Best-worst Scaling Research Articles

Best-worst scaling in studying the impact of the coronavirus pandemic on health professionals in Ghana

In this study, we utilized a best-worst scaling experiment design to assess the potential factors associated with depression, anxiety, and stress among health professionals following the experience of the COVID-19 pandemic. The maximum difference model was performed to analyze the potential risk factors associated with depression, anxiety, and stress. As a case study, a total of 300 health professionals in Ghana were included in the survey. The majority, 112 (68.7%) male health professionals and 97 (70.8%) female health professionals reported that they had encountered suspected COVID-19 patients. 83 (50.9%) of the male health professionals and 76 (55.5%) of the female health professionals reported that they had encountered confirmed COVID-19 patients. A considerable proportion of the males 59 (36.2%) and females 57 (41.6%) health professionals reported coming into direct contact with COVID-19 lab specimens. The findings indicated that a high proportion of health professionals encountered suspected or confirmed COVID-19 patients, while a considerable proportion had direct contact with COVID-19 lab specimens leading to psychological problems. Risk factors such as contact with confirmed COVID-19 patients, the relentless spread of the coronavirus, death of patients and colleagues, shortage of medical protective equipment, direct contact with COVID-19 lab specimens, and the permanent threat of being infected should be given special attention, and necessary psychological intervention provided for health professionals endorsing these risk factors. Improving the supply of medical protective equipment to meet occupational protection practices, sufficient rest, and improving the vaccination of the population might help safeguard health professionals from depression, anxiety, and stress. Our results provide insight into policy discussions on the mental health of health professionals and interventions that are essential to enhance psychological resilience.

Deconstructing consumers’ low-carbon tourism promotion preference and its consequences: A heuristic-systematic model

In the context of low-carbon tour promotion, consumers lack the motivation to translate environmental awareness into practical action; moreover, it is unclear which form of promotion is the most effective for travel agencies. Thus, this study considers consumers’ preference for low-carbon promotion as an entry point and adopts the best-worst scaling method to analyze their preference characteristics. In addition, it introduces a heuristic-systematic model to analyze the influence of consumer preferences on travel agency image and low-carbon tourism behavior intention. The results show that consumer preferences are deconstructed into different types of tourism experiences according to heuristic and systematic paths, such that they create a positive effect on image evaluation and behavioral intentions. This study reveals the significance of consumer preference in low-carbon tour promotion scenarios, which helps break the promotion deadlock and promote tourism enterprises to optimize their service design.

Prioritization of Adverse Consequences After Total Knee Arthroplasty Contributing to a Poor Response: A Best-Worst Scaling Exercise Among Total Knee Arthroplasty Patients and Knee Specialists

BackgroundTotal knee arthroplasty (TKA) can have a number of adverse consequences for patients that might contribute to a poor outcome. This study aimed to prioritize these consequences, from the perspective of patients and knee specialists. MethodsThere were 95 TKA patients and 63 knee specialists who prioritized a set of 29 adverse consequences, based on a previous qualitative study, using a Maximum Difference Scaling method. A hierarchical Bayesian analysis was used to calculate relative importance scores. Differences and agreements between patients versus knee specialists and satisfied versus dissatisfied patients were analyzed using Mann-Whitney-U tests and Kendall’s coefficients of concordance. ResultsThere were 4 out of 5 items in the top-5 of both patients and knee specialists that were similar, however, the ranking was different. The highest-ranked consequence for patients was: “Inability to do normal activities such as walking, cycling, swimming and heavy household chores”, while knee specialists ranked: “No improvement in pain during the day” as the highest. “No improvement in walking” was in the patients’ top-5, but was not ranked in the top-5 of knee specialists. For satisfied and dissatisfied patients, the top-5 of consequences was similar. ConclusionComparable perspectives were found for patients versus knee specialists and satisfied versus dissatisfied patients on the importance of adverse consequences after TKA. However, when looking in more detail, differences in ranking of specific subitems suggest that patients place slightly more importance on the inability to perform valued activities, while knee specialists prioritize lack of pain relief to a higher degree.

