Development of a tool for eliciting patient priority from among competing cardiovascular disease, medication-symptoms, and fall injury outcomes.
OBJECTIVE
To develop a choice task for eliciting priorities in the face of competing cardiovascular disease (CVD) outcomes, medication-related symptoms, and fall injuries.


METHODS
Conjoint analysis.


METHODS
Senior housing site.


METHODS
Convenience sample of 15 senior housing residents for the pretest, 13 residents for the pilot test.


METHODS
The final task included 11 sets of choices. In each, one option optimized the risk of one or two of the three outcomes at the expense of the other(s); the second option did the reverse. Relative importance scores for CVD, fall injury, and medication-symptom outcomes were calculated. Reliability was assessed for two administrations using intraclass correlations (ICCs). Wilcoxon rank sum tests were used to evaluate order effects.


RESULTS
The ICCs between choice task administrations were 0.70 for fall injuries, 0.73 for medication symptoms, and 0.56 for CVD outcomes. The ICCs with removal of two outliers were 0.84, 0.72, and 0.84, respectively. Whether CVD or fall injuries appeared first had no effect on scores.


CONCLUSIONS
Preliminary evidence of comprehensibility and reliability supports using the choice task to determine whether individuals' priorities differ in the face of competing outcomes.
Tinetti
Mary E
ME
Department of Medicine, Section of Geriatrics, New Haven, Connecticut 06520-8025, USA. mary.tinetti@yale.edu
McAvay
Gail J
GJ
Fried
Terri R
TR
Foody
JoAnne M
JM
Bianco
Luann
L
Ginter
Sandra
S
Fraenkel
Liana
L
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000187:drug effects; D006292:Health Priorities / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D008134:Long-Term Care; D008297:Male; D010865:Pilot Projects; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology* / Q000534:rehabilitation
D002317:Cardiovascular Agents