A labelled discrete choice experiment adds realism to the choices presented: preferences for surveillance tests for Barrett esophagus.
A labelled discrete choice experiment adds realism to the choices presented: preferences for surveillance tests for Barrett esophagus.
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DOI：
10.1186/1471-2288-9-31
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发表时间：
2009-05-19
影响因子：
4
通讯作者：
Steyerberg EW
中科院分区：
文献类型：
--
作者：
Kruijshaar ME;Essink-Bot ML;Donkers B;Looman CW;Siersema PD;Steyerberg EW
离散选择实验（DCEs）允许通过要求受访者在场景之间进行选择来系统地评估偏好。我们进行了一个标记的离散选择实验与现实的选择，调查患者的权衡之间的预期健康收益和负担的检测监测巴雷特食管（BE）。根据2个属性选择了15种选择方案：1）检查类型（内窥镜检查和两种负担较轻的虚构检查），2）监测频率。每一种测试频率组合都与其自身的食管腺癌死亡风险的实际降低相关。拟合条件logit模型。在297例合格患者（155例BE和142例非特异性上消化道症状）中，247例（84%）完成了问卷调查。患者更喜欢监测而不是不监测。目前每1-2年一次的监测计划是最受欢迎的替代方案。与健康收益较低的人相比，人们更喜欢健康收益较高的人，除非测试频率超过每年一次。对于类似的健康收益，患者更喜欢视频胶囊而不是唾液拭子，最不喜欢内窥镜检查。在医疗保健环境中使用现实场景的标记DCE的第一个例子表明，这样的实验是可行的。考虑到设置和研究问题的标签和非标签设计的比较建议。
Discrete choice experiments (DCEs) allow systematic assessment of preferences by asking respondents to choose between scenarios. We conducted a labelled discrete choice experiment with realistic choices to investigate patients' trade-offs between the expected health gains and the burden of testing in surveillance of Barrett esophagus (BE). Fifteen choice scenarios were selected based on 2 attributes: 1) type of test (endoscopy and two less burdensome fictitious tests), 2) frequency of surveillance. Each test-frequency combination was associated with its own realistic decrease in risk of dying from esophageal adenocarcinoma. A conditional logit model was fitted. Of 297 eligible patients (155 BE and 142 with non-specific upper GI symptoms), 247 completed the questionnaire (84%). Patients preferred surveillance to no surveillance. Current surveillance schemes of once every 1–2 years were amongst the most preferred alternatives. Higher health gains were preferred over those with lower health gains, except when test frequencies exceeded once a year. For similar health gains, patients preferred video-capsule over saliva swab and least preferred endoscopy. This first example of a labelled DCE using realistic scenarios in a healthcare context shows that such experiments are feasible. A comparison of labelled and unlabelled designs taking into account setting and research question is recommended.
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影响因子：
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