly, and visually balanced, thereby reducing visual overload. Moreover, it supported comparative judgment by allowing users to clearly distinguish and compare domains without cognitive fatigue. Regarding duration placement, 26 participants preferred upfront placement, stating that it provided essential context for evaluation. Interestingly, the participants preferring upfront placement prioritized survival duration, while those preferring end placement emphasized the quality of life. Conclusion While the yellow-highlighted, bold-underlined, and graphic formats improved comprehension, we recommend the bold-underlined format for future SF-6Dv2 valuation studies as it balances comprehension enhancement with greater stability in choice contexts. The findings also suggest that the presentation format has the potential to influence DCE response patterns, warranting further consideration in survey design.

This study presents a framework for determining the prioritization of vaccine introduction in the National Immunization Program (NIP) of the Republic of Korea, with a focus on case examples assessed in 2021 and 2023. We describe the predefined criteria for evaluating the prioritization of vaccines in the NIP and the established process in the Republic of Korea. These criteria included disease characteristics, vaccine characteristics, rationality and efficiency of resource allocation, and the acceptance of immunization. The process of prioritizing NIP introduction involved several sequential steps: a demand survey, evidence collection, preliminary evaluation, priority evaluation, and decision making. In 2021 and 2023, 14 and 25 committee members participated in evaluating the prioritization of vaccines in the NIP, respectively. Overall, 13 and 19 NIP vaccine candidates were included in the 2021 and 2023 evaluations, respectively. Through the Delphi survey and consensus processes, the priority order was determined: vaccination against Rotavirus infection was the top priority in 2021, while Influenza 4v (for chronic disease patients) took precedence in 2023. This study demonstrates an evidence-based decision-making process within the healthcare field. The outlined approach may provide valuable guidance for policymakers in other countries seeking to prioritize the inclusion of new vaccines in their NIP.

Kim J, et al. Infect Chemother. 2023 Nov;55:e50. https://doi.org/10.3947/ic.2023.0064