Designing Discrete Choice Experiments Using a Patient-Oriented Approach

Aguiar, Magda; Harrison, Mark; Munro, Sarah; Burch, Tiasha; Kaal, K. Julia; Hudson, Marie; Bansback, Nick; Laba, Tracey‐Lea

doi:10.1007/s40271-020-00431-w

Cited by 13 publications

(13 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Secondly, by replicating decision-making, which requires trade-offs to be made between features of treatments, these methods can reveal whether potential modifications to treatments will influence participation in a RCT. For example, we found that a holistic, multidisciplinary, team, which was strongly endorsed as an important theme by people with scleroderma in our qualitative work [22], did not positively impact predicted participation in a trial. We believe our results will be informative for the design of any future trials of AHSCT for people with scleroderma, as we have described the preferences and trade-offs for Fig.…”

Section: Discussionmentioning

confidence: 79%

“…A conversation between patients, clinicians, and researchers (TB, MHu, MH, NB) about the interpretation of the SCOT trial for patient-physician decision-making resulted in development of a patient-oriented project, to explore how patient perspectives could be formally elicited and used in design of RCTs. Two patient partners (TB, JB) were integrated into the research team and contributed to all stages of the project, including formulation of the research question and funding application (TB), survey design, recruitment, data analysis, interpretation, and dissemination (TB and JB); this process and the level of engagement aligns with the concept of co-production in PPI [14] which has been described elsewhere and our framework for patient involvement is summarized in the supplementary material (Table S1) [21,22].…”

Section: Patient and Public Involvementmentioning

confidence: 99%

“…Treatment characteristics (attributes) were developed using qualitative methods [22], as recommended by best practice [24], and reflect the most important aspects of the decision about whether or not to undergo AHSCT treatment (Supplementary material (Table S1)). We used a nominal group technique (NGT) in a focus group with eight people with scleroderma in British Columbia, as part of a patient-oriented qualitative approach to design the DCE [22]. The NGT was designed to allow in-person and virtual participation to allow the perspectives of scleroderma patients in urban, rural and remote settings to participate.…”

Section: Dce Survey Designmentioning

confidence: 99%

See 2 more Smart Citations

Co-production of randomized clinical trials with patients: a case study in autologous hematopoietic stem cell transplant for patients with scleroderma

Aguiar

Laba

Munro

et al. 2021

Trials

Self Cite

View full text Add to dashboard Cite

Background Increasingly, it is argued that clinical trials struggle to recruit participants because they do not respond to key questions or study treatments that patients will be willing or able to use. This study explores how elicitation of patient-preferences can help designers of randomized controlled trials (RCTs) understand the impact of changing modifiable aspects of treatments or trial design on recruitment. Methods Focus groups and a discrete choice experiment (DCE) survey were used to elicit preferences of people with scleroderma for autologous hematopoietic stem cell transplant (AHSCT) treatment interventions. Preferences for seven attributes of treatment (effectiveness, immediate and long-term risk, care team composition and experience, cost, travel distance) were estimated using a mixed-logit model and used to predict participation in RCTs. Results Two hundred seventy-eight people with scleroderma answered the survey. All AHSCT treatment attributes significantly influenced preferences. Treatment effectiveness and risk of late complications contributed the most to participants’ choices, but modifiable factors of distance to treatment center and cost also affected preferences. Predicted recruitment rates calibrated with participation in a recent trial (33%) and suggest offering a treatment closer to home, at lower patient cost, and with holistic, multidisciplinary care could increase participation to 51%. Conclusions Through a patient engaged approach to preference elicitation for different features of AHSCT treatment options, we were able to predict what drives the decisions of people with scleroderma to participate in RCTs. Knowledge regarding concerns and the trade-offs people are willing to make can inform clinical study design, improving recruitment rates and potential uptake of the treatment of interest.

show abstract

Section: Discussionmentioning

confidence: 79%

Section: Patient and Public Involvementmentioning

confidence: 99%

Section: Dce Survey Designmentioning

confidence: 99%

See 1 more Smart Citation

Co-production of randomized clinical trials with patients: a case study in autologous hematopoietic stem cell transplant for patients with scleroderma

