Best-worst Scaling Research Articles

OP220 What Factors Do Clinicians Value Most In Selecting Physician Preference Items? A Survey Among Italian Orthopaedists

IntroductionPhysician preference items (PPIs) are high-cost medical devices on which clinicians express firm preferences with respect to a particular manufacturer and a specific product. The aim of this research is to understand what are the most important factors, as well as their relative importance, in the choice of new PPIs (that is, hip or knee prosthesis) adoption on behalf of orthopaedic clinicians in Italy.MethodsBased on a literature review and clinical experts’ opinions, we identified a number of key factors (for example, health technology assessment (HTA) recommendation) and their corresponding levels (for example positive HTA recommendation). We administered an online survey to hospital orthopaedists using two experimental techniques for preference elicitation (that is, discrete choice experiment (DCE) and case 1 best-worst scaling (BWS)). BWS data were analysed through descriptive statistics (that is, best-minus-worst score) and conditional logit model. A mixed logit model was applied to DCE data, and a willingness-to-pay (WTP) was estimated. All analyses were conducted using Stata 16.ResultsA total of ninety orthopaedists (95% male; mean age: 52.8 years) were enrolled in the survey. In BWS, the most important factor was ‘clinical evidence’, followed by ‘quality of products’, ‘HTA recommendations’ and ‘previous experience’, while the least important was ‘cost’. DCE results suggested that orthopaedists prefer high-quality products with robust clinical evidence, positive HTA recommendation and affordable cost, and for which clinicians have a consolidated experience of use and a good relationship with the sales representative. The WTP for a high-quality product was estimated at EUR1,733, and for a good relationship at EUR2,843.ConclusionsThis is the first study aimed at analysing the multidimensionality of clinician's decision-making process in selecting new PPIs in orthopaedics in Italy. Despite the quality of products being declared as one of the most important dimensions in BWS, when other factors populate a hypothetical DCE scenario, physicians are not willing to accept quality at any cost (for example, high quality and very bad support from the producer or with uncertain clinical evidence).

A pompous snack: On the unreasonable complexity of the world's third-worst jokes.

Although studies of humour are as old as the Western academic tradition, most theories are too vague to allow for modelling and prediction of humour judgments. Previous work in modelling humour judgments has succeeded by focusing on the world's worst jokes: the slight humour of single nonwords (Westbury, Shaoul, Moroschan, & Ramscar, 2016) and single words (Westbury & Hollis, 2019). Here that work is extended to the world's third-worst jokes, adjective-noun pairs such as dancing dildo, flabby goldfish, and pompous snack. Participants used best-worst scaling to rate the humour of random word pairs. Those judgments were modelled using both linear regression and genetic programming, which is not constrained by assumptions of linearity. The linear regression models were as successful as the nonlinear models at predicting humour judgments, accounting for 27% of the variance in a 540-item validation set. Predictors associated only with the noun and with the relationship between the adjective and noun accounted for much more variance (over 14% each) than predictors associated only with the adjective (6.3%). Greater cosine distance of the adjective word2vec vector from the vectors of the shared neighbors of the noun and adjective is associated with higher humour ratings, whereas the opposite relationship is true for the noun. This captures a form of incongruity not seen in single items, by which neighbours of the adjective become unexpectedly relevant only when the noun brings them into focus. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

BWS(Best-Worst Scaling Method) 방법을 적용한 와인선택속성에 관한 연구

The goal of this study is to identify the properties of wine selection that the consumer thinks most important when they buys the wine by using the BWS(Best-Worst Scaling) analysis. We grasped the relative importance of 13 factors as the selection property when buying wine with the use of general counting method. This research showed the following results: first, the important properties of 13 property factors were the taste, price and recommendation in order, while the less important properties were the color, label and alcohol proof etc.; second, this research observed the importance of 13 selection factors with the demographic characteristics when buying the wine. The result observed by gender analyzed that both men and women made much of the taste, while they didn't make much of the wine color. The result observed by age showed that the recommendation factor made much at the most of age was not made much by the age of 51 years old, while they made much of the promotion factor. The result observed by income showed that only those with less than 30 million won of income made much of the promotion factor. This research seems to grasp the wine selection property that can affect consumer's selection, and provide the importance in order of preference, and to be used as marketing data to activate the sales when it is applied to wine company. This research suggested that in the wine market where the consumer's desire is diversified, we can develop the better wine products by verifying the properties of wine selection, and that we can make use of this research in several promotion activities that fit to the target customer and consumption situation.

