将离散选择实验与摇摆权衡进行比较,以估计属性的相对重要性:肺癌患者偏好的案例研究
J Veldwijk1,2,3, I P Smith3, S Oliveri4
1Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, the Netherlands.
概括
离散选择实验 (DCE) 和直接评分的摇摆权重 (SW-DR) 都测量了患者的偏好,但与SW-DR相比,DCE在属性重要性和权重方面表现出显著差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 患者偏好研究 患者偏好研究
- 卫生经济学 卫生经济学
背景情况:
- 离散选择实验 (DCE) 广泛用于患者偏好诱导,但复杂且昂贵.
- 像直接评级 (SW-DR) 的摇摆权衡等更简单的方法存在,但经验性比较是有限的.
- 了解治疗属性的相对重要性对于共享决策至关重要.
研究的目的:
- 直接比较来自DCE和SW-DR的属性重要性排名和权重.
- 评估这两种方法的可用性和受访者体验.
- 为选择适当的偏好诱导方法提供指导.
主要方法:
- 意大利和比利时共有307名非小细胞肺癌患者参加了在线调查.
- 使用DCE和SW-DR两种方法来评估偏好.
- 用随机参数逻辑 (DCE) 和排名顺序中心体 (SW-DR) 分析了属性重要性,并通过科恩加权卡帕和迪里克莱回归进行了比较.
主要成果:
- 大多数 (>65%) 患者发现DCE和SW-DR任务易于理解和完成.
- 无论使用哪种方法,生存是最重要的属性.
- 在综合属性排名 (P < 0.01) 中观察到显著差异,与SW-DR相比,DCE的属性权重差异较大 (P < 0.01).
- 在两种方法之间的个人级别属性排名中发现了中等一致性 (加权卡帕0.53至0.55).
结论:
- DCE和SW-DR都能确定属性的重要性,但它们的结果存在显著差异.
- 虽然通常很容易使用,但这些方法在属性权重和排名方面产生了不同的结果.
- 需要进一步的研究,以指导选择各种决策背景的偏好诱导方法.
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