Investigating Individuals' Preferences in Determining the Functions of Smartphone Apps for Fighting Pandemics: Best-Worst Scaling Survey Study.

Smartphone apps have been beneficial in controlling and preventing the COVID-19 pandemic. However, there is a gap in research surrounding the importance of smartphone app functions from a user's perspective. Although the insights and opinions of different stakeholders, such as policymakers and medical professionals, can influence the success of a public health policy, any strategy will face difficulty in achieving the expected effect if it is not based on a method that users can accept. This study aimed to assess the importance of a hypothetical smartphone app's functions for managing health during a pandemic based on the perspective of user preferences. A cross-sectional and web-based survey using the best-worst scaling (BWS) method was used to investigate the general population's preferences for important smartphone app functions. Participants were recruited from a professional surveying company's web-based surveying panel. The attributes of the BWS questionnaire were developed based on a robust process, including literature review, interviews, and expert discussion. A balanced incomplete block design was used to construct the choice task to ensure the effectiveness of the research design. Count analysis, conditional logit model analysis, and mixed logit analysis were used to estimate preference heterogeneity among respondents. The responses of 2153 participants were eligible for analysis. Nearly 55% (1192/2153) were female, and the mean age was 31.4 years. Most participants (1765/2153, 81.9%) had completed tertiary or higher education, and approximately 70% (1523/2153) were urban residents. The 3 most vital functions according to their selection were "surveillance and monitoring of infected cases," "quick self-screening," and "early detection of infected cases." The mixed logit regression model identified significant heterogeneity in preferences among respondents, and stratified analysis showed that some heterogeneities varied in respondents by demographics and COVID-19-related characteristics. Participants who preferred to use the app were more likely to assign a high weight to the preventive functions than those who did not prefer to use it. Conversely, participants who showed lower willingness to use the app tended to indicate a higher preference for supportive functions than those who preferred to use it. This study ranks the importance of smartphone app features that provide health care services during a pandemic based on the general population's preferences in China. It provides empirical evidence for decision-makers to develop eHealth policies and strategies that address future public health crises from a person-centered care perspective. Continued use of apps and smart investment in digital health can help improve health outcomes and reduce the burden of disease on individuals and communities.

Consumers’ Preferences for Digital Corporate Content on Company Websites: A Best–Worst Scaling Analysis

Digital content marketing (DCM) complements traditional marketing communication approaches and is a major focus of research. Uses and gratifications research posits that DCM only unfolds positive effects if it provides valuable content to consumers. However, there is limited evidence on what constitutes gratifying digital corporate content on company websites. This study aimed to elicit consumers’ preferences for key characteristics of digital corporate content on company websites and whether preferences differ among consumer subgroups. Best–worst scaling (BWS) was used to reveal preferences. To obtain BWS data, a cross-sectional survey was employed. The study sample comprised 1527 consumers from Germany, Switzerland, and Austria. Data were analyzed using counting analysis and conditional logit modeling. Subgroup comparisons were performed with t-tests and one-way ANOVA. The results consistently show that consumers prioritize information value as the most important content characteristic, followed by value in use, entertainment value, process value, and social value. Subgroup comparisons revealed generally similar priorities among consumers, with the greatest heterogeneity being found in assessments of the importance of social value. The study also suggests that consumers prioritize digital corporate content characteristics on company websites differently than they do on social media. These findings contribute to the evolving literature on DCM and provide insights that could help set evidence-based priorities in DCM practice.

