A labelled discrete choice experiment adds realism to the choices presented: preferences for surveillance tests for Barrett esophagus.
BACKGROUND
Discrete choice experiments (DCEs) allow systematic assessment of preferences by asking respondents to choose between scenarios. We conducted a labelled discrete choice experiment with realistic choices to investigate patients' trade-offs between the expected health gains and the burden of testing in surveillance of Barrett esophagus (BE).


METHODS
Fifteen choice scenarios were selected based on 2 attributes: 1) type of test (endoscopy and two less burdensome fictitious tests), 2) frequency of surveillance. Each test-frequency combination was associated with its own realistic decrease in risk of dying from esophageal adenocarcinoma. A conditional logit model was fitted.


RESULTS
Of 297 eligible patients (155 BE and 142 with non-specific upper GI symptoms), 247 completed the questionnaire (84%). Patients preferred surveillance to no surveillance. Current surveillance schemes of once every 1-2 years were amongst the most preferred alternatives. Higher health gains were preferred over those with lower health gains, except when test frequencies exceeded once a year. For similar health gains, patients preferred video-capsule over saliva swab and least preferred endoscopy.


CONCLUSIONS
This first example of a labelled DCE using realistic scenarios in a healthcare context shows that such experiments are feasible. A comparison of labelled and unlabelled designs taking into account setting and research question is recommended.
Kruijshaar
Michelle E
ME
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. michelle.kruijshaar@hpa.org.uk
Essink-Bot
Marie-Louise
ML
Donkers
Bas
B
Looman
Caspar W N
CW
Siersema
Peter D
PD
Steyerberg
Ewout W
EW
D000818:Animals; D001471:Barrett Esophagus / Q000175:diagnosis*; D002755:Choice Behavior; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires