• Media type: E-Article
  • Title: Women’s preference to apply shared decision-making in breast cancer screening: a discrete choice experiment
  • Contributor: Hernández-Leal, María José; Pérez-Lacasta, María José; Cardona-Cardona, Angels; Codern-Bové, Núria; Vidal-Lancis, Carmen; Rue, Montserrat; Forné, Carles; Carles-Lavila, Misericòrdia
  • imprint: BMJ, 2022
  • Published in: BMJ Open
  • Language: English
  • DOI: 10.1136/bmjopen-2022-064488
  • ISSN: 2044-6055
  • Keywords: General Medicine
  • Origination:
  • Footnote:
  • Description: <jats:sec><jats:title>Objective</jats:title><jats:p>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).</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Data collection related to BCSP was conducted between June and November 2021 in Catalonia, Spain.</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>Sixty-five women aged between 50 and 60.</jats:p></jats:sec><jats:sec><jats:title>Main outcome measures</jats:title><jats:p>Women’s perceived utility of each attribute, trade-off on these attributes and WTP for SDM in BCSP.</jats:p></jats:sec><jats:sec><jats:title>Result</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The participant women refused a current paternalistic model and preferred either SDM or informed decision-making in BCSP.</jats:p></jats:sec>
  • Access State: Open Access