scholarly journals Valuation of Viticultural Adaptation to Climate Change in Vineyards: A Discrete Choice Experiment to Prioritize Trade-Offs Perceived by Citizens

2020 ◽  
Vol 9 (2) ◽  
pp. 99-112
Author(s):  
Verónica Farreras ◽  
Laura Abraham
Keyword(s):  
Climate Change ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Water Availability ◽  
Choice Experiment ◽  
Social Preferences ◽  
Chemical Fertilizers ◽  
Trade Off ◽  
Percentage Points ◽  
Conservation Of Biodiversity

On a climate change scenario, a discrete choice experiment was applied to elicit the trade-off values for three environmental impacts of current viticultural management practices in vineyards of Mendoza, Argentina. Water availability for other uses was found to be the most concerning topic for the population, followed by use of chemical fertilizers and then by use and conservation of biodiversity. An increase of one percentage point in water availability was estimated to add each citizen on average 13.05 Argentinean pesos – 0.74 US dollars – per year in terms of increased welfare, a figure equivalent to the welfare drop a citizen would experience after an increase of 1.45 percentage points in the use of chemical fertilizers annually per hectare, or a decrease of 2.69 percentage points in the use and conservation of biodiversity. These trade-off values may help policy makers, planners, regional managers, and ecologists to take social preferences into account in setting resource allocation priorities intended to support viticulture. This study approach provides a framework that could guide similar assessments in other regions.

scholarly journals Treatment Preference Among Patients With Spinal Muscular Atrophy (SMA): A Discrete Choice Experiment

2020 ◽  
Author(s):  
Alisha Monnette ◽  
Er Chen ◽  
Dongzhe Hong ◽  
Alessandra Bazzano ◽  
Stacy Dixon ◽  
...  
Keyword(s):  
Spinal Muscular Atrophy ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Muscular Atrophy ◽  
Route Of Administration ◽  
Oral Medication ◽  
Treatment Preference ◽  
Minimal Risk ◽  
Trade Off

Abstract OBJECTIVE: To examine patient/caregiver preference for key attributes of treatments for spinal muscular atrophy (SMA). BACKGROUND: In the rapidly evolving SMA treatment landscape, it is critically important to understand how attributes of potential treatments may impact patient/caregiver choices.DESIGN/METHODS: A discrete choice experiment survey was developed based on qualitative interviews. Patients with SMA (18 years) and caregivers of patients were recruited through a U.S. patient organization. Respondents made choices in each of 12 sets of hypothetical treatments. The relative importance of five treatment characteristics was compared (measured by regression coefficients [RC] of conditional logit models): (1) improvement or stabilization of motor function, (2) improvement or stabilization of breathing function, (3) indication for all ages or pediatric patients only, (4) route of administration (repeated intrathecal [IT] injections, one-time intravenous [IV] infusion, daily oral delivery) and (5) potential harm (mild, moderate, serious/life threatening).RESULTS: Patient ages ranged from less than 1 to 67 years (n=101, 65 self-reported and 36 caregiver-reported) and 64 were female. Total SMA subtypes included: type 1 (n=21), type 2 (n=48), type 3 (n=29), other (n=3). Prior spinal surgery was reported in 47 patients. Nusinersen and onasemnogene abeparvovec-xioi use were reported in 59 and 10 patients, respectively. Improvement in motor and breathing function was highly valued (RC: 0.65, 95% confidence interval [CI]: 0.47–0.83 and RC: 0.79, 95% CI: 0.60–0.98, respectively). Oral medication and one-time infusion were strongly preferred over repeated IT injections (RC: 0.80, 95% CI: 0.60–0.98 and RC: 0.51, 95% CI: 0.30–0.73, respectively). Patients least preferred an age-restricted label/approved use ( 2 years of age) (RC: -1.28, 95% CI: -1.47 to -1.09). Cross-attributes trade-off decision suggested a lower willingness for a high-risk therapy despite additional efficacy gain. For some patients, there may be willingness to trade off additional gains in efficacy for a change in route of administration from repeated intrathecal administration to oral medication.CONCLUSIONS: Improvements in motor/breathing function, broad indication, oral or one-time infusion, and minimal risk were preferred treatment attributes. Treatment decisions should be made in clinical context and be tailored to patient needs.

scholarly journals How do surgeons’ trade-off between patient outcomes and risk of complications in total knee arthroplasty? a discrete choice experiment in Australia

