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Discrete choice

A Tucker, K J Donnelly, C Rowan, S McDonald, A P Foster
OBJECTIVES: The aim of the current study was to evaluate the functional outcomes, revision and mortality rates for 3 implants used for unstable intertrochanteric hip fractures; the sliding hip screw (SHS), with or without a trochanteric stabilisation plate (TSP), and cephalomedullary nail (CMN). DESIGN: Multicentre National Prospective Cohort Study SETTING:: Northern Ireland PATIENT/PARTICIPANTS:: Patients were identified from a prospective database. Fractures were classified according to AO A31A2...
October 7, 2017: Journal of Orthopaedic Trauma
Katharina Schmidt, Kathrin Damm, Arndt Vogel, Heiko Golpon, Michael P Manns, Tobias Welte, J-Matthias Graf von der Schulenburg
OBJECTIVES: There is increasing interest in studies that examine patient preferences to measure health-related outcomes. Understanding patients' preferences can improve the treatment process and is particularly relevant for oncology. In this study, we aimed to identify the subgroup-specific treatment preferences of German patients with lung cancer (LC) or colorectal cancer (CRC). METHODS: Six discrete choice experiment (DCE) attributes were established on the basis of a systematic literature review and qualitative interviews...
2017: Patient Preference and Adherence
Caroline M Vass, Stuart Wright, Michael Burton, Katherine Payne
Discrete choice experiments (DCEs) are used to quantify the preferences of specified sample populations for different aspects of a good or service and are increasingly used to value interventions and services related to healthcare. Systematic reviews of healthcare DCEs have focussed on the trends over time of specific design issues and changes in the approach to analysis, with a more recent move towards consideration of a specific type of variation in preferences within the sample population, called taste heterogeneity, noting rises in the popularity of mixed logit and latent class models...
October 14, 2017: Patient
Katherine R Courtright, Scott D Halpern, Steven Joffe, Susan S Ellenberg, Jason Karlawish, Vanessa Madden, Nicole B Gabler, Stephanie Szymanski, Kuldeep N Yadav, Laura M Dember
BACKGROUND: Pragmatic clinical trials embedded in routine delivery of clinical care can lead to improvements in quality of care, but often have design features that raise ethical concerns. METHODS: We performed a discrete choice experiment and used conjoint analysis to assess how specific attributes of pragmatic dialysis trials influenced patients' and physicians' willingness to have their dialysis facility participate in a hypothetical trial of hypertension management...
October 11, 2017: Trials
Eliza L Y Wong, Juan Manuel Ramos-Goñi, Annie W L Cheung, Amy Y K Wong, Oliver Rivero-Arias
BACKGROUND: An international valuation protocol exists for obtaining societal values for each of the 3125 health states of the five-level EuroQol-five dimensions (EQ-5D-5L) questionnaire. A feedback module (FM) that can be related to theoretical models used in behavioral economics was recently included in this protocol. OBJECTIVES: Our objective was to assess the impact of using an FM to estimate an EQ-5D-5L value set in Hong Kong. METHODS: EQ-5D-5L health states were elicited using a composite time trade-off (C-TTO) and a discrete-choice (DC) experiment...
October 10, 2017: Patient
Victoria Alguera-Lara, Michelle M Dowsey, Jemimah Ride, Skye Kinder, David Castle
OBJECTIVES: We reviewed the literature on shared decision making (regarding treatments in psychiatry), with a view to informing our understanding of the decision making process and the barriers that exist in clinical practice. METHODS: Narrative review of published English-language articles. RESULTS: After culling, 18 relevant articles were included. Themes identified included models of psychiatric care, benefits for patients, and barriers...
October 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Joachim Marti, Marcus Bachhuber, Jordyn Feingold, David Meads, Michael Richards, Sean Hennessy
OBJECTIVES: Investigate the acceptability of financial incentives for initiating a medically supervised benzodiazepine discontinuation programme among people with long-term benzodiazepine use and to identify programme features that influence willingness to participate. METHODS: We conducted a discrete choice experiment in which we presented a variety of incentive-based programs to a sample of older adults with long-term benzodiazepine use identified using the outpatient electronic health record of a university-owned health system...
