Measuring patient preferences for treatment of colorectal cancer using discrete choice modelling

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Around the world, governments, medical professional bodies, individual clinicians and patients are trying to make decisions in health care more rationally. More of these decisions are 'informed' by evidence-based medicine, which depends on a systematic review of all relevant evidence of acceptable scientific rigour. This kind of systematic review has been conducted for the management of colorectal cancer. Patients making choices about possible treatment for colorectal cancer will then have the best 'evidence-based' information to hand. But not enough is known about what aspects of the treatment options matter most to patients. Choosing between different treatment options involves weighing up or trading-off different factors associated with each therapy. Depending on the clinical stage of their cancer, patients may have to choose between the type and size of surgical operation, whether or not to have chemotherapy and-or radiotherapy, the side effects of treatment, the chance of a recurrence of the disease and an early death as well as their quality of life. This research project will ask patients who have already been treated for their colorectal cancer what kind of tradeoffs they make between factors such as disease-free survival, toxicity of treatment and longer term quality of life. This will be done using hypothetical clinical scenarios comparing one type of treatment to another. In this way, the hypothetical choices will be informed by the patient's experience with treatment without asking them to reflect or dwell directly on their own treatment choices. The answers to the hypothetical choice questions can be used to assess what factors in treatment are most important to patients and by how much. This information can then be used by clinicians when presenting evidence-based information on treatment for patients newly diagnosed colorectal cancer.