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Identification of novel skin ageing genes: evidence from across the pigmentary continuum

that help physicians ‘diagnose’ their patients’ priorities in the management of their disease. There is clear evidence that not all benefits from psoriasis treatments are equally valuable. Patients’ willingness to accept costs or risks varies with the severity and location of their lesions. Adverse events also are not all equally concerning. Thus, the most desirable combination of expected benefits and risks can vary in meaningful ways across patients. As with other clinical information needed to choose an appropriate therapy, the assessment of acceptable combinations of treatment benefits, risks and burdens should be undertaken systematically and follow best practices. Furthermore, diagnosis of a patient’s treatment preferences should be implemented in a way that saves time during the clinical encounter, and should motivate more targeted discussions about treatment options. Tools that meet these standards are in development and are already in use in other disease areas, such as oncology. Expanding treatment discussions to systematically include patients’ preferences also can improve patient– physician communication, and alter their treatment decisions and satisfaction with the treatment. The number of therapies available today represent a broad pool of tools that can help us treat patients successfully by leveraging evidence on their likelihood of success and patients’ evaluation of the relative importance of the trade-offs required to achieve that level of improvement with a specific degree of confidence. While patient preference information will never be a substitute for clinical judgements, it can be a powerful complement to improve overall patient wellbeing, including the effects of treatment and financial burdens of the disease.