Discrete Choice Experiments and Conjoint Analyses in Health Screening Programs for Type 2 Diabetes and Liver Disease:...

We aimed to summarize the evidence on the use of discrete choice experiments (DCEs) and conjoint analyses to quantify stakeholders' preferences for screening programs for type 2 diabetes (T2D) and liver diseases, with a specific focus on metabolic dysfunction-associated steatotic liver disease (MASLD).

For this scoping review, five databases (MEDLINE [PubMed], PubMed Central, EMBASE [Ovid], Europe PMC, Google Scholar) were searched with the assistance of a librarian, and deduplicated records were screened by two independent reviewers. Inclusion criteria: using DCE/CA, addressing screening programs for T2D and liver disease, published in English, French, or Spanish after January 1990.

Among 2,282 studies, 9 (7 from high- and 2 from low-income countries) elicited preferences for screening for liver disease (n = 1), hepatitis C (n = 1), hepatitis B (n = 1), hepatocellular carcinoma (n = 2), noncommunicable diseases (n = 2), diabetic retinopathy (n = 1), and cardiovascular diseases (n = 1). No studies addressed MASLD screening in T2D. Stakeholders included patients (n = 3), health care providers (n = 1), patients plus health care providers (n = 1), and the general population (n = 3). Studies used 18 structure, 6 process, and 4 outcome attributes. Screening sensitivity, setting, duration, provider, and cost were the most important structure attributes in participant choices. Physician support for treatment was the preferred process attribute. Outcome attributes were the least used, but of major importance (screening adherence followed by treatment) when considered.

With no study focusing on MASLD screening in T2D, our scoping review highlights the need to develop a DCE addressing this topic to better design a patient-centred continuum of care.