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Review
. 2023 Sep;57(5):976-986.
doi: 10.1007/s43441-023-00525-1. Epub 2023 May 20.

Patient Preferences Regarding Surgical Treatment Methods for Symptomatic Uterine Fibroids

Olufemi Babalola  1 , David Gebben  2 , Michelle E Tarver  2 , Roopina Sangha  3 , Jason Roberts  2 , Veronica Price  2
Affiliations
Review

Patient Preferences Regarding Surgical Treatment Methods for Symptomatic Uterine Fibroids

Olufemi Babalola et al. Ther Innov Regul Sci. 2023 Sep.

Abstract

Study objective: The purpose of this study is to rank the factors that are most and least important to patients with symptomatic uterine fibroids when considering surgical treatment options.

Materials and methods: Using a best worst scaling (BWS) preference elicitation approach, participants completed an online survey to rank factors associated with fibroid surgical treatments. Survey content was based on a literature review and included the following factors: symptom relief; surgical complications; repeat treatment; recovery time; cosmetic effects; risk of spreading undiagnosed cancer; sexual outcomes; maintenance of child-bearing; continuation of menses; unpredictable menses; and location of procedure. Participants completed 11 BWS tasks. For each task, we presented participants with a subset of 5 factors from the possible 11, and participants chose the most important and least important factor. Participants' responses were analyzed using conditional logistic regression to determine the relative importance of factors. Patient priorities were further explored via age and race.

Results: 285 respondents with symptomatic uterine fibroids (69 physician-confirmed and 216 self-reported) who had not undergone prior surgical treatment completed the survey. Respondents were enrolled from two clinical sites (clinical site cohort) and an online consumer panel (panel cohort). Both cohorts identified symptom relief, cancer risk, repeat treatment and complications as the most important factors in selecting surgical treatment options and location of procedure, return to normal activities after surgery, and cosmetic effects like presence of a scar after the surgical treatment as the least important factors. Of note, younger women (≤ 40) placed greater importance on the ability to have children after the procedure.

Conclusion: Information regarding the factors most and least important to patients with symptomatic uterine fibroids might inform development and regulatory evaluation of new technologies and procedures. Study results may be useful in efforts to develop a set of outcomes to include in future fibroids clinical studies.

Keywords: Benefit-risk assessment; Best Worst Scaling; Patient preferences; Patient priorities; Product development; Uterine fibroids.

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Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Figures

Figure 1
Figure 1
A Sample Best–Worst Choice Task. Suppose you have been asked by your doctor to consider some surgical treatment options for your uterine fibroids. From the choices below, please select the factor that is most important and select the least important factor when deciding about possible surgery. Please choose only one factor for each column.
Figure 2
Figure 2
The Factor Rankings Among the Clinical Site Cohort. Bars denote the relative importance estimate for each factor. Error bars represent the 95% confidence intervals for the estimates. From the figure, on average, respondents noted symptom relief was the most important factor and avoiding a scar the least important.
Figure 3
Figure 3
The Factor Rankings Among the Panel Cohort. Bars denote the relative importance estimate for each factor. Error bars represent the 95% confidence intervals for the estimates.
See this image and copyright information in PMC

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