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公众、医学专业人员和患者对移植供体器官分配的偏好:离散选择实验的研究方案

Public, medical professionals' and patients' preferences for the allocation of donor organs for transplantation: study protocol for discrete choice experiments.

作者信息

Oedingen Carina, Bartling Tim, Krauth Christian

机构信息

Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany.

Center for Health Economics Research Hannover (CHERH), Hannover, Germany.

出版信息

BMJ Open. 2018 Oct 17;8(10):e026040. doi: 10.1136/bmjopen-2018-026040.

Abstract

INTRODUCTION

Organ transplantation is the treatment of choice for patients with severe organ failure. Nevertheless, donor organs are a scarce resource resulting in a large mismatch between supply and demand. Therefore, priority-setting leads to the dilemma of how these scarce organs should be allocated and who should be considered eligible to receive a suitable organ. In order to improve the supply-demand mismatch in transplantation medicine, this study explores preferences of different stakeholders (general public, medical professionals and patients) for the allocation of donor organs for transplantation in Germany. The aims are (1) to determine criteria and preferences, which are relevant for the allocation of scarce donor organs and (2) to compare the results between the three target groups to derive strategies for health policy.

METHODS AND ANALYSIS

We outline the study protocol for discrete choice experiments, where respondents are presented with different choices including attributes with varied attribute levels. They were asked to choose between these choice sets. First, systematic reviews will be conducted to identify the state of art. Subsequently, focus group discussions with the public and patients as well as expert interviews with medical professionals will follow to establish the attributes that are going to be included in the experiments and to verify the results of the systematic reviews. Using this qualitative exploratory work, discrete choice studies will be designed to quantitatively assess preferences. We will use a D-efficient fractional factorial design to survey a total sample of 600 respondents according to the public, medical professionals and patients each. Multinomial conditional logit model and latent class model will be analysed to estimate the final results.

ETHICS AND DISSEMINATION

This study has received Ethics Approval from the Hannover Medical School Human Ethics Committee (Vote number: 7921_BO_K_2018). Findings will be disseminated through conference presentations, workshops with stakeholders and peer-reviewed journal articles.

摘要

引言

器官移植是重症器官衰竭患者的首选治疗方法。然而,供体器官是一种稀缺资源,导致供需严重不匹配。因此,确定优先次序引发了如何分配这些稀缺器官以及谁应被视为有资格接受合适器官的两难问题。为了改善移植医学中的供需不匹配状况,本研究探讨了不同利益相关者(普通公众、医学专业人员和患者)对德国移植供体器官分配的偏好。目的是:(1)确定与稀缺供体器官分配相关的标准和偏好;(2)比较三个目标群体的结果,以制定卫生政策策略。

方法与分析

我们概述了离散选择实验的研究方案,向受访者展示不同的选择,包括具有不同属性水平的属性。要求他们在这些选择集之间进行选择。首先,将进行系统评价以确定现有水平。随后,将与公众和患者进行焦点小组讨论,并与医学专业人员进行专家访谈,以确定将纳入实验的属性,并验证系统评价的结果。利用这项定性探索性工作,设计离散选择研究以定量评估偏好。我们将使用D效率分数析因设计,根据公众、医学专业人员和患者各自调查600名受访者的总样本。将分析多项条件logit模型和潜在类别模型以估计最终结果。

伦理与传播

本研究已获得汉诺威医学院人类伦理委员会的伦理批准(投票编号:7921_BO_K_2018)。研究结果将通过会议报告、与利益相关者的研讨会以及同行评审期刊文章进行传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2ae/6196962/4c456b044d6e/bmjopen-2018-026040f01.jpg

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