Barriers and Expectations for Patients in Post-Osteoporotic Fracture Care in France: The EFFEL Study

ObjectivesThis study aimed to quantify the relative importance of barriers to better secondary prevention of osteoporotic fractures and of care expectations expressed by patients with osteoporotic fractures in France. MethodsA qualitative exploration of potential barriers to care and expectations was undertaken through a systematic literature review and in-depth patients interviews. A list of 21 barriers and 21 expectations was identified. These were presented to 324 subjects with osteoporotic fractures, identified in a representative sample of the French population, in the form of best-worst scaling questionnaires. Patients rated the relative importance of the attributes, and arithmetic mean importance scores were calculated and ranked. A Bayesian hierarchical model was also performed to generate a relative importance score. Latent class analysis was performed to identify potential subgroups of patients with different response profiles. ResultsA total of 7 barriers were rated as the most important, relating to awareness of osteoporosis and coordination of care. The highest-ranked barrier, “my fracture is not related to osteoporosis,” was significantly more important than all the others (mean importance score 0.45; 95% confidence interval 0.33-0.56). A similar ranking of attributes was obtained with both the arithmetic and the Bayesian approach. For expectations, no clear hierarchy of attributes was identified. Latent class analysis discriminated 3 classes of respondents with significant differences in response profiles (the educated environmentalists, the unaware, and the victims of the system). ConclusionsBetter quality of care of osteoporosis and effective secondary fracture prevention will require improvements in patient education, training of healthcare professionals, and coordination of care.

What gets resident physicians stressed and how would they prefer to be supported? A best–worst scaling study

IntroductionPhysician burnout has severe consequences on clinician well-being. Residents face numerous work-stressors that can contribute to burnout; however, given specialty variation in work-stress, it is difficult to identify systemic stressors...

Supplementary Material: Preferences of European dairy stakeholders in breeding for resilient and efficient cattle: A best-worst scaling approach

Supplementary Material: Preferences of European dairy stakeholders in breeding for resilient and efficient cattle: A best-worst scaling approach

Beyond a question of liking: Examining military foods using the Best-Worst Scaling technique

Packaged military foods are often under consumed by personnel during training and operational situations, increasing the risk of diminished health and performance. Considerable effort is therefore committed to selecting or improving foods to increase the likelihood of consumption. These decisions are commonly informed by hedonic liking—a single, but important influence on choice and consumption. This paper examined the utility of Best-Worst Scaling (BWS) in a military context as a measure of choice to extend measurement beyond liking and closer to the desired goal of consumption. Two studies (involving n = 303 civilians; n = 300 military personnel) compared ratings of liking and choice (BWS) and examined choice patterns across evoked military scenarios. Results confirmed hedonic liking was a poor predictor of choice at a product level (50% of the variance explained) and at an individual level (26% of the variance explained). BWS provided better discrimination between products than liking. At a group level, choice patterns were relatively consistent across scenarios. BWS was used to identify most preferred and least preferred products. When there was variation in choice patterns within the group, ‘certain winners’, ‘polarising products’ and ‘definite losers’ could be identified. This demonstrates how Best-Worst Scaling could be used as a decision making tool during military ration pack development.

