{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T15:12:51Z","timestamp":1792422771013,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychiatry Clin Neurosci"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To determine the smallest worthwhile difference (SWD) for lecanemab, a disease\u2010modifying drug for Alzheimer's disease (AD), among the general Japanese population using a benefit\u2010harm trade\u2010off method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an online survey with 658 participants to evaluate their preferences for the treatment effect of lecanemab, given its associated risks and high cost. We calculated SWD as the minimum required increase in the possibility of maintaining cognitive function (relative to the 50% without lecanemab) that patients would accept in exchange for the burdens of treatment (adverse effects, costs, other inconveniences). We examined the median SWD for two scenarios: a family member (SWD\u2010families) and others (SWD\u2010others), and analyzed subgroup differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median SWD revealed a 15% increase for SWD\u2010families and SWD\u2010others. This value exceeds the drug's actual efficacy of an 8% increase. Notably, 17% of respondents reported zero SWD, driven by an intense fear of AD and possibly high expectations from media coverage. Including these participants, nearly half of the respondents considered the current effect worthwhile. No noticeable difference was found between the SWD\u2010families and SWD\u2010others.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Based on Japanese clinical scenarios, the public's median expectation for lecanemab exceeds its efficacy, though its current benefit remains acceptable to nearly half the population. These findings underscore that the SWD is shaped by psychological drivers, including fear and hope, rather than just reasoned evaluation. Clinicians must manage these expectations, accounting for highly heterogeneous treatment preferences. Future research should account for emotional factors that can overshadow a rational assessment of treatment value.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pcn.70082","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:51:47Z","timestamp":1779277907000},"page":"740-747","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Public acceptance and expectations for Lecanemab: Insights from a Smallest Worthwhile Difference study"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3926-8867","authenticated-orcid":false,"given":"Aran","family":"Tajika","sequence":"first","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences Kyoto University Graduate School of Medicine\/School of Public Health  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0109-7425","authenticated-orcid":false,"given":"Kenji","family":"Omae","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences Kyoto University Graduate School of Medicine\/School of Public Health  Kyoto Japan"},{"name":"Department of Innovative Research and Education for Clinicians and Trainees (DiRECT) Fukushima Medical University Hospital  Fukushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4269-4800","authenticated-orcid":false,"given":"Ethan","family":"Sahker","sequence":"additional","affiliation":[{"name":"Population Health and Policy Research Unit, Center for Medical Education and Internationalization, Graduate School of Medicine Kyoto University  Kyoto 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A.","family":"Furukawa","sequence":"additional","affiliation":[{"name":"Kyoto University Office of Institutional Advancement and Communications  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"WHO.Dementia.Fact sheetsWorld Health Organization.2023."},{"key":"e_1_2_9_3_1","unstructured":"University K.Research Report on the Prevalence Survey and Future Projections of Dementia and Mild Cognitive Impairment Subsidized by the Ministry of Health Labour and Welfare's Grant for the Promotion of Health Care for the Elderly (in 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