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  • 标题:Older adults’ preferences for colorectal cancer-screening test attributes and test choice
  • 本地全文:下载
  • 作者:Christine E Kistler ; Thomas M Hess ; Kirsten Howard
  • 期刊名称:Patient Preference and Adherence
  • 印刷版ISSN:1177-889X
  • 电子版ISSN:1177-889X
  • 出版年度:2015
  • 卷号:9
  • 页码:1005-1016
  • DOI:10.2147/PPA.S82203
  • 出版社:Dove Medical Press Ltd
  • 摘要:Background: Understanding which attributes of colorectal cancer (CRC) screening tests drive older adults’ test preferences and choices may help improve decision making surrounding CRC screening in older adults. Materials and methods: To explore older adults’ preferences for CRC-screening test attributes and screening tests, we conducted a survey with a discrete choice experiment (DCE), a directly selected preferred attribute question, and an unlabeled screening test-choice question in 116 cognitively intact adults aged 70–90 years, without a history of CRC or inflammatory bowel disease. Each participant answered ten discrete choice questions presenting two hypothetical tests comprised of four attributes: testing procedure, mortality reduction, test frequency, and complications. DCE responses were used to estimate each participant’s most important attribute and to simulate their preferred test among three existing CRC-screening tests. For each individual, we compared the DCE-derived attributes to directly selected attributes, and the DCE-derived preferred test to a directly selected unlabeled test. Results: Older adults do not overwhelmingly value any one CRC-screening test attribute or prefer one type of CRC-screening test over other tests. However, small absolute DCE-derived preferences for the testing procedure attribute and for sigmoidoscopy-equivalent screening tests were revealed. Neither general health, functional, nor cognitive health status were associated with either an individual’s most important attribute or most preferred test choice. The DCE-derived most important attribute was associated with each participant’s directly selected unlabeled test choice. Conclusion: Older adults’ preferences for CRC-screening tests are not easily predicted. Medical providers should actively explore older adults’ preferences for CRC screening, so that they can order a screening test that is concordant with their patients’ values. Effective interventions are needed to support complex decision making surrounding CRC screening in older adults.
  • 关键词:colorectal cancer screening; patient preferences; values clarification; discrete choice experiment; conjoint analysis; test attributes
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