OBJECTIVES: To estimate the value key stakeholders place on different attributes describing outcomes for a child with a surgical condition in order to inform an algorithm to allow between-hospital comparisons.

METHODS: A discrete choice experiment (DCE) was conducted on samples from (i) parents of children with surgical conditions and people that had a surgical condition as a child (n=253); (ii) health care professionals (HCP) (n=114); and (iii) adults in the general public (n=753). Attributes included major/minor planned operations, major/minor emergency operations; hospital-treated infections; quality of life; and survival. All groups completed a choice task that included a palliative scenario. Responses were analysed using mixed logit models. Comparisons among groups were made using relative attribute importance (RAI) and associated 95% confidence interval scores using survival as the reference. A stakeholder consultation was conducted to select the group of preferences to use in the final algorithm.

RESULTS: Quality of life and survival drove choices in all the groups. The palliative scenario exhibited the largest utility decrement among all coefficients. Parents/people treated value quality of life and survival similarly (RAI = 0.96, 0.798 to 1.194) whereas for HCP quality of life was more important than survival (RAI = 1.47; 0.950 to 1.987). Members of the general public value more survival than quality of life (RAI = 0.82; 0.708 to 0.938). The remaining attributes were considered significantly less important than survival but HCP value more reductions in these attributes than the other groups. Stakeholders selected preferences from parents/people treated and HCP to include in the final algorithm.

CONCLUSIONS: This is the first research study to understand preferences about what constitutes successful treatment in children with a surgical condition. An algorithm has been created to facilitate comparisons of paediatric surgical outcomes between hospitals in the UK.