Development of a tool for eliciting patient priority from among competing cardiovascular disease, medication-symptoms, and fall injury outcomes.

摘要

OBJECTIVES: To develop a choice task for eliciting priorities in the face of competing cardiovascular disease (CVD) outcomes, medication-related symptoms, and fall injuries. DESIGN: Conjoint analysis. SETTING: Senior housing site. PARTICIPANTS: Convenience sample of 15 senior housing residents for the pretest, 13 residents for the pilot test. MEASUREMENTS: The final task included 11 sets of choices. In each, one option optimized the risk of one or two of the three outcomes at the expense of the other(s); the second option did the reverse. Relative importance scores for CVD, fall injury, and medication-symptom outcomes were calculated. Reliability was assessed for two administrations using intraclass correlations (ICCs). Wilcoxon rank sum tests were used to evaluate order effects. RESULTS: The ICCs between choice task administrations were 0.70 for fall injuries, 0.73 for medication symptoms, and 0.56 for CVD outcomes. The ICCs with removal of two outliers were 0.84, 0.72, and 0.84, respectively. WhetherCVD or fall injuries appeared first had no effect on scores. CONCLUSION: Preliminary evidence of comprehensibility and reliability supports using the choice task to determine whether individuals' priorities differ in the face of competing outcomes.