title: Valuing Preferences for the Process and Outcomes of Clinical Genetics Services: A Pilot Study.
abstract: BACKGROUND
  Understanding preferences for the process and outcomes of clinical genetics services (CGS) is a first step to developing these services appropriately.
  
  
  OBJECTIVE
  The aim of this study was to quantify the relative importance of attributes defining the process of service delivery and the patient outcomes of CGS.
  
  
  METHODS
  An online hybrid conjoint analysis discrete choice experiment (CA-DCE) was piloted in a purposive sample (n = 37) of CGS patients and non-patients to identify (i) service attributes (n = 13) perceived to facilitate informed decision making; (ii) relative preferences for six attributes (5 process, 1 outcome: ability to make an informed decision). A three-step approach was taken to link the data from the CA-DCE using hierarchical information integration and ordered logit and multinomial logit models. Marginal willingness-to-pay (WTP) values were calculated.
  
  
  RESULTS
  Services that facilitate informed decision making, with shorter waiting times and involving pre-consultation contact were preferred. Estimated WTP values were: service location (£3170; 95% CI -391 to 15,098); waiting time (-£1080; 95% CI -3659 to -603); pre-consultation contact (£7765; 95% CI 2542-33,937); improved informed decision making (£2254; 95% CI 775-9866).
  
  
  CONCLUSIONS
  This study suggests that hybrid stated preference experiments offer a practical solution to understanding preferences for how CGS services are delivered.
authors.affiliation: Manchester Centre for Health Economics, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
authors.forename: Ewan
authors.initials: E
authors.lastname: Gray
authors.affiliation: Manchester Centre for Health Economics, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Eden
authors.affiliation: Manchester Centre for Health Economics, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Vass
authors.affiliation: Institute of Cancer and Genetics, Cardiff University, Cardiff, UK.
authors.forename: Marion
authors.initials: M
authors.lastname: McAllister
authors.affiliation: Institute for Choice, University of South Australia, Sydney, Australia.
authors.forename: Jordan
authors.initials: J
authors.lastname: Louviere
authors.affiliation: Manchester Centre for Health Economics, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK. Katherine.payne@manchester.ac.uk.
authors.forename: Katherine
authors.initials: K
authors.lastname: Payne
mesh_terms: D002755:Choice Behavior; D003657:Decision Making; D033142:Genetic Services / Q000592:standards*; D006302:Health Services Research / Q000379:methods / Q000592:standards*; D006801:Humans; D020407:Internet; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000592:standards*; D057240:Patient Preference / Q000706:statistics & numerical data*; D010865:Pilot Projects; D013222:State Medicine / Q000592:standards; D011795:Surveys and Questionnaires; D006113:United Kingdom