A cross-cultural study on consumer preferences for olive oil

In this paper, we study consumer preferences for olive oil across four countries (Denmark, France, Tunisia, and the US). Based on a large-scale study with olive oil consumers (N = 3,462), we use the Best-Worst Scaling method to measure perceived importance for product attributes known to influence consumer choice. Our results show that consumers across all countries rate type, price, prior experience, and country of origin as important product attributes. On the other hand, packaging, label design, and brands are considered as less important product attributes. While the perceived importance for olive oil attributes differs across countries, the order of importance is almost similar for all countries. We further derive a three-segment solution and describe each segment based on its attitudinal beliefs, usage, and socio-demographic profile. We discuss implications for the study of consumer preferences for olive oil and provide managerial insights.

Development and validation of the food allergy severity score.

BackgroundThe heterogeneity and lack of validation of existing severity scores for food allergic reactions limit standardization of case management and research advances. We aimed to develop and validate a severity score for food allergic reactions.MethodsFollowing a multidisciplinary experts consensus, it was decided to develop a food allergy severity score (FASS) with ordinal (oFASS) and numerical (nFASS) formats. oFASS with 3 and 5 grades were generated through expert consensus, and nFASS by mathematical modeling. Evaluation was performed in the EuroPrevall outpatient clinic cohort (8232 food reactions) by logistic regression with request of emergency care and medications used as outcomes. Discrimination, classification, and calibration were calculated. Bootstrapping internal validation was followed by external validation (logistic regression) in 5 cohorts (3622 food reactions). Correlation of nFASS with the severity classification done by expert allergy clinicians by Best‐Worst Scaling of 32 food reactions was calculated.ResultsoFASS and nFASS map consistently, with nFASS having greater granularity. With the outcomes emergency care, adrenaline and critical medical treatment, oFASS and nFASS had a good discrimination (receiver operating characteristic area under the curve [ROC‐AUC]>0.80), classification (sensitivity 0.87–0.92, specificity 0.73–0.78), and calibration. Bootstrapping over ROC‐AUC showed negligible biases (1.0 × 10−6–1.23 × 10−3). In external validation, nFASS performed best with higher ROC‐AUC. nFASS was strongly correlated (R 0.89) to best‐worst scoring of 334 expert clinicians.ConclusionFASS is a validated and reliable method to measure severity of food allergic reactions. The ordinal and numerical versions that map onto each other are suitable for use by different stakeholders in different settings.

Choices in Sustainable Food Consumption: How Spanish Low Intake Organic Consumers Behave

The consumption of organic products has consistently increased over the last decades, covering increasingly diversified consumers, both in the characteristics and the reasons associated with consumption. This heterogeneity evidences the need to examine in depth the reasons for the purchase and consumption of these products. The core aim of this study is related to the motivational drivers of organic consumption. The survey included 250 respondents from Andalusia (Spain) who completed an online questionnaire and personal interviews. A convenience sampling method was applied, and the best-worst scaling method allowed us to analyze ten attributes of organic purchasing behavior. Health benefits and environmental impact are the key attributes explaining the consumption of organic products. To deeply understand organic consumer motivations, we studied the influence of six classification variables over the studied attributes. Applying ordinal regressions, we found that having children under 18 at home and a consumer’s academic level contribute in a relevant way to explain the valorization of the health benefits attribute. Also, the place to purchase organic food and academic level correlates with the valuation of GMOs in food. Andalusia is one of the largest European regions for organic production but with minor relevance in consumption. Nevertheless, despite this apparent paradox, the results of the present study point to a consumer profile very similar to other European countries with consolidated organic consumption.

