title: Discrete choice experiment produced estimates of acceptable risks of therapeutic options in cancer patients with febrile neutropenia.
abstract: OBJECTIVE
  To use a discrete choice experiment (DCE) to describe patient/proxy tolerance for the number of clinic visits, and chances of readmission, intensive care unit admission, and mortality to accept oral outpatient management of low-risk febrile neutropenia.
  
  
  METHODS
  Adults and children aged 12-18 years with cancer and parents of pediatric cancer patients were asked to choose between outpatient oral and inpatient intravenous management of low-risk febrile neutropenia. Using a DCE, we varied the attribute levels with the outpatient option and kept them constant for the inpatient option.
  
  
  RESULTS
  Seventy-eight adults, 153 parents, and 43 children provided responses. All four attributes significantly affected choices. The mean tolerance (95% confidence interval) for the number of clinic visits per week was 3.6 (2.2-4.8), 2.1 (1.1-3.2), and 4.3 (2.5-6.0) to accept outpatient management among adults, parents, and children, respectively. With thrice weekly clinic visits and 7.5% chance of readmission, probabilities of accepting the outpatient strategy were 50% (44-54%) for adults, 43% (39-48%) for parents, and 53% (46-59%) for children.
  
  
  CONCLUSIONS
  Using a DCE, we determined that a 7.5% chance of readmission and clinic visits more frequently than thrice weekly are unlikely to be acceptable.
authors.affiliation: Department of Pediatrics, Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. lillian.sung@sickkids.ca
authors.forename: Lillian
authors.initials: L
authors.lastname: Sung
authors.forename: Shabbir M
authors.initials: SM
authors.lastname: Alibhai
authors.forename: Marie-Chantal
authors.initials: MC
authors.lastname: Ethier
authors.forename: Oliver
authors.initials: O
authors.lastname: Teuffel
authors.forename: Sylvia
authors.initials: S
authors.lastname: Cheng
authors.forename: David
authors.initials: D
authors.lastname: Fisman
authors.forename: Dean A
authors.initials: DA
authors.lastname: Regier
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D000553:Ambulatory Care / Q000706:statistics & numerical data; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D002755:Choice Behavior; D005260:Female; D005334:Fever / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D007263:Infusions, Parenteral; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy* / Q000401:mortality; D009864:Ontario / Q000453:epidemiology; D010290:Parents / Q000523:psychology; D057240:Patient Preference / Q000523:psychology; D012189:Retrospective Studies; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents