Quantifying patient preferences for symptomatic breast clinic referral: a decision analysis study

Area of Science:

• Decision analysis
• Health economics
• Medical decision-making

Background:

• Investigating patient preferences in breast cancer diagnostics is crucial for personalized care.
• Understanding women's willingness to accept risk influences diagnostic strategy selection.

Purpose of the Study:

• To analyze the impact of women's preferences on choosing between referral or watchful waiting for potential breast cancer symptoms.
• To estimate individual preferred diagnostic strategies using decision analysis.

Main Methods:

• A community-based study involving 35 women aged 30-60 years.
• Utilized the standard gamble utility method to assess risk tolerance across 11 health scenarios.
• Formal decision analysis estimated preferred diagnostic strategies, with sensitivity analysis on probability estimates.

Main Results:

• 71.4% of participants preferred watchful waiting over referral for triple assessment.
• Referral for triple assessment became the dominant strategy only at an 18% probability of breast cancer.
• Majority of participants were employed, university-educated, and knew someone with breast cancer.

Conclusions:

• Watchful waiting is an acceptable initial management strategy for most women presenting with breast symptoms.
• Current breast cancer referral guidelines should more explicitly consider patient preferences.
• Integrating patient values enhances shared decision-making in breast symptom management.