The Impact of Gastrointestinal Symptoms on Patients’ Well-Being: Best–Worst Scaling (BWS) to Prioritize Symptoms of the Gastrointestinal Symptom Score (GIS)

Background: The gastrointestinal symptom score (GIS) is used in a standardized form to ascertain dyspeptic symptoms in patients with functional dyspepsia in clinical practice. As a criterion for evaluating the effectiveness of a treatment, the change in the summed total point value is used. The total score ranges from 0 to 40 points, in which a higher score represents a more serious manifestation of the disease. Each symptom is included with equal importance in the overall evaluation. The objective of this study was to test this assumption from a patients’ perspective. Our aim was to measure the priorities of patients for the ten gastrointestinal symptoms by using best–worst scaling. Method: A best–worst scaling (BWS) object scaling (Case 1) was applied. Therefore, the symptoms of the GIS were included in a questionnaire using a fractional factorial design (BIBD—balanced incomplete block design). In each choice set, the patients selected the component that had the most and the least impact on their well-being. The BIB design generated a total of 15 choice sets, which each included four attributes. Results: In this study, 1096 affected patients were asked for their priorities regarding a treatment of functional dyspepsia and motility disorder. Based on the data analysis, the symptoms abdominal cramps (SQRT (B/W): −1.27), vomiting (SQRT (B/W): −1.07) and epigastric pain (SQRT (B/W): −0.76) were most important and thus have the greatest influence on the well-being of patients with functional dyspepsia and motility disorders. In the middle range are the symptoms nausea (SQRT (B/W): −0.69), acid reflux/indigestion (SQRT (B/W): −0.29), sickness (SQRT (B/W): −0.26) and retrosternal discomfort (SQRT (B/W): 0.26), whereas the symptoms causing the least impact are the feeling of fullness (SQRT (B/W): 0.80), early satiety (SQRT (B/W): 1.54) and loss of appetite (SQRT(B/W): 1.95). Discussion: Unlike the underlying assumption of the GIS, the BWS indicated that patients did not weight the 10 symptoms equally. The results of the survey show that the three symptoms of vomiting, abdominal cramps and epigastric pain are weighted considerably higher than symptoms such as early satiety, loss of appetite and the feeling of fullness. The evaluation of the BWS data has illustrated, however, that the restrictive assumption of GIS does not reflect the reality of dyspeptic patients. Conclusions: In conclusion, a preference-based GIS is necessary to make valid information about the real burden of illness and to improve the burden of symptoms in the indication of gastrointestinal conditions. The findings of the BWS demonstrate that the common GIS is not applicable to represent the real burden of disease. The results suggest the potential modification of the established GIS by future research using a stated preference study.

Perceptions of Hospice and Transfusion Access Among Patients with Advanced Blood Cancers: Results from a Best-Worst Scaling Survey