Older adult patient preferences for the content and format of prescription medication labels – A best-worst scaling and discrete choice experiment study

BackgroundPatient preferences for the content and format of prescription medication labels (PMLs, i.e., sticker labels placed on medication bottles/packets at dispensing) have been extensively studied. However, accommodating all preferences on PMLs is impractical due to space limitations. Understanding how patients prioritise the content and format attributes of PMLs can inform improvements while working within PML space constraints. ObjectivesWe aimed to (1) identify a ranking of medication-related content attributes to be prioritised on PMLs using best-worst scaling (BWS), and (2) determine the relative importance of format attributes when incorporated onto PMLs using discrete choice experiment (DCE), from the perspective of older adult patients in Singapore. MethodsAttributes were informed by our prior qualitative study and PML best practice guidelines. For the BWS component, the assessed content attributes were indication, precautions, interaction or paired medicines, food instructions, side effects, expiry date, and missed dose action, all of which are currently not legally mandated on PMLs in Singapore. A BWS object case was used to rank the content attributes. For the DCE component, in a series of questions, participants were asked to choose between two PML options each time, that varied in the presentation of dosage-frequency instructions, font size, presentation of dosage, presentation of precautions, and font colour of precautions. A mixed logit model estimated the relative utilities of format attribute levels, enabling the calculation of importance scores of the format attributes. ResultsThe study recruited 280 participants (mean age: 68.8 ± 5.4 years). The three most-preferred content attributes were indication, precautions and interaction or paired medicines. The top three format preferences were tabular style presentation of dosage-frequency instructions, large font size and precautions in red colour. ConclusionsHealthcare institutions should consider improving their PMLs based on the leading content and format preferences voiced by older adult patients. The methodology adopted in the study can also be used for aligning the content and format of other patient education materials with patient preferences.

Consumer Preferences for Olive Oil in Spain: A Best-Worst Scaling Approach

This paper studies the preferences of consumers for olive oil in Spain, which is the largest producer and consumer of olive oil worldwide. Olive oil is a prominent, sustainable, healthy, and distinctive product associated with the Mediterranean diet. Based on a survey conducted among a sample of 402 consumers, we apply the Best Worst Scaling method to measure the importance of some attributes that influence consumer preferences for olive oil. Our results show that consumers rate price, geographical origin, protected designation of origin label, and olive variety, as important product attributes. Conversely, attributes such as organic label certification, size, and packaging material are considered less important. As the perceived importance of olive oil attributes differs across individuals, we further estimate a five-class solution and describe each class in terms of knowledge and consumption of Extra Virgin Olive Oil (EVOO) and the socio-demographic characteristics of the respondents. Finally, we discuss the implications of studying consumer preferences for olive oil and provide managerial insights.

Measuring Mental Health Service Preferences Amongst Illinois Dairy Producers

ABSTRACT Objectives To mitigate mental health concerns of farmers, research is needed to investigate strategies that encourage help-seeking behavior in this population. This study attempts to identify those help-seeking strategies. Six mental health service options were examined. Methods A survey, implementing a best-worst scaling choice experiment, was disseminated to members of the Illinois Milk Producers Association. Two methods of analysis were conducted. The first, a count-based method, employs a simple count-based approach to measure the relative preferences for the six mental health service options in question. The second is more complex and employs a latent-class logit regression model to measure individual preferences. Results The mental-health service options, ranked in order from most preferred to least preferred were: 1) speak to family and friends, 2) keep it to myself, 3) utilize programs offered by agricultural organizations, 4) search online for self-help resources, 5) talk to a mental health professional, and 6) use “tele-health” support services. Conclusion This study examined an important gap in the literature concerning help-seeking preferences of dairy farmers. It is the first to utilize a choice experiment approach to assess help-seeking preferences among this understudied population. Results provide important empirical evidence to support distinct categories of farmers who may be weighing options regarding how to best address their mental health concerns.

