Brinkmann Melanie, von Holt Isabell, Diedrich Leonie, Krauth Christian, Seidel Gabriele, Dreier Maren
Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany.
Patient Prefer Adherence. 2022 Aug 10;16:2051-2066. doi: 10.2147/PPA.S365429. eCollection 2022.
This qualitative study is part of the SIGMO study, which evaluates general populations' preferences for colorectal cancer (CRC) screening in Germany using a discrete choice experiment. Attribute identification and selection are essential in the construction of choice tasks and should be evidence-based ensuring that attributes are relevant to potential beneficiaries and contribute to overall utility. Therefore, this qualitative study aims to identify relevant attributes characterizing CRC screening tests from the perspective of those eligible for screening in Germany.
Individuals aged 50 to 60 were purposively selected. A questioning route was developed and piloted. Four focus groups (FG) (n=20) were conducted (November 2019) with two moderators and one observer each. FGs were audio recorded, transcribed, and analyzed using qualitative content analysis. Attributes were deductively assigned based on a priori identified attribute categories, and inductively derived.
Across FGs, 24 attributes (n=293 codes) were discussed, five of which (sedation, inability to work, transportation home, predictive values, waiting time for screening colonoscopy) were inductively derived (n=76 codes). Four attributes identified a priori were not addressed in any FG. The most frequently discussed attribute category was procedural characteristics, followed by measures of screening test validity, benefits, harms, and structural characteristics of health care. The most commonly addressed attributes were preprocedural bowel cleansing, kind of procedure, and predictive values.
Newly identified attributes characterizing CRC screening tests from an individual's perspective, and a priori identified attributes not addressed by any FG stress the added value of qualitative research and thereby the importance of applying a mix of methods in identifying and selecting attributes for the construction of choice tasks. This study meets the requirements for a transparent and detailed presentation of the qualitative methods used in this process, which has rarely been the case before.
本定性研究是SIGMO研究的一部分，该研究使用离散选择实验评估德国普通人群对结直肠癌（CRC）筛查的偏好。属性识别和选择在构建选择任务中至关重要，应基于证据，确保属性与潜在受益者相关并有助于整体效用。因此，本定性研究旨在从德国符合筛查条件者的角度识别表征CRC筛查测试的相关属性。
有意选择年龄在50至60岁的个体。制定并试点了一条询问路径。于2019年11月进行了四个焦点小组（FG）（n = 20）讨论，每个小组有两名主持人和一名观察员。焦点小组讨论进行了录音、转录，并使用定性内容分析法进行分析。属性基于预先确定的属性类别进行演绎分配，并进行归纳推导。
在各个焦点小组中，共讨论了24个属性（n = 293个编码），其中五个属性（镇静、无法工作、回家交通、预测值、结肠镜筛查等待时间）是归纳得出的（n = 76个编码）。预先确定的四个属性在任何焦点小组中均未被提及。讨论最频繁的属性类别是程序特征，其次是筛查测试有效性、益处、危害以及医疗保健结构特征的衡量指标。最常提及的属性是术前肠道清洁、程序类型和预测值。
从个体角度新识别出的表征CRC筛查测试的属性，以及任何焦点小组均未提及的预先确定的属性，凸显了定性研究的附加价值，从而强调了在识别和选择用于构建选择任务的属性时采用多种方法的重要性。本研究满足了在此过程中对所使用定性方法进行透明且详细呈现的要求，而此前这种情况很少见。
