Patient Preferences Regarding Surgical Treatment Methods for Symptomatic Uterine Fibroids

Abstract

<h3>Study Objective</h3> The purpose of this study is to rank the benefit-risk factors that are most/least important to patients with symptomatic uterine fibroids. <h3>Design</h3> Using a best worst scaling (BWS) preference elicitation approach, eligible, consenting participants completed an online survey to rank factors associated with fibroid treatments. Survey content was based on a literature review and included the following factors: symptom relief; surgical complications; repeat treatment; recovery time; cosmetic effects; risk of cancer; sexual outcomes; maintenance of child-bearing continuation of menses; unpredictable menses; and location of procedure. Participants completed 11 BWS tasks. For each task, we presented participants with a subset of 5 factors from the possible 11, and participants chose the most important and least important factor. <h3>Setting</h3> N/A. <h3>Patients or Participants</h3> 285 women with symptomatic uterine fibroids (69 physician-confirmed and 216 self-reported) who had not undergone prior surgical treatment completed the survey. Participants were enrolled from two clinical sites and an online consumer panel. <h3>Interventions</h3> N/A. <h3>Measurements and Main Results</h3> Each cohort's responses were analyzed using conditional logistic regression to determine the relative importance of factors. Both cohorts identified symptom relief, cancer risk, repeat treatment and complications as the most important factors in selecting treatment options and cosmetic effects like presence of a scar after the treatment, location of treatment, and return to normal activities after surgery, as the least important factors. Of note, younger women (≤ 40) placed greater importance on the ability to have children after the procedure. <h3>Conclusion</h3> Information regarding the factors most and least important to patients with symptomatic uterine fibroids might inform shared-decision making efforts between women and their providers, as well as provide insights to guide development and evaluation of new technologies and procedures.