Background: Patients with hematologic malignancies have low rates of hospice use, and when they do enroll, they often do so in the last three days of life. While lack of access to transfusions in hospice has been posited to be a key barrier to hospice use for this population, data are lacking regarding the perception of patients with blood cancers about the importance of transfusion access compared to traditional hospice services. We sought to characterize the utility of transfusions and hospice services from the perspective of patients with advanced blood cancers, who would potentially be eligible for hospice care.Methods: In October 2020, we began a web-based survey of patients with hematologic malignancies recruited from the clinics of two large cancer centers. Eligible patients were at least 18 years of age, had at least two outpatient visits to the cancer center, and had a physician-estimated prognosis of six months or less based on their hematologic oncologist answering “no” to a modified “surprise” question (Hudson KE, JPM 2018): “would you be surprised if this patient died within the next six months?” A physician-estimated prognosis of ≤ 6 months was used for study inclusion as this is an eligibility criterion for hospice. The survey was developed through literature review, a series of patient/caregiver focus groups (n=27) and cognitive debriefing with blood cancer patients (n=5). The survey included a best-worst scaling (BWS) section to assess patients' perceptions of the utility of various services routinely provided in hospice (visiting nurse, case manager, home health aide, chaplain, social worker, respite care) as well as non-routine services (transfusion access, transportation, peer support, telemedicine through videoconferencing). We asked patients to imagine a program developed to support quality of life for patients with blood cancers just like them. We then presented them with 10 questions with different combinations of the services in groups of 4 and participants were asked to select the service they considered “most important” and “least important” in deciding whether to sign up for the program. The BWS questions were constructed using a near balanced incomplete block design (Louviere JJ, Patient 2010). We conducted a hierarchical Bayesian analysis to ascertain a standardized utility score assigned to each service, a measure of the average propensity to choose a service as most important more often than least important. Analyses were conducted using Sawtooth (Sawtooth Software, Inc).Results: As of July 2021, 102 patients had completed the survey (response rate: 64.6%). The median age of respondents was 71 years (IQR 63, 77). The majority of respondents were male, white, and married/living with partner (Table). The most common diagnosis was acute leukemia (38.2%). Patients considered access to blood transfusions to have the highest importance (Figure) with a standardized utility score of 21.1, 95% confidence interval [CI] [19.6-22.6], followed by telemedicine (19.4, 95% CI [17.8-20.9]), transportation to/from medical appointments (13.4, 95% CI 11.7-15.1), and visiting nurses (10.8, 95% [9.5-12.2]. The three least important services perceived by respondents were access to respite care (4.7, 95% CI [3.9-5.6]), social workers (4.5, 95% CI [3.5-5.5]), and chaplains (2.3, 95% CI [1.3-3.3]).Conclusions: In this cohort of blood cancer patients who would potentially be eligible for hospice care, access to blood transfusions had the greatest level of importance relative to services routinely provided in hospice settings. The high value placed on transfusion access suggests that this factor plays a crucial role in hospice decision making. Accordingly, lack of transfusion access in many hospices likely reduces the propensity of patients with blood cancers to choose hospice. Innovative hospice delivery models that include access to palliative transfusions may have strong potential to increase hospice use and optimize end-of-life care for this patient population. [Display omitted] DisclosuresHuntington: Genentech: Consultancy; SeaGen: Consultancy; Thyme Inc: Consultancy; Servier: Consultancy; Novartis: Consultancy; Bayer: Honoraria; AstraZeneca: Consultancy, Honoraria; AbbVie: Consultancy; DTRM Biopharm: Research Funding; TG Therapeutics: Research Funding; Flatiron Health Inc.: Consultancy; Pharmacyclics: Consultancy, Honoraria; Celgene: Consultancy, Research Funding.

Which Attributes Are Most and Least Important to Patients When Considering Gout Flare Burden Over Time? A Best-worst Scaling Choice Study.

Several factors contribute to the patient experience of gout flares, including pain intensity, duration, frequency, and disability. It is unknown which of these factors are most important to patients when considering flare burden over time, including those related to the cumulative experience of all flares, or the experience of a single worst flare. This study aimed to determine which flare attributes are the most and least important to the patient experience of flare burden over time. Participants with gout completed an anonymous online survey. Questions were aimed at identifying which attributes of gout flares, representing both individual and cumulative flare burden, were the most and least important over a hypothetical 6-month period. A best-worst scaling method was used to determine the importance hierarchy of the included attributes. Fifty participants were included. Difficulty doing usual activities during the worst flare and pain of the worst flare were ranked as the most important, whereas average pain of all flares was considered the least important. Overall, attributes related to the single worst gout flare were considered more important than attributes related to the cumulative impact of all flares. When thinking about the burden of gout flares over time, patients rank activity limitation and pain experienced during their worst gout flare as the most important contributing factors, whereas factors related to the cumulative impact of all flares over time are relatively less important.

An identification of customers’ preferred restaurant menu measures during a crisis using Best-Worst Scaling (BWS)

ABSTRACT The restaurant’s menu is considered the primary determinant of a restaurant’s profitability and customer satisfaction. This article explores consumers’ preferences of restaurant menu measures applied during a crisis. Based on pertinent literature review in conjunction with inputs from F&B experts, the researchers identified a list of 6 restaurant menu practices that managers implement during a crisis. The researchers used the Best-Worst Scaling (BWS) method to identify customers’ choices for the menu measures. Based on the analysis of survey responses from 568 restaurant customers, the findings demonstrate that menu measures applied during a crisis are perceived differently across the three restaurant categories: fine dining, casual dining, and quick service. The results of this study have not only practical contribution to the case of Lebanon, but they also fill a gap in the knowledge, and extend the existing literature with restaurant consumers’ preference of menu measures during a crisis, and provide a list of practices to be implemented by F&B professionals.

