General populations’ preferences for colorectal cancer screening: rationale and protocol for the discrete choice experiment in the SIGMO study

Brinkmann, Melanie; Diedrich, Leonie; Krauth, Christian; Robra, BP; Stahmeyer, Jona T.; Dreier, Maren

doi:10.1136/bmjopen-2020-042399

Cited by 7 publications

(6 citation statements)

References 30 publications

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“… 16 The SIGMO study is registered at the German Clinical Trials Register (DRKS00019010), and a study protocol was published. 6 …”

Section: Methodsmentioning

confidence: 99%

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Attributes Characterizing Colorectal Cancer Screening Tests That Influence Preferences of Individuals Eligible for Screening in Germany: A Qualitative Study

Brinkmann¹,

Holt²,

Diedrich³

et al. 2022

PPA

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Purpose This qualitative study is part of the SIGMO study, which evaluates general populations’ preferences for colorectal cancer (CRC) screening in Germany using a discrete choice experiment. Attribute identification and selection are essential in the construction of choice tasks and should be evidence-based ensuring that attributes are relevant to potential beneficiaries and contribute to overall utility. Therefore, this qualitative study aims to identify relevant attributes characterizing CRC screening tests from the perspective of those eligible for screening in Germany. Patients and Methods Individuals aged 50 to 60 were purposively selected. A questioning route was developed and piloted. Four focus groups (FG) (n=20) were conducted (November 2019) with two moderators and one observer each. FGs were audio recorded, transcribed, and analyzed using qualitative content analysis. Attributes were deductively assigned based on a priori identified attribute categories, and inductively derived. Results Across FGs, 24 attributes (n=293 codes) were discussed, five of which (sedation, inability to work, transportation home, predictive values, waiting time for screening colonoscopy) were inductively derived (n=76 codes). Four attributes identified a priori were not addressed in any FG. The most frequently discussed attribute category was procedural characteristics, followed by measures of screening test validity, benefits, harms, and structural characteristics of health care. The most commonly addressed attributes were preprocedural bowel cleansing, kind of procedure, and predictive values. Conclusion Newly identified attributes characterizing CRC screening tests from an individual’s perspective, and a priori identified attributes not addressed by any FG stress the added value of qualitative research and thereby the importance of applying a mix of methods in identifying and selecting attributes for the construction of choice tasks. This study meets the requirements for a transparent and detailed presentation of the qualitative methods used in this process, which has rarely been the case before.

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“… 16 The SIGMO study is registered at the German Clinical Trials Register (DRKS00019010), and a study protocol was published. 6 …”

Section: Methodsmentioning

confidence: 99%

“…study evaluates whether sigmoidoscopy should be additionally offered for CRC screening in Germany. 6 Part of the study is a discrete choice experiment (DCE) to determine general populations’ preferences for CRC screening. A DCE is a stated preference elicitation method that originates from (health) economics.…”

Section: Introductionmentioning

confidence: 99%

Attributes Characterizing Colorectal Cancer Screening Tests That Influence Preferences of Individuals Eligible for Screening in Germany: A Qualitative Study

Brinkmann¹,

Holt²,

Diedrich³

et al. 2022

PPA

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“…The protocol of the DCE was published elsewhere. 25 The specific objectives of the modelling approach are to evaluate the effects of the extended screening offer on: 1. The participation rates and participation shift between the different screening measures.…”

Section: Open Accessmentioning

confidence: 99%

“…The protocol of the DCE was published elsewhere. 25 The specific objectives of the modelling approach are to evaluate the effects of the extended screening offer on:…”

Section: Introductionmentioning

confidence: 99%

Additional offer of sigmoidoscopy in colorectal cancer screening in Germany: rationale and protocol of the decision-analytic modelling approach in the SIGMO study

