BACKGROUND: Discrete choice experiments (DCEs) allow systematic assessment of preferences by asking respondents to choose between scenarios. We conducted a labelled discrete choice experiment with realistic choices to investigate patients' trade-offs between the expected health gains and the burden of testing in surveillance of Barrett esophagus (BE). METHODS: Fifteen choice scenarios were selected based on 2 attributes: 1) type of test (endoscopy and two less burdensome fictitious tests), 2) frequency of surveillance. Each test-frequency combination was associated with its own realistic decrease in risk of dying from esophageal adenocarcinoma. A conditional logit model was fitted. RESULTS: Of 297 eligible patients (155 BE and 142 with non-specific upper GI symptoms), 247 completed the questionnaire (84%). Patients preferred surveillance to no surveillance. Current surveillance schemes of once every 1-2 years were amongst the most preferred alternatives. Higher health gains were preferred over those with lower health gains, except when test frequencies exceeded once a year. For similar health gains, patients preferred video-capsule over saliva swab and least preferred endoscopy. CONCLUSION: This first example of a labelled DCE using realistic scenarios in a healthcare context shows that such experiments are feasible. A comparison of labelled and unlabelled designs taking into account setting and research question is recommended.

Additional Metadata
Persistent URL dx.doi.org/10.1186/1471-2288-9-31, hdl.handle.net/1765/16198
Citation
Kruijshaar, M.E., Essink-Bot, M.L.E., Donkers, A.C.D., Looman, C.W.N., Siersema, P.D., & Steyerberg, E.W.. (2009). A labelled discrete choice experiment adds realism to the choices presented: preferences for surveillance tests for Barrett esophagus.. B M C Medical Ethics, 9(1), 1–10. doi:10.1186/1471-2288-9-31