Purpose: Shared decision making can help men with localized prostate cancer make better informed decisions. A key component of shared decision-making is identification of patient preferences for outcomes of care. However, existing methods of patient preference assessment suffer from significant challenges to validity and feasibility. Conjoint analysis, a method of preference assessment taken from Marketing Science, has shown superior validity compared with existing methods in early testing. We report pilot patient satisfaction and decision quality data from a trial of conjoint analysis-based preference assessment in men with newly diagnosed prostate cancer
Method: We developed a conjoint analysis application which allowed real time, individual level conjoint analysis. 30 men with incident localized prostate cancer were recruited in the West LA Veterans Affairs Urology Clinic and randomized to education with a brochure about prostate cancer treatment or preference assessment using conjoint analysis in addition to the brochure. Men underwent the intervention in the clinic prior to their cancer counseling session. Men undergoing values clarification received a report detailing the strength of their preferences for treatment attributes (such as sexual dysfunction) intended for review with their doctor. After the cancer consultation, men were surveyed with instruments measuring elements of decision quality and patient satisfaction with care.
Result: Pilot data indicate a trend towards improved patient satisfaction in men who had preference assessment with conjoint analysis vs. those who did not. Mean scores on two patient satisfaction items differed significantly between cohorts, “Overall satisfaction with care” (1.3 vs 2.0, p<0.04) and “Thoroughness of main cancer practitioner” (1.1 vs 1.7, p<0.04). Pilot data showed a non-significant trend towards better scores in other items related to decision quality, such as decisional conflict, disease-specific knowledge, and measures of shared decision making.
Conclusion: Individual-level, conjoint analysis-based preference assessment is feasible in the clinic setting. Pilot data indicate that prostate cancer patients who undergo values clarification with conjoint analysis felt more satisfied with their carel and that they perceived that the cancer practitioner counseling them was more thorough than men who did not. The latter finding may be explained by the use of the preference report that was used as a discussion point post values clarification
See more of: The 34th Annual Meeting of the Society for Medical Decision Making