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Patient preferences for the diagnosis of coeliac disease: A discrete choice experiment.
Shiha, Mohamed G; Wickramasekera, Nyantara; Raju, Suneil A; Penny, Hugo A; Sanders, David S.
Afiliación
  • Shiha MG; Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK.
  • Wickramasekera N; Academic Unit of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK.
  • Raju SA; Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK.
  • Penny HA; Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK.
  • Sanders DS; Academic Unit of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK.
United European Gastroenterol J ; 2024 Aug 27.
Article en En | MEDLINE | ID: mdl-39192618
ABSTRACT

BACKGROUND:

There is potential for a paradigm shift from a biopsy-to a serology-based diagnosis of coeliac disease in selected adult patients. However, it remains unknown if this approach would be acceptable to patients. We aimed to explore patients' preferences regarding the no-biopsy approach for coeliac disease diagnosis.

METHODS:

We developed a discrete choice experiment survey containing 12 different scenarios with two possible alternatives (endoscopy & biopsy or serology) to estimate patient preferences. The scenarios were based on 5 attributes risk of false positive results, risk of missed diagnosis, waiting time to start treatment, risk of complications, discomfort, or pain. Patient preferences and the relative importance of the attributes were estimated using a mixed logit model.

RESULTS:

In total, 385 people (70.6% female, 98.2% white) across the four nations of the United Kingdom completed the survey. Respondents preferred a serology-based diagnosis over endoscopy and duodenal biopsies (59% vs. 41%, ß coefficient 1.54, p < 0.001). Diagnostic test accuracy (p < 0.001), shorter waiting time to start treatment (p < 0.001), and discomfort levels during the procedure (p < 0.001) were the most important attributes to respondents. The risk of complications, including perforation and bleeding, did not significantly influence respondents' choices. Respondents with previous endoscopy experience were more willing to undergo endoscopy compared with those who never had one.

CONCLUSION:

The no-biopsy approach to diagnosing coeliac disease is acceptable and preferred by patients over endoscopy and biopsy. Our findings highlight the importance of patient-centred care and shared decision-making in guiding diagnostic strategies for optimal patient outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: United European Gastroenterol J Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: United European Gastroenterol J Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido