What matters most to patients when choosing treatment for mild–moderate asthma? Results from a discrete choice experiment

Thorax ◽  
2020 ◽  
Vol 75 (10) ◽  
pp. 842-848
Author(s):  
Christina Baggott ◽  
Paul Hansen ◽  
Robert J Hancox ◽  
Jo Katherine Hardy ◽  
Jenny Sparks ◽  
...  
Keyword(s):  
Treatment Regimen ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Controlled Trial ◽  
Final Analysis ◽  
Mild Asthma ◽  
Relative Importance ◽  
Shortness Of Breath ◽  
Moderate Asthma

BackgroundAn as-needed combination preventer and reliever regimen was recently introduced as an alternative to conventional daily preventer treatment for mild asthma. In a subgroup analysis of the PRACTICAL study, a pragmatic randomised controlled trial of budesonide–formoterol reliever therapy versus maintenance budesonide plus terbutaline reliever therapy in adults with mild asthma, we recently reported that about two-thirds preferred as-needed combination preventer and reliever therapy. The aim of this study was to determine the relative importance of attributes associated with these two asthma therapies in this subgroup of participants who indicated their preferred treatment in the PRACTICAL study.MethodsAt their final study visit, a subgroup of participants indicated their preferred treatment and completed a discrete choice experiment using the Potentially All Pairwise RanKings of all possible Alternatives method and 1000minds software. Treatment attributes and their levels were selected from measurable study outcomes, and included: treatment regimen, shortness of breath, steroid dose and likelihood of asthma flare-up.ResultsThe final analysis dataset included 288 participants, 64% of whom preferred as-needed combination preventer and reliever. Of the attributes, no shortness of breath and lowest risk of asthma flare-up were ranked highest and second highest, respectively. However, the relative importance of the other two attributes varied by preferred therapy: treatment regimen was ranked higher by participants who preferred as-needed treatment than by participants who preferred maintenance treatment.ConclusionsKnowledge of patient preferences for treatment attributes together with regimen characteristics can be used in shared decision-making regarding choice of treatment for patients with mild–moderate asthma.Trial registration numberACTRN12616000377437.

scholarly journals Discrete choice experiment for eliciting preference for health services for patients with ALS and their informal caregivers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katy Tobin ◽  
Sinead Maguire ◽  
Bernie Corr ◽  
Charles Normand ◽  
Orla Hardiman ◽  
...  
Keyword(s):  
Health Services ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Strong Preference ◽  
Multidisciplinary Teams ◽  
Relative Importance ◽  
Trade Offs ◽  
Als Patients ◽  
The Impact

Abstract Background Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative condition with a mean life expectancy of 3 years from first symptom. Understanding the factors that are important to both patients and their caregivers has the potential to enhance service delivery and engagement, and improve efficiency. The Discrete Choice Experiment (DCE) is a stated preferences method which asks service users to make trade-offs for various attributes of health services. This method is used to quantify preferences and shows the relative importance of the attributes in the experiment, to the service user. Methods A DCE with nine choice sets was developed to measure the preferences for health services of ALS patients and their caregivers and the relative importance of various aspects of care, such as timing of care, availability of services, and decision making. The DCE was presented to patients with ALS, and their caregivers, recruited from a national multidisciplinary clinic. A random effects probit model was applied to estimate the impact of each attribute on a participant’s choice. Results Patients demonstrated the strongest preferences about timing of receiving information about ALS. A strong preference was also placed on seeing the hospice care team later rather than early on in the illness. Patients also indicated their willingness to consider the use of communication devices. Grouping by stage of disease, patients who were in earlier stages of disease showed a strong preference for receipt of extensive information about ALS at the time of diagnosis. Caregivers showed a strong preference for engagement with healthcare professionals, an attribute that was not prioritised by patients. Conclusions The DCE method can be useful in uncovering priorities of patients and caregivers with ALS. Patients and caregivers have different priorities relating to health services and the provision of care in ALS, and patient preferences differ based on the stage and duration of their illness. Multidisciplinary teams must calibrate the delivery of care in the context of the differing expectations, needs and priorities of the patient/caregiver dyad.

scholarly journals SARS-CoV-2 Testing Service Preferences of Adults in the United States: Discrete Choice Experiment (Preprint)

2020 ◽  
Author(s):  
Rebecca Zimba ◽  
Sarah Kulkarni ◽  
Amanda Berry ◽  
William You ◽  
Chloe Mirzayi ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Turnaround Time ◽  
Urgent Care ◽  
Relative Importance ◽  
Test Type ◽  
Specimen Type ◽  
Testing Uptake ◽  
Community Transmission

