Women's preference to apply shared decision-making in breast cancer screening: a discrete choice experiment.

Autor:	Hernández-Leal MJ; Department of Economics, University Rovira i Virgili, Reus, Spain.; Research Centre on Economics and Sustainability (ECO-SOS), Reus, Spain.; Research Group on Statistics, Economic Evaluation and Health (GRAEES), Reus, Spain., Pérez-Lacasta MJ; Department of Economics, University Rovira i Virgili, Reus, Spain.; Research Group on Statistics, Economic Evaluation and Health (GRAEES), Reus, Spain., Cardona-Cardona A; Area Q: Evaluation and Research in the Field of Social Sciences and Health, Barcelona, Spain., Codern-Bové N; School of Nursing and Occupational Therapy (EUIT), Autonomous University of Barcelona, Terrasa, Spain., Vidal-Lancis C; Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Spain., Rue M; Research Group on Statistics, Economic Evaluation and Health (GRAEES), Reus, Spain.; Department of Basic Medical Sciences, University of Lleida-IRB, Lleida, Spain., Forné C; Department of Basic Medical Sciences, University of Lleida, Lleida, Spain.; HEOR freelance consultant, Heorfy Consulting, Reus, Spain., Carles-Lavila M; Department of Economics, University Rovira i Virgili, Reus, Spain misericordia.carles@urv.cat.; Research Centre on Economics and Sustainability (ECO-SOS), Reus, Spain.; Research Group on Statistics, Economic Evaluation and Health (GRAEES), Reus, Spain.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2022 Nov 08; Vol. 12 (11), pp. e064488. Date of Electronic Publication: 2022 Nov 08.
DOI:	10.1136/bmjopen-2022-064488
Abstrakt:	Objective: To analyse women's stated preferences for establishing the relative importance of each attribute of shared decision-making (SDM) and their willingness to pay (WTP) for more participatory care in breast cancer screening programmes (BCSP). Design: A discrete choice experiment was designed with 12 questions (choice tasks). It included three attributes: 'How the information is obtained', regarding benefits and harms; whether there is a 'Dialogue for scheduled mammography' between the healthcare professional and the woman; and, 'Who makes the decision', regarding participation in BCSP. Data were obtained using a survey that included 12 choice tasks, 1 question on WTP and 7 socioeconomic-related questions. The analysis was performed using conditional mixed-effect logit regression and stratification according to WTP. Setting: Data collection related to BCSP was conducted between June and November 2021 in Catalonia, Spain. Participants: Sixty-five women aged between 50 and 60. Main Outcome Measures: Women's perceived utility of each attribute, trade-off on these attributes and WTP for SDM in BCSP. Result: The only significant attribute was 'Who makes the decision'. The decision made alone (coefficient=2.879; 95% CI=2.297 to 3.461) and the decision made together with a healthcare professional (2.375; 95% CI=1.573 to 3.177) were the options preferred by women. The former contributes 21% more utility than the latter. Moreover, 52.3% of the women stated a WTP of €10 or more for SDM. Women's preferences regarding attributes did not influence their WTP. Conclusions: The participant women refused a current paternalistic model and preferred either SDM or informed decision-making in BCSP. Competing Interests: Competing interests: The authors declare that they have no conflict of interest. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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