College of Business, Clemson University, Clemson, SC, USA.
University of Rochester Medical Center, Rochester, NY, USA.
Med Decis Making. 2018 Jul;38(5):601-613. doi: 10.1177/0272989X18763802. Epub 2018 Apr 3.
Current colorectal cancer screening guidelines by the US Preventive Services Task Force endorse multiple options for average-risk patients and recommend that screening choices should be guided by individual patient preferences. Implementing these recommendations in practice is challenging because they depend on accurate and efficient elicitation and assessment of preferences from patients who are facing a novel task.
To present a methodology for analyzing the sensitivity and stability of a patient's preferences regarding colorectal cancer screening options and to provide a starting point for a personalized discussion between the patient and the health care provider about the selection of the appropriate screening option.
This research is a secondary analysis of patient preference data collected as part of a previous study. We propose new measures of preference sensitivity and stability that can be used to determine if additional information provided would result in a change to the initially most preferred colorectal cancer screening option.
Illustrative results of applying the methodology to the preferences of 2 patients, of different ages, are provided. The results show that different combinations of screening options are viable for each patient and that the health care provider should emphasize different information during the medical decision-making process.
Sensitivity and stability analysis can supply health care providers with key topics to focus on when communicating with a patient and the degree of emphasis to place on each of them to accomplish specific goals. The insights provided by the analysis can be used by health care providers to approach communication with patients in a more personalized way, by taking into consideration patients' preferences before adding their own expertise to the discussion.
美国预防服务工作组的现行结直肠癌筛查指南支持多种针对一般风险患者的选择，并建议根据患者的个人偏好来指导筛查选择。在实践中实施这些建议具有挑战性，因为它们依赖于对面临新任务的患者进行准确和有效的偏好 elicitation 和评估。
提出一种分析结直肠癌筛查选择患者偏好敏感性和稳定性的方法，并为患者和医疗保健提供者之间关于选择适当筛查选项的个性化讨论提供起点。
本研究是对先前研究中收集的患者偏好数据的二次分析。我们提出了偏好敏感性和稳定性的新度量标准，可以用来确定提供额外信息是否会导致最初最偏好的结直肠癌筛查选项发生变化。
提供了应用该方法对 2 名不同年龄患者偏好的说明性结果。结果表明，对于每个患者，不同的筛查选项组合都是可行的，并且医疗保健提供者在医疗决策过程中应强调不同的信息。
敏感性和稳定性分析可以为医疗保健提供者提供与患者沟通时的重点话题，并确定对每个话题的强调程度，以实现特定目标。分析提供的见解可以被医疗保健提供者用来以更个性化的方式接近与患者的沟通，在将自己的专业知识加入讨论之前，考虑到患者的偏好。
