title: Patients' and urologists' preferences for prostate cancer treatment: a discrete choice experiment.
abstract: BACKGROUND
  Patients' preferences are important for shared decision making. Therefore, we investigated patients' and urologists' preferences for treatment alternatives for early prostate cancer (PC).
  
  
  METHODS
  A discrete choice experiment was conducted among 150 patients who were waiting for their biopsy results, and 150 urologists. Regression analysis was used to determine patients' and urologists' stated preferences using scenarios based on PC treatment modality (radiotherapy, surgery, and active surveillance (AS)), and risks of urinary incontinence and erectile dysfunction.
  
  
  RESULTS
  The response rate was 110 out of 150 (73%) for patients and 50 out of 150 (33%) for urologists. Risk of urinary incontinence was an important determinant of both patients' and urologists' stated preferences for PC treatment (P<0.05). Treatment modality also influenced patients' stated preferences (P<0.05), whereas the risk of erectile dysfunction due to radiotherapy was mainly important to urologists (P<0.05). Both patients and urologists preferred AS to radical treatment, with the exception of patients with anxious/depressed feelings who preferred radical treatment to AS.
  
  
  CONCLUSIONS
  Although patients and urologists generally may prefer similar treatments for PC, they showed different trade-offs between various specific treatment aspects. This implies that urologists need to be aware of potential differences compared with the patient's perspective on treatment decisions in shared decision making on PC treatment.
authors.affiliation: Department of Public Health, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, The Netherlands. e.debekker@erasmusmc.nl
authors.forename: E W
authors.initials: EW
authors.lastname: de Bekker-Grob
authors.forename: M C J
authors.initials: MC
authors.lastname: Bliemer
authors.forename: B
authors.initials: B
authors.lastname: Donkers
authors.forename: M-L
authors.initials: ML
authors.lastname: Essink-Bot
authors.forename: I J
authors.initials: IJ
authors.lastname: Korfage
authors.forename: M J
authors.initials: MJ
authors.lastname: Roobol
authors.forename: C H
authors.initials: CH
authors.lastname: Bangma
authors.forename: E W
authors.initials: EW
authors.lastname: Steyerberg
mesh_terms: D000368:Aged; D003657:Decision Making; D007172:Erectile Dysfunction / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D057240:Patient Preference / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000523:psychology / Q000532:radiotherapy* / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D014549:Urinary Incontinence / Q000209:etiology / Q000517:prevention & control