Patient Preferences Regarding Surgical Treatment Methods for Symptomatic Uterine Fibroids

<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.

Self-Reported Preferences for Help-Seeking and Barriers to Using Mental Health Supports Among Internal Medicine Residents: Exploratory Use of an Econometric Best-Worst Scaling Framework for Gathering Physician Wellness Preferences.

BackgroundBurnout interventions are limited by low use. Understanding resident physician preferences for burnout interventions may increase utilization and improve the assessment of these interventions.ObjectiveThis study aims to use an econometric best-worst scaling (BWS) framework to survey internal medicine resident physicians to establish help-seeking preferences for burnout and barriers to using wellness supports by quantifying selections for 7 wellness support options and 7 barriers.MethodsInternal medicine resident physicians at our institution completed an anonymous web-based BWS survey during the 2020-2021 academic year. This cross-sectional study was analyzed with multinomial logistic regression and latent class modeling to determine the relative rank ordering of factors for seeking support for burnout and barriers to using wellness supports. Analysis of variance with Tukey honest significant difference posthoc test was used to analyze differences in mean utility scores representing choice for barriers and support options.ResultsOf the 163 invited residents, 77 (47.2% response rate) completed the survey. Top-ranking factors for seeking wellness supports included seeking informal peer support (best: 71%; worst: 0.6%) and support from friends and family (best: 70%; worst: 1.6%). Top-ranking barriers to seeking counseling included time (best: 75%; worst: 5%) and money (best: 35%; worst: 21%).ConclusionsOverall, our findings suggest that low utilization of formal mental health support is reflective of resident preferences to seek help informally and that increasing utilization will require addressing pragmatic barriers of time and cost. Assessing physician preferences for wellness-related initiatives may contribute to understanding the low utilization of formal mental health services among physicians, which can be determined using a BWS framework.

Case 2 best-worst scaling: For good or for bad but not for both

This paper studies the performance of case 2 best-worst scaling (BWS) when it is applied to a mix of positive and negative attributes, for example in studying treatments characterized by both benefits and harms. Intuitively, such a mix of positive and negative attributes leads to dominance. We analytically show that dominance leads to infinitely large differences between the parameter estimates for the positive versus negative attributes. The results from a simulation study confirm our analytical results: parameter values of the attributes could not be accurately recovered. When only a single positive attribute was used, even the relative ordering of the attribute level preferences was not identified. As a result, case 2 BWS can be used to elicit preferences if only good (positive) or only bad (negative) attributes are included in the choice tasks, but not for both since dominance will impact parameter estimation and therefore decision-making.

Analyses of consumers' preferences and of the correspondence between direct and indirect label claims and the fatty acid profile of milk in large retail chains in northern Italy

Combined results from 2 survey studies were used to obtain information useful for the industries and retailers involved in the milk production and selling chain in North Italy. The first survey identified different clusters of fluid milk purchasers by examining their preferences and attitudes toward 12 intrinsic-extrinsic and credence milk attributes, by applying best-worst scaling methodology, whereas the second survey characterized the fatty acid (FA) profiles of commercial milk sold by large-scale retailers to verify the correspondence between the actual FA profile and the direct and indirect claims on the labels. To summarize information about the FA profile of milk, which may be considered an advanced attribute of milk quality, the milk FA index (MFAI) was calculated for each milk sample. A total of 130 milk samples (around 85% of the labels in northern Italy) and a total of 502 participants who answered a face-to-face questionnaire were considered in the 2 surveys. The milk samples were 13.1% organic, 9.2% certified as being of mountain origin, and over 50% noncertified but linked to cow grazing or to a mountain environment on their labels. The FA profiles showed a wide range of variation, with saturated FA ranging from 63.4 to 71.8, and polyunsaturated FA from 2.76 to 5.85. The FA profile and MFAI index of certified milk (organic or mountain-derived) were significantly different from the profiles of noncertified milk, whereas no correspondence was observed between the retail price and milk quality. When ranked on the basis of MFAI, which proved to be a good discriminating tool, the certified milks presented a bimodal distribution, indicating that certification does not always guarantee a real difference. The consumers chose milk considering the origin of the product, brand, expiration date, and process certification as the most important attributes, whereas they rated price and organic certification as the least important attributes. The study showed that about 20% of the consumers had a high propensity to buy milk on the basis of its quality. However, this attribute is often incorrectly indicated or not indicated at all on the milk label, with misleading images or claims that do not correspond to the actual FA quality of the milk. Having a clear index that offers information about the FA profile could thus be an interesting tool to improve the awareness of buyers and to valorize and differentiate milk products.