et al. 2022

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IntroductionIn Germany, statutory insured persons are entitled to a stool test (faecal immunochemical test (FIT)) or colonoscopy for colorectal cancer (CRC) screening, depending on age and sex, yet participation rates are rather low. Sigmoidoscopy is a currently not available screening measure that has a strong evidence base for incidence and mortality reduction. Due to its distinct characteristics, it might be preferred by some, who now reject colonoscopy. The objective of this study is to estimate the economic consequences of the additional offer of sigmoidoscopy for CRC screening in Germany compared with the present screening practice while considering the preferences of the general population.Methods and analysisA decision-analytic modelling approach will be developed that compares the present CRC screening programme in Germany (FIT, colonoscopy) with a programme extended by sigmoidoscopy from a societal perspective. A decision tree and Markov model will be combined to assess both short-term and long-term effects, such as CRC and adenoma detection rates, the number of CRC cases, CRC mortality as well as complications. The incremental cost per quality-adjusted life year gained for each alternative will be calculated. The model will incorporate the general population’s preferences based on a discrete choice experiment. Further, input parameters will be taken from the literature, the German cancer registry and health insurance claims data.Ethics and disseminationEthical approval for the study was obtained from the Ethics Committee of Hannover Medical School (ID: 8671_BO_K_2019). The findings of the study will be published in peer-reviewed journals and presented at national and/or international conferences.Trial registration numberDRKS00019010.

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“…The SIGMO study (Sigmoidoscopy as an evidence-based colorectal cancer screening test – a possible option?) analyses screening eligible populations’ preferences for CRC screening in Germany using a DCE [ 20 ]. To construct preference elicitation tasks, the identification and selection of attributes are an essential step and should be supported by evidence [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Attributes in stated preference elicitation studies on colorectal cancer screening and their relative importance for decision-making among screenees: a systematic review

et al. 2022

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Introduction The SIGMO study (Sigmoidoscopy as an evidence-based colorectal cancer screening test – a possible option?) examines screening eligible populations’ preferences for colorectal cancer (CRC) screening in Germany using a discrete choice experiment (DCE). Attribute identification and selection are essential for the construction of choice tasks and should be evidence-based. As a part of the SIGMO study this systematic review provides an overview of attributes included in studies eliciting stated preferences for CRC screening tests and their relative importance for decision-making. Methods Systematic search (November 2021) for English-language studies published since January 2000 in PubMed, Embase, Web of Science, Biomedical Reference Collection: Corporate Edition, LIVIVO and PsycINFO. DCEs and conjoint analysis ranking or rating tasks on screening eligible populations’ preferences for stool testing, sigmoidoscopy, and/or colonoscopy were included. Attributes were extracted and their relative importance was calculated and ranked. Risk of bias (RoB) of included studies was assessed using a modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Study selection and RoB rating were carried out independently by two reviewers. Data were extracted by one reviewer and checked by another one. Results A total of 23 publications on 22 studies were included. Overall RoB was rated as serious/critical for 21 studies and as moderate for 2 studies. Main reasons for high RoB were non-random sampling, low response rates, lack of non-responder analyses, and, to a lesser extent, weaknesses in the measurement instrument and data analysis. Extracted attributes (n = 120) referred to procedure-related characteristics (n = 42; 35%), structural characteristics of health care (n = 24; 20%), test characteristics (n = 23; 19%), harms (n = 16; 13%), benefits (n = 13; 11%), and level of evidence (n = 2; 2%). Most important attributes were reduction in CRC mortality (and incidence) (n = 7), test sensitivity (n = 7), out-of-pocket costs (n = 4), procedure (n = 3), and frequency (n = 2). Conclusions Health preference studies on CRC were found to have a high RoB. The composition of choice tasks revealed a lack of attributes on patient-important outcomes (like incidence reduction), while attributes not considered relevant for individual screening decisions (like sensitivity) were frequently used. Future studies eliciting stated preferences in cancer screening should apply the principles of informed decision-making in attribute identification and selection.

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General populations’ preferences for colorectal cancer screening: rationale and protocol for the discrete choice experiment in the SIGMO study

Cited by 7 publications

References 30 publications

Attributes Characterizing Colorectal Cancer Screening Tests That Influence Preferences of Individuals Eligible for Screening in Germany: A Qualitative Study

Attributes Characterizing Colorectal Cancer Screening Tests That Influence Preferences of Individuals Eligible for Screening in Germany: A Qualitative Study

Additional offer of sigmoidoscopy in colorectal cancer screening in Germany: rationale and protocol of the decision-analytic modelling approach in the SIGMO study

Attributes in stated preference elicitation studies on colorectal cancer screening and their relative importance for decision-making among screenees: a systematic review

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