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- Title
Preferences of patients and clinicians for treatment of Graves' disease: a discrete choice experiment.
- Authors
van Kinschot, Caroline M. J.; Soekhai, Vikas R.; de Bekker-Grob, Esther W.; Visser, W. Edward; Peeters, Robin P.; van Ginhoven, Tessa M.; van Noord, Charlotte
- Abstract
Objective: Treatment options for Graves' disease (GD) consist of antithyr oid drugs (ATD), radioactive iodine (RAI) and total thyroidectomy (TT). Guidelines recommend to discuss these options with patients, taking into account patients' preferences. This study aims to evaluate and compare patients' and clinicians' preferences and the trade-offs made in choosing treatment. Design and methods: A discrete choice experiment (DCE) was performed with GD patie nts with a first diagnosis or recurrence in the previous year, and with clinicians. Participa nts were offered hypothetical treatment options which differed in type of treatment, rates of remission, severe side e ffects, permanent voice changes and hypocalcemia. Preference heterogeneity was assessed by latent-class analysis. Results: In this study, 286 (82%) patients and 61 (18%) clinicians part icipated in the DCE. All treatment characteristics had a significant effect on treatment choice (P < 0.05). Remission rate was the most important determinant and explained 37 and 35% of choices in patients and clinicians, res pectively. Both patients and clinicians preferred ATD over surgery and RAI. A strong negative preference toward RAI t reatment was observed in a subclass of patients, whereas clinicians preferred RAI over surgery. Conclusion: For both patients and clinicians, remission rate was the most important determinant of treatment choice and ATD was the most preferred treatment option. Patients had a negative preference toward RAI compared to alternatives, whereas clinicians preferred RAI over surgery. Cl inicians should be aware that their personal attitude toward RAI differs from that of their patients. This study on pa tients' and clinicians' preferences can support shared decision making and thereby improve clinical treatment.
- Subjects
MEDICAL personnel; PATIENT preferences; IODINE isotopes; TREATMENT effectiveness; DECISION making; THYROID diseases
- Publication
European Journal of Endocrinology, 2021, Vol 184, Issue 6, p803
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-20-1490