%0 Journal Article
%T A labelled discrete choice experiment adds realism to the choices presented: preferences for surveillance tests for Barrett esophagus
%A Michelle E Kruijshaar
%A Marie-Louise Essink-Bot
%A Bas Donkers
%A Caspar WN Looman
%A Peter D Siersema
%A Ewout W Steyerberg
%J BMC Medical Research Methodology
%D 2009
%I BioMed Central
%R 10.1186/1471-2288-9-31
%X Fifteen choice scenarios were selected based on 2 attributes: 1) type of test (endoscopy and two less burdensome fictitious tests), 2) frequency of surveillance. Each test-frequency combination was associated with its own realistic decrease in risk of dying from esophageal adenocarcinoma. A conditional logit model was fitted.Of 297 eligible patients (155 BE and 142 with non-specific upper GI symptoms), 247 completed the questionnaire (84%). Patients preferred surveillance to no surveillance. Current surveillance schemes of once every 1¨C2 years were amongst the most preferred alternatives. Higher health gains were preferred over those with lower health gains, except when test frequencies exceeded once a year. For similar health gains, patients preferred video-capsule over saliva swab and least preferred endoscopy.This first example of a labelled DCE using realistic scenarios in a healthcare context shows that such experiments are feasible. A comparison of labelled and unlabelled designs taking into account setting and research question is recommended.Discrete choice experiments (DCEs) have been proposed as a means to improve systematic assessment of patients' preferences regarding screening and surveillance programs [1]. It is suggested that traditional decision modelling and cost-utility analyses are insufficiently capable of including process effects, such as patient burden, and non-health outcomes, such as information, of diagnostic or therapeutic interventions [2] and that they fail to identify the most optimal program set-up from series of efficient programs [1]. In the end, patient or population preferences determine the acceptance of a program, and hence the realization of the expected population health gains. Current important areas of application include priority setting in health care (e.g., [3]), and patient preferences for characteristics of health care delivery (e.g, [4]) or for treatment alternatives (e.g., [5]).In a DCE, respondents are asked to choose
%U http://www.biomedcentral.com/1471-2288/9/31