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029406 ◽  
Author(s):  
Sandie Szawlowski ◽  
Peter F M Choong ◽  
Jinhu Li ◽  
Elizabeth Nelson ◽  
Mandana Nikpour ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Night Time ◽  
Trade Off ◽  
Orthopaedic Surgeons ◽  
Trade Offs ◽  
Total Knee ◽  
And Function

ObjectiveTo measure the trade-off between risk of complications versus patient improvement in pain and function in orthopaedic surgeons’ decisions about whether to undertake total knee arthroplasty (TKA).MethodsA discrete choice experiment asking surgeons to make choices between experimentally-designed scenarios describing different levels of operative risk and dimensions of pain and physical function. Variation in preferences and trade-offs according to surgeon-specific characteristics were also examined.ResultsThe experiment was completed by a representative sample of 333 orthopaedic surgeons (n=333): median age 52 years, 94% male, 91% fully qualified. Orthopaedic surgeons were willing to accept substantial increases in absolute risk associated with TKA surgery for greater improvements in a patient’s pain and function. The maximum risk surgeons were willing to accept was 40% for reoperation and 102% for the need to seek further treatment from a general practitioner or specialist in return for a change from postoperative severe night-time pain at baseline to no night-time pain at 12 months. With a few exceptions, surgeon-specific characteristics were not associated with how much risk a surgeon is willing to accept in a patient undergoing TKA.ConclusionThis is the first study to quantify risk-benefit trade-offs among orthopaedic surgeons performing TKA, using a discrete choice experiment. This study provides insight into the risk tolerance of surgeons.

793 PATIENTS’ PREFERENCES FOR ACTIVE SURVEILLANCE OR STANDARD ESOPHAGECTOMY AFTER NEOADJUVANT CHEMORADIOTHERAPY: A DISCRETE CHOICE EXPERIMENT IN PATIENTS AFTER STANDARD ESOPHAGECTOMY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Berend Van Der Wilk ◽  
Inge Spronk ◽  
Bo J Noordman ◽  
Ben M Eyck ◽  
Juanita Haagsma ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Neoadjuvant Chemoradiotherapy ◽  
Trade Off ◽  
Attribute Levels ◽  
One Year ◽  
Treatment Alternatives

Abstract   Active surveillance after neoadjuvant chemoradiotherapy for locally advanced resectable esophageal cancer is currently topic of investigation. In a discrete choice experiment, patients’ preferences can be quantified by asking patients to state their preference over hypothetical treatment alternatives. The aim of the present study was to assess patients’ preferences for either active surveillance or standard esophagectomy in patients who underwent neoadjuvant chemoradiotherapy followed by surgery without signs of recurrence. Methods A discrete choice experiment was performed in esophageal cancer patients who underwent neoadjuvant chemoradiotherapy followed by standard esophagectomy at least one year earlier. Patients completed a questionnaire consisting of eighteen choice sets considering active surveillance or standard esophagectomy. Treatment alternatives were characterized by attributes with varying attribute levels hypothesized to influence treatment choice: five-year survival, short-term and long-term health related quality of life (HRQOL), annual number of diagnostics required and the risk that esophagectomy is still necessary later in time. The importance of attributes and willingness to trade-off 5-year survival for other attributes were assessed using panel latent class model. Results A total of 107 patients were consecutively included, of whom 100 (93%) responded between August 2018 and October 2020. Regardless of the attribute levels, 28 patients preferred active surveillance and 28 patients preferred standard esophagectomy. When considering both treatments, five-year survival and long-term HRQOL were considered most important attributes. Patients were willing to trade-off 5.4% five-year overall survival to obtain a better long-term HRQOL. Conclusion At least one year after neoadjuvant chemoradiotherapy and esophagectomy, over a quarter of patients would choose not to undergo standard esophagectomy again, regardless of the attribute levels. Patients were willing to trade-off five-year survival chance in order to achieve an HRQOL which was much better than their own situation. When considering both treatments, five-year survival and long-term HRQOL were the most important determinants in the choice for treatment.

scholarly journals Social Preferences for Orphan Drugs: A Discrete Choice Experiment Among the French General Population

2020 ◽  
Vol 7 ◽  
Author(s):  
Mondher Toumi ◽  
Aurélie Millier ◽  
Olivier Cristeau ◽  
Katia Thokagevistk-Desroziers ◽  
Julie Dorey ◽  
...  
Keyword(s):  
General Population ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Social Preferences ◽  
Orphan Drugs
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