Preference assessment method affects decision-analytic recommendations: a prostate cancer treatment example.
OBJECTIVE
To evaluate the effect of preference assessment method on treatment recommended by an individualized decision-analytic model for early prostate cancer.


METHODS
Health state preferences were elicited by time tradeoff, rating scale, and a power transformation of the rating scale from 63 men ages 55 to 75. The authors used these values in a Markov model to determine whether radical prostatectomy or watchful waiting yielded the greater quality-adjusted life expectancy.


RESULTS
Time tradeoff and transformed rating scale recommendations differed widely. Time tradeoff and transformed rating scale utilities differed in their treatment recommendation for 21% to 52% of men, and the mean difference in quality-adjusted life years varied from less than 0.5 to greater than 1.0.


CONCLUSIONS
Treatment recommendations from the prostate cancer decision model were sensitive to the method of preference assessment. If decision analysis is used to counsel individual patients, careful consideration must be given to the method of preference elicitation.
Elkin
Elena B
EB
Department of Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Cowen
Mark E
ME
Cahill
Daniel
D
Steffel
Mary
M
Kattan
Michael W
MW
D000368:Aged; D003661:Decision Support Techniques; D006305:Health Status Indicators; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008390:Markov Chains; D008824:Michigan; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D011336:Probability; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000523:psychology / Q000628:therapy*; D019057:Quality-Adjusted Life Years; D015203:Reproducibility of Results; D016019:Survival Analysis; D013995:Time