Patients' preferences for quality-of-life aspects in sarcopenia: a best-worst scaling study.

As information on patients' preferences regarding quality-of-life aspects in sarcopenia is lacking, this study aims to assess the relative importance of the 14 items of a QoL questionnaire designed for sarcopenia (the SF-SarQoL) using a best-worst scaling (BWS) survey. Participants, aged 65years or older and community dwelling, who previously participated in the SarcoPhAge study, received a BWS survey via the mail. An object case BWS was selected in which participants completed 12 choice tasks, picking the most and least important aspect from 4 out of 14 SF-SarQoL items for each task. Relative importance scores (RIS) were estimated using Hierarchical Bayes modelling. A cluster analysis was also conducted to investigate whether several profiles with regards to QoL preferences were present. A total of 163 participants were included, aged 75 (IQR: 73-81) years old, and mostly women (n = 107; 65.6%). Two items were found to be significantly more important than others: "feeling a reduction of physical capacity" (RIS = 11.26), and "having balance problems" (RIS = 11.09). The least important items were "experiencing difficulty carrying heavy objects" (RIS = 2.89), and "feeling a reduction in muscle mass" (RIS = 3.82). We found relatively weak evidence for the presence of two clusters. One cluster prioritized items related to falls where the second prioritized items related to feeling physically capable. Not all QoL aspects were equally important. The relative weight of each QoL aspect may be used to interpret QoL results obtained with the SF-SarQoL or to inform target outcomes in interventional studies.

Multisite evaluation of institutional processes and implementation determinants for pharmacogenetic testing to guide antidepressant therapy.

There is growing interest in utilizing pharmacogenetic (PGx) testing to guide antidepressant use, but there is lack of clarity on how to implement testing into clinical practice. We administered two surveys at 17 sites that had implemented or were in the process of implementing PGx testing for antidepressants. Survey 1 collected data on the process and logistics of testing. Survey 2 asked sites to rank the importance of Consolidated Framework for Implementation Research (CFIR) constructs using best‐worst scaling choice experiments. Of the 17 sites, 13 had implemented testing and four were in the planning stage. Thirteen offered testing in the outpatient setting, and nine in both outpatient/inpatient settings. PGx tests were mainly ordered by psychiatry (92%) and primary care (69%) providers. CYP2C19 and CYP2D6 were the most commonly tested genes. The justification for antidepressants selected for PGx guidance was based on Clinical Pharmacogenetics Implementation Consortium guidelines (94%) and US Food and Drug Administration (FDA; 75.6%) guidance. Both institutional (53%) and commercial laboratories (53%) were used for testing. Sites varied on the methods for returning results to providers and patients. Sites were consistent in ranking CFIR constructs and identified patient needs/resources, leadership engagement, intervention knowledge/beliefs, evidence strength and quality, and the identification of champions as most important for implementation. Sites deployed similar implementation strategies and measured similar outcomes. The process of implementing PGx testing to guide antidepressant therapy varied across sites, but key drivers for successful implementation were similar and may help guide other institutions interested in providing PGx‐guided pharmacotherapy for antidepressant management.