Patient preferences for whole-body MRI or conventional staging pathways in lung and colorectal cancer: a discrete choice experiment.
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Date
2019-07ICR Author
Author
Miles, A
Taylor, SA
Evans, REC
Halligan, S
Beare, S
Bridgewater, J
Goh, V
Janes, S
Navani, N
Oliver, A
Morton, A
Rockall, A
Clarke, CS
Morris, S
STREAMLINE investigators
Type
Journal Article
Metadata
Show full item recordAbstract
Objectives To determine the importance placed by patients on attributes associated with whole-body MRI (WB-MRI) and standard cancer staging pathways and ascertain drivers of preference. Methods Patients recruited to two multi-centre diagnostic accuracy trials comparing WB-MRI with standard staging pathways in lung and colorectal cancer were invited to complete a discrete choice experiment (DCE), choosing between a series of alternate pathways in which 6 attributes (accuracy, time to diagnosis, scan duration, whole-body enclosure, radiation exposure, total scan number) were varied systematically. Data were analysed using a conditional logit regression model and marginal rates of substitution computed. The relative importance of each attribute and probabilities of choosing WB-MRI-based pathways were estimated. Results A total of 138 patients (mean age 65, 61% male, lung n = 72, colorectal n = 66) participated (May 2015 to September 2016). Lung cancer patients valued time to diagnosis most highly, followed by accuracy, radiation exposure, number of scans, and time in the scanner. Colorectal cancer patients valued accuracy most highly, followed by time to diagnosis, radiation exposure, and number of scans. Patients were willing to wait 0.29 (lung) and 0.45 (colorectal) weeks for a 1% increase in pathway accuracy. Patients preferred WB-MRI-based pathways (probability 0.64 [lung], 0.66 [colorectal]) if they were equivalent in accuracy, total scan number, and time to diagnosis compared with a standard staging pathway. Conclusions Staging pathways based on first-line WB-MRI are preferred by the majority of patients if they at least match standard pathways for diagnostic accuracy, time to diagnosis, and total scan number. Key points • WB-MRI staging pathways are preferred to standard pathways by the majority of patients provided they at least match standard staging pathways for accuracy, total scan number, and time to diagnosis. • For patients with lung cancer, time to diagnosis was the attribute valued most highly, followed by accuracy, radiation dose, number of additional scans, and time in a scanner. Preference for patients with colorectal cancer was similar. • Most (63%) patients were willing to trade attributes, such as faster diagnosis, for improvements in pathway accuracy and reduced radiation exposure.
Collections
Subject
STREAMLINE investigators
Humans
Colorectal Neoplasms
Lung Neoplasms
Positron-Emission Tomography
Tomography, X-Ray Computed
Magnetic Resonance Imaging
Neoplasm Staging
Regression Analysis
Prospective Studies
Adult
Aged
Middle Aged
Female
Male
Whole Body Imaging
Patient Preference
Surveys and Questionnaires
Positron Emission Tomography Computed Tomography
Language
eng
Date accepted
2019-03-11
License start date
2019-07
Citation
European radiology, 2019, 29 (7), pp. 3889 - 3900