Aguiar

Laba

Munro

et al. 2021

Trials

Self Cite

View full text Add to dashboard Cite

show abstract

“…Future research to quantify the preferences of these groups is needed for comparison. Understanding the preferences of clinicians and children and their caregivers is valuable for the design of studies involving novel neurotechnologies; understanding how individuals consider choices and make trade‐offs—for either technological or other interventions including diet or alternative approaches—is also invaluable for the design of clinical studies and trials, recruitment and participation in research, and for the improvement of treatment delivery 31–33 …”

Section: Discussionmentioning

confidence: 99%

Clinician preferences for neurotechnologies in pediatric drug‐resistant epilepsy: A discrete choice experiment

et al. 2022

Self Cite

View full text Add to dashboard Cite

Objective Novel and minimally invasive neurotechnologies offer the potential to reduce the burden of epilepsy while avoiding the risks of conventional resective surgery. Few neurotechnologies have been tested in randomized controlled trials with pediatric populations, leaving clinicians to face decisions about whether to recommend these treatments with insufficient evidence about the relevant risks and benefits. This study specifically explores the preferences of clinicians for treating pediatric drug‐resistant epilepsy (DRE) with novel neurotechnologies. Methods A discrete‐choice experiment (DCE) was designed to elicit the preferences of clinicians with experience in treating children with DRE using novel neurotechnological interventions. The preferences for six key attributes used when making treatment decisions (chances of clinically significant improvement in seizures, major and minor risks from intervention, availability of evidence, financial burden for the family, and access to the intervention) were estimated using a conditional logit model. The estimates from this model were then used to predict the adoption of existing novel neurotechnological interventions. Results Sixty‐eight clinicians completed the survey: 33 neurosurgeons, 28 neurologists, and 7 other clinicians. Most clinicians were working in the United States (74%), and the remainder (26%) in Canada. All attributes, apart from the nearest location with access to the intervention, influenced preferences significantly. The chance of clinically significant improvement in seizures was the most positive influence on clinician preferences, but low‐quality evidence and a higher risk of major complications could offset these preferences. Of the existing neurotechnological interventions, vagus nerve stimulation was predicted to have the highest likelihood of adoption; deep brain stimulation had the lowest likelihood of adoption. Significance The preferences of clinicians are drive primarily by the likelihood of achieving seizure freedom for their patients, but preferences for an intervention are largely eradicated if only low quality of evidence supporting the intervention is available. Until better evidence supporting the use of potentially effective, novel neurotechnologies becomes available, clinicians are likely to prefer more established treatments.

show abstract

“…This themed issue includes eight papers that highlight innovative ways HEOR researchers have engaged patients and/or the public; projects that have trained patients/the public in HEOR and those that have educated HEOR researchers on the patient perspective; and research that quantifies the value-added patient/public engagement on the impact of the project and/or programme of research. It includes research undertaken in Canada [16], the US [17,18] and the UK [19][20][21][22], across a range of HEOR areas: outcomes research [17,19], preference elicitation [16,21], decision analytic modelling [22], and value assessment [18], including a general perspective of principles to improve patient involvement in HEOR [20]. A highlight of the themed issue is a commentary by a patient partner [23]; this provides a unique reflection of the experience of the patient as a partner in the research process.…”

mentioning

confidence: 99%

Patient and Public Involvement in Health Economics and Outcomes Research

Lorgelly

2021

Patient

View full text Add to dashboard Cite

Designing Discrete Choice Experiments Using a Patient-Oriented Approach

Cited by 13 publications

References 27 publications

Co-production of randomized clinical trials with patients: a case study in autologous hematopoietic stem cell transplant for patients with scleroderma

Co-production of randomized clinical trials with patients: a case study in autologous hematopoietic stem cell transplant for patients with scleroderma

Clinician preferences for neurotechnologies in pediatric drug‐resistant epilepsy: A discrete choice experiment

Patient and Public Involvement in Health Economics and Outcomes Research

Contact Info

Product

Resources

About