Discrete choice experiment produced estimates of acceptable risks of therapeutic options in cancer patients with febrile neutropenia

作者：Sung Lillian^*; Alibhai Shabbir M; Ethier Marie Chantal; Teuffel Oliver; Cheng Sylvia; Fisman David; Regier Dean A

来源：Journal of Clinical Epidemiology, 2012, 65(6): 627-634.

DOI：10.1016/j.jclinepi.2011.11.008

• Conjoint analysis
• Discrete choice experiment
• Febrile neutropenia
• Adult
• Children
• Outpatient management

Objective: To use a discrete choice experiment (DCE) to describe patient/proxy tolerance for the number of clinic visits, and chances of readmission, intensive care unit admission, and mortality to accept oral outpatient management of low-risk febrile neutropenia.
Study Design and Setting: Adults and children aged 12-18 years with cancer and parents of pediatric cancer patients were asked to choose between outpatient oral and inpatient intravenous management of low-risk febrile neutropenia. Using a DCE, we varied the attribute levels with the outpatient option and kept them constant for the inpatient option.
Results: Seventy-eight adults, 153 parents, and 43 children provided responses. All four attributes significantly affected choices. The mean tolerance (95% confidence interval) for the number of clinic visits per week was 3.6(2.2-4.8), 2.1 (1.1-3.2), and 43 (2.5-6.0) to accept outpatient management among adults, parents, and children, respectively. With thrice weekly clinic visits and 7.5% chance of readmission, probabilities of accepting the outpatient strategy were 50% (44-54%) for adults, 43% (39-48%) for parents, and 53% (46-59%) for children.
Conclusion: Using a DCE, we determined that a 7.5% chance of readmission and clinic visits more frequently than thrice weekly are unlikely to be acceptable.

• 出版日期2012-6