October 6, 2017: BMJ Open
Celine Miani, Catriona Manville, Peter Burge, Sonja Marjanovic, Joanna Chataway
This study aimed to inform Hepatitis C (HCV) treatment by (1) better understanding the nexus of factors physicians consider when making HCV treatment decisions; (2) investigating the comparative influence and importance of specific factors and the trade-offs implicated in the decisionmaking process; and (3) examining how much thrombocytopenia impacts treatment decisions and how it impacts treatment. To meet this goal, we conducted five analyses, focusing on four European countries characterised by different approaches to healthcare organisation and financing, which alongside cultural differences may have potential implications for treatment pathways for patients with HCV infection...
January 2017: Rand Health Quarterly
Annabelle Blangero, Simon P Kelly
In situations where impending sensory events demand fast action choices, we must be ready to prioritize higher-value courses of action in order to avoid missed opportunities. When such a situation first presents itself, stimulus-action contingencies and their relative value must be encoded in order to establish a value-biased state of preparation for an impending sensorimotor decision. Here we sought to identify neurophysiological signatures of such processes in the human brain (both female and male). We devised a task requiring fast action choices based on the discrimination of a simple visual cue, in which the differently-valued sensory alternatives were presented 750-800 msec beforehand as peripheral "targets" that specified the stimulus-action mapping for the upcoming decision...
October 5, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Guyonne Kalb, Daniel Kuehnle, Anthony Scott, Terence Chai Cheng, Sung-Hee Jeon
Little is known about the response of physicians to changes in compensation: Do increases in compensation increase or decrease labour supply? In this paper, we estimate wage elasticities for physicians. We apply both a structural discrete choice approach and a reduced-form approach to examine how these different approaches affect wage elasticities at the intensive margin. Using uniquely rich data collected from a large sample of general practitioners (GPs) and specialists in Australia, we estimate 3 alternative utility specifications (quadratic, translog, and box-cox utility functions) in the structural approach, as well as a reduced-form specification, separately for men and women...
October 4, 2017: Health Economics
Mo Zhou, Winter Maxwell Thayer, John F P Bridges
BACKGROUND: Latent class analysis (LCA) has been increasingly used to explore preference heterogeneity, but the literature has not been systematically explored and hence best practices are not understood. OBJECTIVE: We sought to document all applications of LCA in the stated-preference literature in health and to inform future studies by identifying current norms in published applications. METHODS: We conducted a systematic review of the MEDLINE, EMBASE, EconLit, Web of Science, and PsycINFO databases...
October 3, 2017: PharmacoEconomics
Kevin J Downes, Carter Cowden, Benjamin L Laskin, Yuan-Shung Huang, Wu Gong, Matthew Bryan, Brian T Fisher, Stuart L Goldstein, Theoklis E Zaoutis
Importance: β-Lactam antibiotics are often coadministered with intravenous (IV) vancomycin hydrochloride for children with suspected serious infections. For adults, the combination of IV vancomycin plus piperacillin sodium/tazobactam sodium is associated with a higher risk of acute kidney injury (AKI) compared with vancomycin plus 1 other β-lactam antibiotic. However, few studies have evaluated the safety of this combination for children. Objective: To assess the risk of AKI in children during concomitant therapy with vancomycin and 1 antipseudomonal β-lactam antibiotic throughout the first week of hospitalization...
October 2, 2017: JAMA Pediatrics
Anke Hagemi, Catrin Plumpton, Dyfrig A Hughes
BACKGROUND: Prescribing policy recommendations aimed at moving immunosuppressant prescribing for renal transplant patients from primary to secondary care may result in benefits of increased safety and reduced cost. However, there is little evidence of patients' preferences for receiving their immunosuppressant therapy from hospitals compared to community dispensing. The aim of this study was to elicit patient preferences for different service configurations focusing in particular on home delivery versus collection of medication from hospital...
