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Attributes Used for Cancer Screening Discrete Choice Experiments: A Systematic Review
Rebekah Hall1, Antonieta Medina-Lara2, Willie Hamilton2
1College of Medicine and Health, University of Exeter, South Cloisters, St Luke's Campus, Heavitree, Exeter, EX1 2LU, UK. rh591@exeter.ac.uk.
Discrete choice experiments (DCEs) help understand cancer screening preferences, but attribute selection is key. Test sensitivity and mortality reduction are most important to the public, yet reporting needs improvement for valid results.
Area of Science:
- Health Services Research
- Decision Science
- Public Health
Background:
- Discrete choice experiments (DCEs) are valuable for understanding preferences related to cancer screening programs.
- However, discrepancies exist between stated and real choices, particularly concerning willingness to undergo screening.
- Effective attribute and level selection is crucial for the validity of DCEs in cancer screening.
Approach:
- A systematic review identified DCEs on cancer screening preferences from 1990 to December 2020.
- Attributes were categorized (test-specific, service delivery, outcomes, monetary) and analyzed for significance and importance.
- Study quality was assessed using the International Society for Pharmacoeconomics and Outcomes Research conjoint analysis checklist.
Key Points:
- Forty-nine studies were reviewed, with colorectal cancer screening being the most common focus (26/49).
- Test sensitivity and mortality reduction were consistently identified as the most significant attributes influencing preferences.
- A high proportion of attributes (90%) were found to be significant in the reviewed studies.
Conclusions:
- Improvements are needed in reporting the identification, selection, and construction of attributes in cancer screening DCEs.
- Consideration of choice task complexity, risk information, and compound attributes is essential.
- Patient and public involvement, alongside stakeholder engagement, is recommended to enhance understanding and optimize study design.
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