Orthodontic Department, Leeds Dental Institute, Clarendon Way, Leeds, LS2 9LU, UK.
Leeds Institute of Health Sciences, Level 10 Worsley Building, Clarendon Way, Leeds, LS2 9TJ, UK.
Patient. 2019 Feb;12(1):137-148. doi: 10.1007/s40271-018-0338-0.
Our objective was to develop and test a discrete-choice experiment (DCE) survey to elicit adolescent and parent preferences for dental care for hypodontia (a developmental condition where one or more teeth fail to develop).
This was a mixed-methods study. Participants were adolescents (aged 12-16 years) with hypodontia and their parents and the dentists providing hypodontia care. Stage one entailed attribute development, as follows. (1) Attribute identification: systematic review of hypodontia literature; interviews with adolescents with hypodontia (n = 8) and parents (n = 8); observation of hypodontia clinical consultations (n = 5); environmental scan of hypodontia patient information resources (n = 30); and systematic analysis of social media posts (n = 176). (2) Attribute selection: stakeholder consultation to develop items for a questionnaire; rating and ranking questionnaire for adolescents with hypodontia and parents (n = 18); further stakeholder consultation. Stage two involved the development of the DCE survey, and stage three included the pre-testing using cognitive interviews with adolescents (n = 12) and parents (n = 8) to assess face and content validity.
The attribute long list included 27 attributes focusing on service delivery and treatment outcome, from which seven 'important' attributes were selected for pre-testing. Cognitive interviewing suggested adolescents found the DCE choice tasks challenging to understand; the survey was modified to enhance its acceptability. One attribute was excluded as it showed poor validity with adolescents. Pre-testing suggested DCE choice tasks encouraged thinking and discussion about preferences for treatment.
Including the target respondent group in all stages of DCE development ensured the final DCE survey was valid and acceptable. DCE methods appear to be a useful tool for exploring joint decision making alongside conventional preference elicitation.
我们的目的是开发和测试一个离散选择实验（DCE）调查，以了解青少年和家长对缺牙症（一种牙齿发育不良的发育状况，一个或多个牙齿未能发育）的牙科护理偏好。
这是一项混合方法研究。参与者为患有缺牙症的青少年（12-16 岁）及其父母和提供缺牙症护理的牙医。第一阶段包括属性开发，如下所示。（1）属性识别：对缺牙症文献进行系统回顾；对 8 名患有缺牙症的青少年和 8 名家长进行访谈；观察缺牙症临床咨询（n=5）；对缺牙症患者信息资源进行环境扫描（n=30）；以及对社交媒体帖子进行系统分析（n=176）。（2）属性选择：利益相关者咨询制定问卷项目；对患有缺牙症的青少年和家长进行评分和排名问卷调查（n=18）；进一步的利益相关者咨询。第二阶段涉及 DCE 调查的开发，第三阶段包括使用认知访谈对青少年（n=12）和家长（n=8）进行预测试，以评估其表面和内容效度。
属性长列表包括 27 个专注于服务提供和治疗结果的属性，从中选择了 7 个“重要”属性进行预测试。认知访谈表明，青少年发现 DCE 选择任务难以理解；对调查进行了修改以提高其可接受性。一个属性因与青少年的有效性较差而被排除在外。预测试表明，DCE 选择任务鼓励对治疗偏好进行思考和讨论。
在 DCE 开发的所有阶段都包括目标受访者群体，确保了最终的 DCE 调查具有有效性和可接受性。DCE 方法似乎是一种有用的工具，可用于探索与传统偏好 elicitation 一起进行联合决策。