English

Functions of innovation systems framework have established their value as tools for exploring socio-technological transitions and economic development. Although the “seven functions” model has demonstrated its academic value across a vast literature, there have been few attempts to explore the role of the model in climate smart farming. Therefore, the aim of this study is to determine relative importance of functions of innovation system on cassava climate smart farming in Kenya. The study focused on the following seven functions of innovations; entrepreneurial activities, knowledge development and diffusion, search for guidance, market development and stabilization, resource mobilization and legitimacy development. Data were collected from 150 cassva farmers in Nyando Sub-County, Kenya. Data analysis deployed the Best-Worst scaling (BWS) choice method and expanded to include the multinomial logistic regression modelling. Results revealed that knowledge development, diffusion and resource mobilization were the functions of innovation systems ranked highest in terms of shared importance among the seven innovation functions. In fostering cassava innovations, their relative importance was knowledge development (19.17%), knowledge diffusion (18.86%) and resource mobilization (14.88%). Evidence from the multinomial logistic regression revealed that farmers chose knowledge development as most important innovation function to foster cassava innovations in the Nyando CSV. Key words: Entrepreneurial activity, knowledge development, market formation, resource mobilization.

Employing a transitivity violation detection algorithm to assess best–worst scaling designs

Abstract When choosing a partial factorial design for best–worst scaling (BWS) or other discrete choice experiment, researchers are faced with design size choices. This work investigates differences between two case 1 (object) BWS choice experiment designs that varied in choice set size and number of questions. Using a random-parameter logit model, preference shares were determined and statistically compared between models. The number of transitivity violations occurring between the experimental designs was analyzed employing a newly developed directed graph algorithm. The relative importance consumers placed on dairy milk attributes differed between the designs studied. The design presenting fewer attributes per choice set forced novel tradeoffs more often and yielded no increase in transitivity violations. In general, if one seeks to establish rank among variables and force tradeoffs, smaller designs should be considered.

Identifying key attributes in sustainable food choices: An analysis using the food values framework

As consumers are key players in the transition towards a sustainable consumption pattern, this study aims to assess what consumers consider most important in sustainable food products in terms of food values and their relative weight in the product purchase decision. A cross-national investigation was conducted among Danish and Italian consumers. Using a Best-Worst Scaling approach, consumers were segmented based on their preferred food values and profiled according to various individual self-identities. Three consumer classes were identified: “private benefit seekers” (35%), “sustainability focused” (32.3%), and “naturalness and health driven” (32.7%). Consumers interested in health and those caring about sustainable aspects were found to share the same identity profile. Since private values, namely healthiness and price, attract the majority of consumers, marketers and policymakers are encouraged to build upon such aspects to promote sustainable consumption rather than relying only on sustainability values being sufficient in themselves.

Will farmers go electric? How Dutch environmental regulation affects tractor purchase motivations and preferences

Farm machinery management can contribute to European agricultural, energy and environmental policy objectives of climate change mitigation and fossil fuel independence by investing in tractor electrification. However, many farmers in the Netherlands (and beyond) have expressed concerns about the future profitability and ability to produce at reasonable costs. The Netherlands is also in a so-called ‘nitrogen crisis’, which further causes policy uncertainty about the introduction of more environmental regulations for nitrogen abatement. We conducted a best-worst scaling survey experiment to elicit preferences for electric tractor attributes and measured attitudes towards environmental regulation using motivational posture theory. The ranking of and correlations across estimated preferences and the purchase intention show that the 156 dairy and arable farmers surveyed evaluated an investment in an electric tractor as not feasible. Another conclusion is that the breakthrough of electric tractors is affected by negative anticipated emotions and feelings concerning the current environmental policy and regulatory context.

Assessing citizens’ views on the importance of animal welfare and other sustainability aspects in livestock farming using best–worst scaling

