Attributes in stated preference elicitation studies on colorectal cancer screening and their relative importance for decision-making among screenees: a systematic review

Abstract Introduction The SIGMO study (Sigmoidoscopy as an evidence-based colorectal cancer screening test – a possible option?) examines screening eligible populations’ preferences for colorectal cancer (CRC) screening in Germany using a discrete choice experiment (DCE). Attribute identification an...

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Main Authors: Melanie Brinkmann, Lara Marleen Fricke, Leonie Diedrich, Bernt-Peter Robra, Christian Krauth, Maren Dreier
Format: Article
Language:English
Published: BMC 2022-09-01
Series:Health Economics Review
Subjects:
Online Access:https://doi.org/10.1186/s13561-022-00394-8
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author Melanie Brinkmann
Lara Marleen Fricke
Leonie Diedrich
Bernt-Peter Robra
Christian Krauth
Maren Dreier
author_facet Melanie Brinkmann
Lara Marleen Fricke
Leonie Diedrich
Bernt-Peter Robra
Christian Krauth
Maren Dreier
author_sort Melanie Brinkmann
collection DOAJ
description Abstract Introduction The SIGMO study (Sigmoidoscopy as an evidence-based colorectal cancer screening test – a possible option?) examines screening eligible populations’ preferences for colorectal cancer (CRC) screening in Germany using a discrete choice experiment (DCE). Attribute identification and selection are essential for the construction of choice tasks and should be evidence-based. As a part of the SIGMO study this systematic review provides an overview of attributes included in studies eliciting stated preferences for CRC screening tests and their relative importance for decision-making. Methods Systematic search (November 2021) for English-language studies published since January 2000 in PubMed, Embase, Web of Science, Biomedical Reference Collection: Corporate Edition, LIVIVO and PsycINFO. DCEs and conjoint analysis ranking or rating tasks on screening eligible populations’ preferences for stool testing, sigmoidoscopy, and/or colonoscopy were included. Attributes were extracted and their relative importance was calculated and ranked. Risk of bias (RoB) of included studies was assessed using a modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Study selection and RoB rating were carried out independently by two reviewers. Data were extracted by one reviewer and checked by another one. Results A total of 23 publications on 22 studies were included. Overall RoB was rated as serious/critical for 21 studies and as moderate for 2 studies. Main reasons for high RoB were non-random sampling, low response rates, lack of non-responder analyses, and, to a lesser extent, weaknesses in the measurement instrument and data analysis. Extracted attributes (n = 120) referred to procedure-related characteristics (n = 42; 35%), structural characteristics of health care (n = 24; 20%), test characteristics (n = 23; 19%), harms (n = 16; 13%), benefits (n = 13; 11%), and level of evidence (n = 2; 2%). Most important attributes were reduction in CRC mortality (and incidence) (n = 7), test sensitivity (n = 7), out-of-pocket costs (n = 4), procedure (n = 3), and frequency (n = 2). Conclusions Health preference studies on CRC were found to have a high RoB. The composition of choice tasks revealed a lack of attributes on patient-important outcomes (like incidence reduction), while attributes not considered relevant for individual screening decisions (like sensitivity) were frequently used. Future studies eliciting stated preferences in cancer screening should apply the principles of informed decision-making in attribute identification and selection.
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spelling doaj.art-ab1bd2c4680c4940931558411c3bdcc32022-12-22T02:06:06ZengBMCHealth Economics Review2191-19912022-09-0112111910.1186/s13561-022-00394-8Attributes in stated preference elicitation studies on colorectal cancer screening and their relative importance for decision-making among screenees: a systematic reviewMelanie Brinkmann0Lara Marleen Fricke1Leonie Diedrich2Bernt-Peter Robra3Christian Krauth4Maren Dreier5Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical SchoolInstitute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical SchoolInstitute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical SchoolInstitute of Social Medicine and Health Systems Research, Otto-von-Guericke University MagdeburgInstitute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical SchoolInstitute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical SchoolAbstract Introduction The SIGMO study (Sigmoidoscopy as an evidence-based colorectal cancer screening test – a possible option?) examines screening eligible populations’ preferences for colorectal cancer (CRC) screening in Germany using a discrete choice experiment (DCE). Attribute identification and selection are essential for the construction of choice tasks and should be evidence-based. As a part of the SIGMO study this systematic review provides an overview of attributes included in studies eliciting stated preferences for CRC screening tests and their relative importance for decision-making. Methods Systematic search (November 2021) for English-language studies published since January 2000 in PubMed, Embase, Web of Science, Biomedical Reference Collection: Corporate Edition, LIVIVO and PsycINFO. DCEs and conjoint analysis ranking or rating tasks on screening eligible populations’ preferences for stool testing, sigmoidoscopy, and/or colonoscopy were included. Attributes were extracted and their relative importance was calculated and ranked. Risk of bias (RoB) of included studies was assessed using a modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Study selection and RoB rating were carried out independently by two reviewers. Data were extracted by one reviewer and checked by another one. Results A total of 23 publications on 22 studies were included. Overall RoB was rated as serious/critical for 21 studies and as moderate for 2 studies. Main reasons for high RoB were non-random sampling, low response rates, lack of non-responder analyses, and, to a lesser extent, weaknesses in the measurement instrument and data analysis. Extracted attributes (n = 120) referred to procedure-related characteristics (n = 42; 35%), structural characteristics of health care (n = 24; 20%), test characteristics (n = 23; 19%), harms (n = 16; 13%), benefits (n = 13; 11%), and level of evidence (n = 2; 2%). Most important attributes were reduction in CRC mortality (and incidence) (n = 7), test sensitivity (n = 7), out-of-pocket costs (n = 4), procedure (n = 3), and frequency (n = 2). Conclusions Health preference studies on CRC were found to have a high RoB. The composition of choice tasks revealed a lack of attributes on patient-important outcomes (like incidence reduction), while attributes not considered relevant for individual screening decisions (like sensitivity) were frequently used. Future studies eliciting stated preferences in cancer screening should apply the principles of informed decision-making in attribute identification and selection.https://doi.org/10.1186/s13561-022-00394-8Colorectal cancer screeningSystematic reviewDiscrete choice experimentRisk of biasGRADEInformed decision-making
spellingShingle Melanie Brinkmann
Lara Marleen Fricke
Leonie Diedrich
Bernt-Peter Robra
Christian Krauth
Maren Dreier
Attributes in stated preference elicitation studies on colorectal cancer screening and their relative importance for decision-making among screenees: a systematic review
Health Economics Review
Colorectal cancer screening
Systematic review
Discrete choice experiment
Risk of bias
GRADE
Informed decision-making
title Attributes in stated preference elicitation studies on colorectal cancer screening and their relative importance for decision-making among screenees: a systematic review
title_full Attributes in stated preference elicitation studies on colorectal cancer screening and their relative importance for decision-making among screenees: a systematic review
title_fullStr Attributes in stated preference elicitation studies on colorectal cancer screening and their relative importance for decision-making among screenees: a systematic review
title_full_unstemmed Attributes in stated preference elicitation studies on colorectal cancer screening and their relative importance for decision-making among screenees: a systematic review
title_short Attributes in stated preference elicitation studies on colorectal cancer screening and their relative importance for decision-making among screenees: a systematic review
title_sort attributes in stated preference elicitation studies on colorectal cancer screening and their relative importance for decision making among screenees a systematic review
topic Colorectal cancer screening
Systematic review
Discrete choice experiment
Risk of bias
GRADE
Informed decision-making
url https://doi.org/10.1186/s13561-022-00394-8
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