Warwick Medical School, University of Warwick, Coventry, UK.
Scientific Advice, National Institute for Health and Care Excellence, London, UK.
BMJ Open. 2019 Jan 29;9(1):e023663. doi: 10.1136/bmjopen-2018-023663.
To undertake a comprehensive assessment of the strength of preferences among young people for attributes of emerging technologies for testing and treatment of asymptomatic chlamydia.
Discrete choice experiment (DCE) with sequential mixed methods design. A staged approach to selection of attributes/levels included two literature reviews, focus groups with young people aged 16-24 years (n=21), experts' review (n=13) and narrative synthesis. Cognitive testing was undertaken to pilot and adapt the initial questionnaire. Online national panel was used for final DCE survey to maximise generalisability. Analysis of questionnaire responses used multinomial logit models and included validity checks.
England.
1230 young people aged 16-24 from a national online panel (completion rate 73%).
ORs for service attributes in relation to reference levels.
The strongest attribute influencing preferences was chlamydia test accuracy (OR 3.24, 95% CI 3.13 to 3.36), followed by time to result (OR 1.81, 95% CI 1.71 to 1.91). Respondents showed a preference for remote chlamydia testing options (self-testing, self-sampling and postal testing) over attendance at a testing location. For accessing treatment following a positive test result, there was a general preference for online (OR 1.21, 95% CI 1.15 to 1.28) versus traditional general practitioner (OR 1.18, 95% CI 1.12 to 1.24) or pharmacy (OR 1.15, 95% CI 1.10 to 1.22) over clinic services. For accessing a healthcare professional and receipt of antibiotics, there was little difference in preferences between options.
Both test accuracy and very short intervals between testing and results were important factors for young people when deciding whether to undergo a routine test for asymptomatic chlamydia, with test accuracy being more important. These findings should assist technology developers, policymakers, commissioners and service providers to optimise technology adoption in service redesign, although use of an online panel may limit generalisability of findings to other populations.
全面评估年轻人对用于无症状衣原体检测和治疗的新兴技术属性的偏好程度。
离散选择实验（DCE）与序贯混合方法设计。属性/水平的选择包括两个文献综述、21 名 16-24 岁年轻人的焦点小组、13 名专家的审查和叙事综合。认知测试用于试点和调整初始问卷。在线全国小组用于最终的 DCE 调查，以最大限度地提高推广性。使用多项逻辑回归模型分析问卷回答，包括有效性检查。
英格兰。
来自全国在线小组的 1230 名 16-24 岁年轻人（完成率 73%）。
影响偏好的最强属性是衣原体检测的准确性（比值比 3.24，95%置信区间 3.13 至 3.36），其次是结果的时间（比值比 1.81，95%置信区间 1.71 至 1.91）。受访者更喜欢远程衣原体检测选项（自我检测、自我采样和邮寄检测）而不是到检测地点。对于阳性检测结果后接受治疗，人们普遍更喜欢在线（比值比 1.21，95%置信区间 1.15 至 1.28）而不是传统的全科医生（比值比 1.18，95%置信区间 1.12 至 1.24）或药店（比值比 1.15，95%置信区间 1.10 至 1.22）诊所服务。对于寻求医疗保健专业人员和接受抗生素治疗，选择之间的偏好差异不大。
在决定是否接受无症状衣原体常规检测时，准确性和检测与结果之间的极短时间间隔对年轻人都是重要因素，准确性更为重要。这些发现应该有助于技术开发者、政策制定者、委托人和服务提供商优化技术在服务重新设计中的采用，尽管在线小组的使用可能会限制发现对其他人群的推广。