In recent years, farm animal welfare has become an important issue from both an animal science and a societal perspective. Moreover, livestock production is increasingly associated with negative consequences for human health, the environment, and the climate. Thus, there is clear evidence that a more sustainable focus in animal husbandry is needed. However, this is a complex and challenging task, as different stakeholders and emerging trade-offs regarding sustainability need to be considered. For example, outdoor climate housing systems may be socially valued and bring benefits to animal welfare, but at the same time may be detrimental to the environment, the climate, human health, or even animal health. With regard to a sustainable, future-oriented transformation of animal husbandry, it is crucial to identify potential trade-offs and to evaluate them from not only a scientific perspective, but also a societal perspective. Therefore, the aim of this study is to find out how citizens assess the importance of various aspects of livestock production from different goal categories (e.g., ensuring animal welfare vs. environmental or climate protection), as well as within the category “ensuring animal welfare” (e.g., good housing conditions vs. good health conditions). A total of 2,000 participants were recruited via an online panel provider using quota and split sampling. We used the best–worst scaling (BWS) approach to measure the importance of the different aspects for four different farm animal species (dairy cows: n = 503; fattening pigs: n = 500; broilers: n = 499; and laying hens: n = 498). The results show that, regardless of animal species, in a trade-off situation, citizens prioritize animal welfare and human health over other sustainability aspects and, in particular, over product attributes (i.e., product price and taste). In terms of animal welfare, the provision of good housing conditions was found to be the most important sub-aspect for all animal species, but good feeding and animal health were also ranked highly. We consider our results valuable for the development of policy frameworks aimed at a sustainable and socially accepted transformation of current animal husbandry.

What are the key factors influencing newly graduated nurses' preference for choosing their workplace? A best-worst scaling approach.

The literature cites many factors that influence a nurse's decision when choosing their workplace. However, it is unclear which attributes matter the most to newly graduated nurses. The study aimed to identify the relative importance of workplace preference attributes among newly graduated nurses. A cross-sectional study. We conducted an online survey and data were collected in June 2022. A total of 1111 newly graduated nurses in South Korea participated. The study employed best-worst scaling to quantify the relative importance of nine workplace preferences and also included questions about participants' willingness to pay for each workplace preferences. The relationships between the relative importance of the workplace attribute and the willingness to pay were determined using a quadrant analysis. The order according to the relative importance of workplace preferences is as follows: salary, working conditions, organizational climate, welfare program, hospital location, hospital level, hospital reputation, professional development, and the chance of promotion. The most important factor, salary, was 16.67 times more important than the least important factor, the chance of promotion, in terms of choosing workplace. In addition, working conditions and organizational climate were recognized as high economic value indicators. Newly graduated nurses nominated better salaries, working conditions, and organizational climate as having a more important role in choosing their workplace. The findings of this study have important implications for institutions and administrators in recruiting and retaining newly graduated nurses.

Dimensions of food-related wellbeing and their relative importance among New Zealand consumers: A quasi-replication and extension approach

Research into perceived wellbeing (WB) can improve understanding of consumer food choices and support development of strategies to promote healthier and more sustainable eating habits. In this research, using online studies, food-related WB was explored among New Zealand consumers. In a “quasi-replication” of Jaeger, Vidal, Chheang, and Ares (2022), Study 1 uncovered word associations to different WB-related terms (‘Sense of wellbeing,’ ‘Lack of wellbeing,’ ‘Feeling good,’ ‘Feeling bad/unhappy,’ ‘Satisfied with life,’ and ‘Dissatisfied with life’) with 912 participants in a between-subjects design. The results confirmed the multidimensional nature of WB, and the need to consider positive and negative aspects of food-related WB, as well as differences linked to physical, emotional, and spiritual WB. Drawing on Study 1, 13 characteristics of food-related WB were identified, and in Study 2 their importance for feeling a ‘Sense of wellbeing’ and ‘Satisfied with life’ was determined with 1206 participants using a between-subjects design. In a further extension, Study 2 also adopted a product-specific perspective and explored the associations of, and importance, for 16 different foods and beverages to food-related WB. Based on Best-Worst Scaling and penalty/lift analysis, the four most important characteristics overall were ‘Is good quality,’ ‘Is healthy,’ ‘Is fresh,’ and ‘Is tasty,’ with the nuance that healthiness contributed most to feeling a ‘Sense of wellbeing’ while good quality contributed most to feeling ‘Satisfied with life.’ The associations to individual foods and beverages underscored that food-related WB is a complex construct arising from an overall evaluation of the different effects of foods (including physical health, social and spiritual aspects of food consumption) and their short-term effects on food-related behaviour. Contextual and individual differences in perceptions of WB in relation to food deserve further investigation.

