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离散选择实验与最佳-最差标度法在中国不孕症治疗中估计患者偏好的实证比较

An Empirical Comparison of Discrete Choice Experiment and Best-Worst Scaling to Estimate Patient Preferences in Infertility Treatment in China.

作者信息

Chen Jiali, Qian Xiaodan, Su Dan, Gong Jinhong, Shang Jingjing, Zhang Lingli, Li Xin

机构信息

Department of Health Policy, School of Health Policy and Management, Nanjing Medical University, Nanjing, People's Republic of China.

Department of Pharmacy, The Second People's Hospital of Changzhou, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, People's Republic of China.

出版信息

Patient Prefer Adherence. 2025 Mar 30;19:869-882. doi: 10.2147/PPA.S501723. eCollection 2025.

Abstract

BACKGROUND

Infertility has become a growing public health problem in China. It is important to accurately and easily obtain patient preferences. This study aimed to obtain and compare stated preference results from the perspective of infertility patients. By assessing the validity and acceptability of both methods, it provides lessons for empirical research and practical application.

METHODS

Discrete choice experiments (DCE) and profile case best-worst scaling (BWS-2) are methods used to identify and weigh various criteria affecting the order of priorities. We conducted a face-to-face survey of female patients with infertility aged between 20-45 years. The survey included socio-demographic information, preference questionnaires and completion of evaluation questions. Attributes included live birth rate, pregnancy rate, degree of participation in treatment decision making, maternal complications, neonatal complications and program cost. Conditional logit models were used to analyze attribute level weights and relative importance was calculated separately.

RESULTS

A total of 330 valid questionnaires were collected. The preferences of patients experiencing infertility were quantified through two stated preference research methods. The findings indicated that patients exhibited a preference for treatment options that were highly effective, exhibited minimal side effects, were patient-centered, and were cost-effective. The BWS-2 and DCE preference weights demonstrated high consistency, with only slight difference observed in the ranking of individual attributes within the order of relative importance. In the view of the patients, the DCE questions were perceived to be less challenging to comprehend and were therefore preferred to be completed.

CONCLUSION

The BWS-2 and DCE exhibit identical validity and highly consistent preference results. In the context of specific research questions, the selection of a method or the combination of methods must be suitable to the purpose of the study in order to ensure that the utility gained is maximized. Further research is required to corroborate these findings.

摘要

背景

不孕症在中国已成为一个日益严重的公共卫生问题。准确且轻松地获取患者偏好至关重要。本研究旨在从不孕症患者的角度获取并比较陈述性偏好结果。通过评估这两种方法的有效性和可接受性,为实证研究和实际应用提供经验教训。

方法

离散选择实验(DCE)和轮廓案例最佳 - 最差尺度法(BWS - 2)是用于识别和权衡影响优先级顺序的各种标准的方法。我们对20 - 45岁的女性不孕症患者进行了面对面调查。调查包括社会人口统计学信息、偏好问卷以及评估问题的填写。属性包括活产率、妊娠率、参与治疗决策的程度、孕产妇并发症、新生儿并发症和项目成本。使用条件逻辑模型分析属性水平权重,并分别计算相对重要性。

结果

共收集到330份有效问卷。通过两种陈述性偏好研究方法对不孕症患者的偏好进行了量化。结果表明,患者倾向于选择高效、副作用小、以患者为中心且具有成本效益的治疗方案。BWS - 2和DCE的偏好权重显示出高度一致性,在相对重要性顺序内个别属性的排名中仅观察到细微差异。在患者看来,DCE问题被认为理解起来挑战性较小,因此更愿意完成。

结论

BWS - 2和DCE具有相同的有效性和高度一致的偏好结果。在特定研究问题的背景下,方法的选择或方法的组合必须适合研究目的,以确保获得的效用最大化。需要进一步的研究来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6376/11969040/b8680cd76a50/PPA-19-869-g0001.jpg

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