BACKGROUND Ascertaining preferences for SARS-CoV-2 testing and incorporating findings into the design and implementation of strategies for delivering testing services may enhance testing uptake and engagement, a prerequisite to reducing onward transmission. OBJECTIVE This study aims to determine important drivers of decisions to obtain a SARS-CoV-2 test in the context of increasing community transmission. METHODS We used a discrete choice experiment to assess preferences for SARS-CoV-2 test type, specimen type, testing venue, and results turnaround time. Participants (n=4793) from the US national longitudinal Communities, Households and SARS-CoV-2 Epidemiology (CHASING) COVID Cohort Study completed our online survey from July 30 to September 8, 2020. We estimated the relative importance of testing method attributes and part-worth utilities of attribute levels, and simulated the uptake of an optimized testing scenario relative to the current typical testing scenario of polymerase chain reaction (PCR) via nasopharyngeal swab in a provider’s office or urgent care clinic with results in >5 days. RESULTS Test result turnaround time had the highest relative importance (30.4%), followed by test type (28.3%), specimen type (26.2%), and venue (15.0%). In simulations, immediate or same-day test results, both PCR and serology, or oral specimens substantially increased testing uptake over the current typical testing option. Simulated uptake of a hypothetical testing scenario of PCR and serology via a saliva sample at a pharmacy with same-day results was 97.7%, compared to 0.6% for the current typical testing scenario, with 1.8% opting for no test. CONCLUSIONS Testing strategies that offer both PCR and serology with noninvasive methods and rapid turnaround time would likely have the most uptake and engagement among residents in communities with increasing community transmission of SARS-CoV-2.

scholarly journals A discrete choice task to measure preferences for harsh discipline among parents of young children

2017 ◽  
Author(s):  
Eric Green ◽  
Rhea Chase ◽  
John Zayzay ◽  
Amy Finnegan ◽  
Eve Puffer
Keyword(s):  
Discrete Choice Experiment ◽  
Response Bias ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Controlled Trial ◽  
Choice Task ◽  
Self Report ◽  
Harsh Discipline ◽  
Increased Risk ◽  
Parent Preferences

Maltreatment in early childhood is difficult to measure. Self-report surveys of parents and guardians are the most common method used, but in many settings social desirabil- ity may lead to underestimates of prevalence. There is also reason to be concerned about response bias in the context of intervention trials. To diversify the tools available to in- tervention researchers, we created and tested a discrete choice experiment to elicit parent preferences for harsh discipline. This study was conducted in Liberia as part of a random- ized controlled trial of a positive parenting program. Baseline data were collected from 609 parents and guardians living in Monrovia and caring for a child age 3 or 4. Participants completed a discrete choice experiment that consisted of 12 parenting vignettes, in addition to a survey of parenting attitudes and behaviors. The vignettes were presented to parents as digital comic strips. Each scene could vary on four attributes: child gender; child offense; setting; number of adults present. For each scene, participants selected 1 of 5 discipline strategies that they would in that situation. The visual discrete choice task was easy to implement, well understood by participants, and has evidence of construct validity as a measure of parent preferences for harsh discipline. Tools like this expand the options for researchers studying the maltreatment of pre-school age children, particularly in the con- text of program evaluations where post-intervention observations may be at increased risk of response bias. It may also be useful in a clinical context.

scholarly journals The policy-seeking voter: evaluations of government performance beyond the economy

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Niels Markwat
Keyword(s):  
Public Opinion ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Value Congruence ◽  
Government Performance ◽  
Relative Importance ◽  
Retrospective Voting ◽  
Individual Preferences ◽  
Promising Development

AbstractVoters hold governments to account through elections, but which criteria are most important to voter evaluations of incumbent performance? While (economic) outcomes have long been central to studies of retrospective voting, recent studies have considered the influence of policy output—the policies implemented by incumbents to achieve their goals. Building on this promising development, this study identifies three ways in which policy output is expected to affect voter evaluations of incumbent performance—the congruence between implemented policy and (1) individual preferences; (2) public opinion; and (3) election pledges. A discrete choice experiment was designed to assess the relative importance of these three aspects of policy output in comparison to each other; as well as to two important economic indicators. Overall, the findings support the notion that policy output matters to voters even beyond outcomes. The findings also show that voters value congruence between policy and their personal preferences considerably more than policy congruence with public opinion; and election pledge fulfillment. This indicates that voters are egotropic in their evaluation of implemented policy, and more policy-seeking than accounted for in much of the empirical retrospective voting literature. These results inform our understanding of how policy output matters to voters, as well as of how voters hold governments accountable for their performance.

scholarly journals Public Preferences regarding Data Linkage for Health Research: A Discrete Choice Experiment

2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Mhairi Aitken ◽  
Gareth McAteer ◽  
Sara Davidson ◽  
Clive Frostick ◽  
Sarah Cunningham-Burley
Keyword(s):  
Data Sharing ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Public Engagement ◽  
Health Research ◽  
Choice Experiment ◽  
Data Linkage ◽  
Public Support ◽  
Influential Factors ◽  
Relative Importance