An empirical comparison of conjoint and best-worst scaling case III methods

The Best-Worst Scaling (BWS) case III method, also called the BWS ‘multi-profile case.’ has been widely used to characterize survey respondent preferences for market goods. The BWS method is similar to conjoint analysis methods in that respondents select from a set of hypothetical item profiles with different attribute levels. Unlike conjoint methods, which allow respondents to select their best/most preferred profile, the BWS case III method asks respondents to select ‘best’ and ‘worst’ profiles in each choice set. This study compares consumer willingness to pay (WTP) estimates from conjoint and BWS case III survey formats. Data on consumer preferences for single-use eating-ware products made from biobased materials were collected. Results suggest that for the most preferred attribute levels, WTPs estimates are similar in magnitude and consistent for signs across methods. For least-preferred attributes, WTP estimates from the conjoint method are higher than those of the BWS method. However, the BWS WTP estimates have smaller confidence intervals.

Identifying factors that influence the decision to reduce, delay, or discontinue treatment due to chemotherapy-induced peripheral neuropathy: A community-centered approach.

e13123 Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common, debilitating side effect of several chemotherapy agents that may necessitate treatment alteration, i.e., dose reduction, delay, or discontinuation. The decision to alter treatment requires careful consideration between the risk of compromising treatment effectiveness and the benefit of reducing CIPN. Because clinical guidelines do not provide sufficient guidance on when and how to alter treatment in patients experiencing CIPN, it is important to incorporate patients' priorities and preferences in shared decision-making so that the treatment plan aligns with desired outcomes. Currently, little is known about what factors influence the decision to alter treatment from the patient's perspective. Our aim was to identify factors influencing treatment alteration decisions in the context of metastatic breast cancer (mBC). Methods: A community-centered approach was used by engaging oncology clinicians (n = 3) and patients with mBC who experienced CIPN (n = 7). First, the research team conducted a literature review and synthesized 20 factors associated with the decision to alter treatment due to CIPN. Next, researchers presented these factors to clinician and patient stakeholders through individual and group interviews. Clinicians were consulted about the clinical accuracy and relevance of the factors. Patients were asked if factors resonated with their experiences and encouraged to suggest additional ones. To ensure validity, two researchers performed an iterative revision of factors and their descriptions after two individual interviews with patients. Further revisions happened during a group meeting with five patients to ensure that factors and descriptions appropriately described their experience and were comprehensible by others. Results: Eleven factors were identified: (1) fear of decreasing treatment effectiveness, (2) worry of looking back and regretting the decision, (3) opinion of family or friends, (4) recommendation from a medical oncologist, (5) input from other healthcare providers, (6) input from other mBC patients, (7) reduce the worsening of CIPN symptoms, (8) reduce the risk of permanent CIPN, (9) option to switch to alternative treatment less likely to cause CIPN, (10) absence of effective therapies to manage CIPN, and (11) knowledge of the risks and benefits of treatment alteration. Conclusions: Engaging community members was a successful approach to identifying 11 factors influencing treatment alteration decisions in patients experiencing CIPN. In future research, an innovative best-worst scaling (BWS) instrument will measure how patients prioritize these factors. The findings will help inform the development of a patient-centered shared decision-making tool to guide treatment decisions and optimize outcomes.

