title: Value redefined for inflammatory bowel disease patients: a choice-based conjoint analysis of patients' preferences.
abstract: Value-based healthcare is an upcoming field. The core idea is to evaluate care based on achieved outcomes divided by the costs. Unfortunately, the optimal way to evaluate outcomes is ill-defined. In this study, we aim to develop a single, preference based, outcome metric, which can be used to quantify overall health value in inflammatory bowel disease (IBD).
  
  
  
  IBD patients filled out a choice-based conjoint (CBC) questionnaire in which patients chose preferable outcome scenarios with different levels of disease control (DC), quality of life (QoL), and productivity (Pr). A CBC analysis was performed to estimate the relative value of DC, QoL, and Pr. A patient-centered composite score was developed which was weighted based on the stated preferences.
  
  
  
  We included 210 IBD patients. Large differences in stated preferences were observed. Increases from low to intermediate outcome levels were valued more than increases from intermediate to high outcome levels. Overall, QoL was more important to patients than DC or Pr. Individual outcome scores were calculated based on the stated preferences. This score was significantly different from a score not weighted based on patient preferences in patients with active disease.
  
  
  
  We showed the feasibility of creating a single outcome metric in IBD which incorporates patients' values using a CBC. Because this metric changes significantly when weighted according to patients' values, we propose that success in healthcare should be measured accordingly.
authors: Division of Digestive Diseases, Center for Inflammatory Bowel Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. Welmoed.vanDeen@med.usc.edu.|Gehr Family Center for Implementation Science, Keck School of Medicine, University of Southern California, 2020 Zonal Avenue, IRD #323, Los Angeles, CA, 90033, USA. Welmoed.vanDeen@med.usc.edu.|Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA, USA. Welmoed.vanDeen@med.usc.edu.
authors: Welmoed K
authors: WK
authors: van Deen
authors: Division of Digestive Diseases, Center for Inflammatory Bowel Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors: Dominic
authors: D
authors: Nguyen
authors: Division of Digestive Diseases, Center for Inflammatory Bowel Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors: Natalie E
authors: NE
authors: Duran
authors: Division of Digestive Diseases, Center for Inflammatory Bowel Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors: Ellen
authors: E
authors: Kane
authors: Department of Medical Oncology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: Martijn G H
authors: MG
authors: van Oijen
authors: Division of Digestive Diseases, Center for Inflammatory Bowel Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
authors: Daniel W
authors: DW
authors: Hommes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002755:Choice Behavior; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D057240:Patient Preference / Q000706:statistics & numerical data*; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Inflammatory bowel diseases; Outcome measurement; Patient preferences; Value equation; Value-based health care