The potential for data collected in the public and private sector to be linked and used in research has led to increasing interest in public acceptability of data sharing and data linkage. The literature has identified a range of factors that are important for shaping public responses and in particular has noted that public support for research conducted through data linkage or data sharing is contingent on a number of conditions being met. In order to examine the relative importance of these conditions a Discrete Choice Experiment (DCE) was conducted via an online questionnaire among members of Ipsos MORI’s online panel in Scotland. The survey was completed by 1,004 respondents. Overall the two most influential factors shaping respondents’ preferences are: the type of data being linked; and, how profits are managed and shared. The type of data being linked is roughly twice as important as who the researchers are. There were slight differences across age groups and between genders and slight differences when comparing respondents with and without long term health conditions. The most notable differences between respondents were found when comparing respondents according to employment and working sector. This study provides much needed evidence regarding the relative importance of various conditions which may be essential for securing and sustaining public support for data-linkage in health research. This may be useful for indicating which factors to focus on in future public engagement and has important implications for the design and delivery of research and public engagement activities. The continuously evolving nature of the field means it will be necessary to revisit the key conditions for public support on an ongoing basis and to examine the contexts and circumstances in which these might change. .

scholarly journals Patient Preferences for Attributes of Chemotherapy for Lung Cancer: Discrete Choice Experiment Study in Japan

2021 ◽  
Vol 12 ◽  
Author(s):  
Yasuo Sugitani ◽  
Kyoko Ito ◽  
Shunsuke Ono
Keyword(s):  
Lung Cancer ◽  
Adverse Events ◽  
Cancer Patients ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Patient Preferences ◽  
Logit Model ◽  
Choice Experiment ◽  
Relative Importance ◽  
Lung Cancer Patients

Our study objective was to determine lung cancer chemotherapy attributes that are important to patients in Japan. A discrete choice experiment survey in an anonymous web-based questionnaire format with a reward was completed by 200 lung cancer patients in Japan from November 25, 2019, to November 27, 2019. The relative importance of patient preferences for each attribute was estimated using a conditional logit model. A hierarchical Bayesian logit model was also used to estimate the impact of each demographic characteristic on the relative importance of each attribute. Of the 200 respondents, 191 with consistent responses were included in the analysis. In their preference, overall survival was the most important, followed by diarrhea, nausea, rash, bone marrow suppression (BMS), progression-free survival, fatigue, interstitial lung disease, frequency of administration, and duration of administration. The preferences were influenced by demographic characteristics (e.g., gender and age) and disease background (e.g., cancer type and stage). Interestingly, the experience of cancer drug therapies and adverse events had a substantial impact on the hypothetical drug preferences. For the Japanese lung cancer patients, improved survival was the most important attribute that influenced their preference for chemotherapy, followed by adverse events, including diarrhea, nausea, rash, and BMS. The preferences varied depending on the patient’s demographic and experience. As drug attributes can affect patient preferences, pharmaceutical companies should be aware of the patient preferences and develop drugs that respond to segmented market needs.

scholarly journals Preferences of people with type 2 diabetes for telemedical lifestyle programmes in Germany: protocol of a discrete choice experiment

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036995 ◽  
Author(s):  
Jana Sommer ◽  
Jan Dyczmons ◽  
Sandra Grobosch ◽  
Veronika Gontscharuk ◽  
Markus Vomhof ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Intervention ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Latent Class ◽  
Controlled Trial ◽  
Intervention Programme ◽  
Registration Number

IntroductionTelemedical lifestyle programmes for people with type 2 diabetes mellitus (T2DM) provide an opportunity to develop a healthier lifestyle and consequently to improve health outcomes. When implementing new programmes into standard care, considering patients’ preferences may increase the success of the participants. This study aims to examine the preferences of people with T2DM with respect to telemedical lifestyle programmes, to analyse whether these preferences predict programme success and to explore the changes that may occur during a telemedical lifestyle intervention.Methods and analysisWe outline the protocol of the development and assessment of a discrete choice experiment (DCE) to examine patient preferences in a telemedical lifestyle programme with regard to the functions of the online portal, communication, responsibilities, group activities and time requirements. To develop the design of the DCE, we conducted pilot work involving healthcare experts and in particular people with T2DM using cognitive pretesting. The final DCE is being implemented within a randomised controlled trial for investigating whether participation in a telemedical lifestyle intervention programme sustainably improves the HbA1c values in 850 members of a large German statutory health insurance with T2DM. Preferences are being assessed before and after participants complete the programme. The DCE data will be analysed using regression and latent class analyses.Ethics and disseminationThe DCE study has been approved by the ethics committee of the medical faculty of the Heinrich Heine University Duesseldorf, registration number 2018-242-ProspDEuA, registered on 6 December 2018. The TeLIPro trial is registered at the US National Library of Medicine, registration number NCT03675919, registered on 15 September 2018. We aim to disseminate our results in peer-reviewed journals, at national and international conferences and among interested patient groups and the public.

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