Evaluating preferences for online psychological interventions to decrease cannabis use in young adults with psychosis: An observational study

Innovative technology-based solutions have the potential to improve access to clinically proven interventions for cannabis use disorder (CUD) in individuals with first episode psychosis (FEP). High patient engagement with app-based interventions is critical for achieving optimal outcomes. 104 individuals 18 to 35 years old with FEP and CUD from three Canadian provinces completed an electronic survey to evaluate preferences for online psychological intervention intensity, participation autonomy, feedback related to cannabis use, and technology platforms and app functionalities. The development of the questionnaire was informed by a qualitative study that included patients and clinicians. We used Best-Worst Scaling (BWS) and item ranking methodologies to measure preferences. Conditional logistic regression models for BWS data revealed high preferences for moderate intervention intensity (e.g., modules with a length of 15 min) and treatment autonomy that included preferences for using technology-based interventions and receiving feedback related to cannabis use once a week. Luce regression models for rank items revealed high preferences for smartphone-based apps, video intervention components, and having access to synchronous communications with clinicians and gamification elements. Results informed the development of iCanChange (iCC), a smartphone-based intervention for the treatment of CUD in individuals with FEP that is undergoing clinical testing.

Patient preferences, regret, and health-related quality of life among older adults with acute myeloid leukemia: A pilot longitudinal study

IntroductionAcute myeloid leukemia (AML) is associated with poor outcomes and is generally incurable. Therefore, understanding preferences of older adults with AML is critical. We sought to assess whether best-worst scaling (BWS) can be used to capture attributes considered by older adults with AML when making initial treatment decisions and longitudinally, as well as assess changes in health-related quality of life (HRQoL) and decisional regret over time. Materials and MethodsIn a longitudinal study for adults ≥60 years with newly diagnosed AML, we collected: (1) attributes of treatment most important to patients using BWS, (2) HRQoL using EQ-5D-5L, (3) decisional regret using the Decisional Regret Scale, and (4) treatment worthiness using the “Was it worth it?” questionnaire. Data was collected at baseline and over six months. A hierarchical Bayes model was used to allocate percentages out of 100%. Due to small sample size, hypothesis testing was performed at α = 0.10 (2-tailed). We analyzed how these measures differed by treatment choice (intensive vs. lower intensity treatment). ResultsMean age of patients was 76 years (n = 15). At baseline, the most important attributes of treatment to patients were response to treatment (i.e., chance that the cancer will respond to treatment; 20.9%). Compared to those who received lower intensity treatment (n = 7) or best supportive care (n = 2), those who received intensive treatment (n = 6) generally ranked “alive one year or more after treatment” (p = 0.03) with higher importance and ranked “daily activities” (p = 0.01) and “location of treatment” (p = 0.01) with less importance. Overall, HRQoL scores were high. Decisional regret was mild overall and lower for patients who chose intensive treatment (p = 0.06). DiscussionWe demonstrated that BWS can be used to assess the importance of various treatment attributes considered by older adults with AML when making initial treatment decisions and longitudinally throughout treatment. Attributes of treatment important to older patients with AML differed between treatment groups and changed over time. Interventions are needed to re-assess patient priorities throughout treatment to ensure care aligns with patient preferences.

Patient Preferences Regarding Surgical Treatment Methods for Symptomatic Uterine Fibroids

Study ObjectiveThe purpose of this study is to rank the factors that are most and least important to patients with symptomatic uterine fibroids when considering surgical treatment options.Materials and MethodsUsing a best worst scaling (BWS) preference elicitation approach, participants completed an online survey to rank factors associated with fibroid surgical 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 spreading undiagnosed 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. Participants’ responses were analyzed using conditional logistic regression to determine the relative importance of factors. Patient priorities were further explored via age and race.Results285 respondents with symptomatic uterine fibroids (69 physician-confirmed and 216 self-reported) who had not undergone prior surgical treatment completed the survey. Respondents were enrolled from two clinical sites (clinical site cohort) and an online consumer panel (panel cohort). Both cohorts identified symptom relief, cancer risk, repeat treatment and complications as the most important factors in selecting surgical treatment options and location of procedure, return to normal activities after surgery, and cosmetic effects like presence of a scar after the surgical treatment as the least important factors. Of note, younger women (≤ 40) placed greater importance on the ability to have children after the procedure.ConclusionInformation regarding the factors most and least important to patients with symptomatic uterine fibroids might inform development and regulatory evaluation of new technologies and procedures. Study results may be useful in efforts to develop a set of outcomes to include in future fibroids clinical studies.