Developing a Discrete Choice Experiment Instrument for Evaluating Patients’ Preferences in Precision Oncology

Abstract

Background: In addition to clinical and technical considerations, patients’ preferences are essential for evaluating interventions such as precision medicine (PM). Objectives: This study aimed to identify and prioritize attributes of precision oncology that are important for patients to develop and validate a standard stated preference instrument. Methods: The key attributes of precision oncology and their related levels were extracted from the systematic literature review and were presented on a validated 5-point Likert scale questionnaire to experts (n = 35). In two rounds of Delphi, participants scored and prioritized the attributes through this personally administered questionnaire to identify the five most important ones to develop a discrete choice experiment (DCE) instrument. The developed DCE questionnaire was subsequently validated, providing a robust and standard instrument for evaluating patients’ preferences for precision oncology. Results: Based on the consensus criteria, the final DCE included four attributes and a total of 14 levels, which were access to treatment (easy/not easy), out-of-pocket (OOP) expenditures (four levels according to treatment costs in the country), change in life expectancy (LE, six levels from an average gain of three months to four years), and change in quality of life (QoL, improvement or no change). Conclusions: The above-mentioned attributes represent patients’ main preferences from the views of the Iranian experts. The developed DCE questionnaire can be used to assess patients’ preferences and willingness to pay (WTP) in precision oncology.