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Updated: Jun 28, 2026

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
Patients were more consistent in randomized trial at prioritizing childbirth preferences using graphic-numeric than
Karen B Eden1, James G Dolan, Nancy A Perrin
1Oregon Health & Science University, Department of Medical Informatics & Clinical Epidemiology, Portland, OR, USA. edenk@ohsu.edu
Objective:
We developed an evidence-based decision aid to help women with a prior cesarean to prioritize their childbirth preferences related to a future birth. Because there was uncertainty about which scale format would assist the patients in being most consistent in prioritizing preferences in a multiattribute decision model, we compared a graphic-numeric scale with a text-anchored scale.
Study Design And Setting:
Ninety-six postnatal women with a prior cesarean were randomized to use 1 of 2 preference scale formats in a computerized childbirth decision aid. We measured the level of inconsistency (intransitivity) when patients prioritized their childbirth preferences and clarity of values before and after using the decision aid.
Results:
When the trade-offs involved risk, women were more consistent when using graphic-numeric than text-anchored formats (P=0.015). They prioritized safety to their baby as 4 times more important than any other decision factor including safety to self. Both groups reduced unclear childbirth values over time (P<0.001). Women who over-used the extreme ends of the scale when evaluating risk were more likely to be inconsistent (P<0.001).
Conclusion:
Patients were more consistent in making trade-offs involving risk using graphic-numeric formats than text-anchored formats to measure patient preferences.
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