A labelled discrete choice experiment adds realism to the choices presented: preferences for surveillance tests for Barrett esophagus

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 1–2 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