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. 2024 Oct 11;5(11):1059-1068.
doi: 10.1002/bco2.443. eCollection 2024 Nov.

Treatment preferences of patients with muscle invasive bladder cancer: A discrete choice experiment

Liam Mannion  1   2   3 , Verity Watson  4 , Vinod Mullassery  2   3 , Rajesh Nair  3 , Thomas Charlton  5 , Margaret Northover  3 , Deborah Enting  2   3 , Mieke Van Hemelrijck  2 , Muhammad Shamim Khan  3 , Ramesh Thurairaja  3 , Suzanne Amery  3 , Kathryn Chatterton  3 , Kate Smith  3 , Simon Hughes  2   3
Affiliations

Treatment preferences of patients with muscle invasive bladder cancer: A discrete choice experiment

Liam Mannion et al. BJUI Compass. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] BJUI Compass. 2024 Dec 30;5(12):1324-1329. doi: 10.1002/bco2.482. eCollection 2024 Dec. BJUI Compass. 2024. PMID: 39744071 Free PMC article.

Abstract

Background: When faced with treatment options, patients are asked to participate in decision-making. We sought to determine which treatment aspects matter most for individuals treated for muscle invasive bladder cancer (MIBC), with an aim to improve understanding of patient preferences and what trade-offs patients are willing to accept. Our study consisted of a discrete choice experiment (DCE): a type of questionnaire used to elicit preferences in the absence of real-world choice.

Methods: The DCE had five attributives, each with three levels. Participants were asked to complete a questionnaire in which they were asked to choose between two hypothetical MIBC treatments. The data were analysed using a conditional logit model, and preferences for, and trade-offs between, attributes were estimated.

Results: We recruited patients with MIBC who had either already completed, were undergoing or had yet to commence radical treatment for MIBC (n = 60). Participants indicated a strong preference for treatments that increased their life expectancy (p = <0.001), had a lower risk of long-term complications (p = <0.001) and less changes to their body image (p = <0.001). Changes to sexual wellbeing (p = 0.09) or an increase in acute side effects (p = 0.99) did not influence preferences. Patients were willing to accept treatments with higher risk of long-term complications to improve their life expectancy or body image.

Conclusion: When deciding on the type of treatment, increased life expectancy is the most important consideration for people with MIBC. The risk of long-term complications and changes to overall body image as a result of treatment are also important. Our study also highlighted that patients are willing to accept a higher risk of long-term complications to improve other treatment outcomes. Understanding patient preferences is important for shared decision-making, which has an impact on quality of care for people living with MIBC.

Keywords: cancer treatment preferences; discrete choice experiment; muscle invasive bladder cancer; patient choice.

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Conflict of interest statement

Simon Hughes is an American Society of Clinical Oncology: Education Council member and British Uro‐oncology Group: Trustee and Committee member. All other authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Example of choice set used in the final discrete choice experiment.
FIGURE 2
FIGURE 2
Preference weights for muscle invasive bladder cancer (MIBC) treatments using the conditional logit model (dummy‐coded) (n = 60).
See this image and copyright information in PMC

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