October 2, 2017: BMC Nephrology
Arianna Zanolini, Jenala Chipungu, Michael Vinikoor, Samuel Bosomprah, Mazuba Mafwenko, Charles Holmes, Harsha Thirumurthy
Background We assessed attitudes and preferences towards HIV self-testing (HIVST) among Zambian adolescents and adults. Methods We conducted a population-based survey of individuals aged 16-49 years old in Lusaka Province, Zambia. HIVST was shown to participants through a short video on oral fluid-based self-testing. In addition to demographics, HIV risk perceptions, and HIV testing history, we assessed participants' acceptability and concerns regarding HIVST. Using a discrete choice experiment, we investigated preferences for the location of self-test pickup, availability of counseling, and cost...
October 2, 2017: AIDS Research and Human Retroviruses
Christopher G Fawsitt, Jane Bourke, Richard A Greene, Brendan McElroy, Nicolas Krucien, Rosemary Murphy, Jennifer E Lutomski
In many countries, there has been a considerable shift towards providing a more woman-centred maternity service, which affords greater consumer choice. Maternity service provision in Ireland is set to follow this trend with policymakers committed to improving maternal choice at hospital level. However, women's preferences for maternity care are unknown, as is the expected demand for new services. In this paper, we used a discrete choice experiment (DCE) to (1) investigate women's strengths of preference for different features of maternity care; (2) predict market uptake for consultant- and midwifery-led care, and a hybrid model of care called the Domiciliary In and Out of Hospital Care scheme; and (3) calculate the welfare change arising from the provision of these services...
September 23, 2017: Health Policy
Marion Danner, Vera Vennedey, Mickaël Hiligsmann, Sascha Fauser, Christian Gross, Stephanie Stock
BACKGROUND: In this study, we conducted an analytic hierarchy process (AHP) and a discrete choice experiment (DCE) to elicit the preferences of patients with age-related macular degeneration using identical attributes and levels. OBJECTIVES: To compare preference-based weights for age-related macular degeneration treatment attributes and levels generated by two elicitation methods. The properties of both methods were assessed, including ease of instrument use. METHODS: A DCE and an AHP experiment were designed on the basis of five attributes...
September 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Tanmay A Gokhale, Eli Medvescek, Craig S Henriquez
Cardiac arrhythmias have been traditionally simulated using continuous models that assume tissue homogeneity and use a relatively large spatial discretization. However, it is believed that the tissue fibrosis and collagen deposition, which occur on a micron-level, are critical factors in arrhythmogenesis in diseased tissues. Consequently, it remains unclear how well continuous models, which use averaged electrical properties, are able to accurately capture complex conduction behaviors such as re-entry in fibrotic tissues...
September 2017: Chaos
Shasha Yi, Cong Pan, Zhonghan Hu
Using an example of a mixed discrete-continuum representation of charges under the periodic boundary condition, we show that the exact pairwise form of the Ewald sum, which is well-defined even if the system is non-neutral, provides a natural starting point for deriving unambiguous Coulomb energies that must remove all spurious dependence on the choice of the Ewald screening factor.
September 28, 2017: Journal of Chemical Physics
Jeremy Koster, Richard McElreath
Behavioral ecologists frequently use observational methods, such as instantaneous scan sampling, to record the behavior of animals at discrete moments in time. We develop and apply multilevel, multinomial logistic regression models for analyzing such data. These statistical methods correspond to the multinomial character of the response variable while also accounting for the repeated observations of individuals that characterize behavioral datasets. Correlated random effects potentially reveal individual-level trade-offs across behaviors, allowing for models that reveal the extent to which individuals who regularly engage in one behavior also exhibit relatively more or less of another behavior...
2017: Behavioral Ecology and Sociobiology
Frank Stenner, Sacha I Rothschild, Daniel Betticher, Clemens Caspar, Rudolf Morant, Razvan Popescu, Daniel Rauch, Urs Huber, Reinhard Zenhäusern, Cyrill Rentsch, Richard Cathomas
BACKGROUND: The aim was to evaluate quality of life (QoL), pain, and fatigue in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with different regimens after first-line docetaxel, as well as disease progression. PATIENTS AND METHODS: Patients with mCRPC having received first-line chemotherapy with docetaxel were eligible. Second-line treatment choice was at the discretion of the local investigator. All patients had regular assessments of QoL with the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire, of fatigue with the Brief Fatigue Inventory, and of pain with the McGill Pain Questionnaire-Short Form...
August 24, 2017: Clinical Genitourinary Cancer
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