Role Preferences in Medical Decision Making: Implications for Health Preference Research
Author(s)
van Til J1, Pearce A2, Ozdemir S3, Hollin I4, Peay H5, Wu AW6, Ostermann J7, Deal K8, Craig BM9
1University of Twente, Technical Medical Center, Enschede, Netherlands, 2University of Sydney, Sydney, NSW, Australia, 3Duke-NUS Medical School, Singapore, Singapore, 4Temple University, Philadelphia, PA, USA, 5RTI Health Solutions, Research Triangle Park, NC, USA, 6Johns Hopkins University, Baltimore, MD, USA, 7University of South Carolina, Columbia, SC, USA, 8McMaster University, Hamilton, ON, Canada, 9University of South Florida, Tampa, FL, USA
OBJECTIVES: Health preference research (HPR) assumes an individualist concept of autonomy, in which the patient is the sole decision maker. In clinical practice, patients have different preferences for their role, for instance they want to delegate a decision to others, such as clinicians, or caregivers. The objective of this paper is to present a conceptual framework of the factors that influence role preferences and the implications of differences in role preferences for HPR.
METHODS: The framework and implications for HPR were based on literature review and multiple rounds of consensus building among experts.
RESULTS: The framework includes patients, caregivers and clinicians as stakeholders in the decision process, and disease, clinical and stakeholder characteristics as main contributors to heterogeneity in role preferences. Heterogeneity in role preferences should be addressed in the formative research prior to a health preference study by investigating how patients’ health preferences may be influenced by others, which other stakeholders are involved in the decision process, and the extent of each stakeholder involvement. In HPR, the preferred role of the patient should be elicited from the respondent or their role should be stated in the framing of tasks. The patient role can be included as an attribute in the task to examine the tradeoffs between role preferences and other attributes. Statistical analyses of health preference data should account for heterogeneity in role preferences, for instance by using preferred role as a covariate in the regression analysis, or through latent class analysis.
CONCLUSIONS: To more closely model real world decision making, HPR must account for role preferences in the design, elicitation, analysis and interpretation of preference evidence. More research is needed to understand differences in role preferences between and among patients, clinicians, and other stakeholders across the decision process and the relationship between different role preferences and the validity and reliability of HPR.
Conference/Value in Health Info
Value in Health, Volume 25, Issue 12S (December 2022)
Acceptance Code
P8
Topic
Patient-Centered Research
Topic Subcategory
Patient Engagement, Stated Preference & Patient Satisfaction
Disease
no-additional-disease-conditions-specialized-treatment-areas