Patient preferences for investigating cancer-related symptoms in Australian general practice: a discrete-choice experiment.

Venning, B; Pearce, A; De Abreu Lourenco, R; Hall, R; Bergin, RJ; Lee, A; Donohoe, K; Emery, J

Patient preferences for investigating cancer-related symptoms in Australian general practice: a discrete-choice experiment.

Venning, B Pearce, A De Abreu Lourenco, R

Hall, R Bergin, RJ Lee, A Donohoe, K Emery, J

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Publisher:: ROYAL COLL GENERAL PRACTITIONERS
Publication Type:: Journal Article
Citation:: Br J Gen Pract, 2024, 74, (745), pp. e517-e526
Issue Date:: 2024-08

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Field	Value	Language
dc.contributor.author	Venning, B
dc.contributor.author	Pearce, A
dc.contributor.author	De Abreu Lourenco, R https://orcid.org/0000-0002-5978-8774
dc.contributor.author	Hall, R
dc.contributor.author	Bergin, RJ
dc.contributor.author	Lee, A
dc.contributor.author	Donohoe, K
dc.contributor.author	Emery, J
dc.date.accessioned	2024-08-21T03:33:54Z
dc.date.available	2024-02-12
dc.date.available	2024-08-21T03:33:54Z
dc.date.issued	2024-08
dc.identifier.citation	Br J Gen Pract, 2024, 74, (745), pp. e517-e526
dc.identifier.issn	0960-1643
dc.identifier.issn	1478-5242
dc.identifier.uri	http://hdl.handle.net/10453/180431
dc.description.abstract	BACKGROUND: Striking the right balance between early cancer diagnosis and the risk of excessive testing for low-risk symptoms is of paramount importance. Patient-centred care must also consider patient preferences for testing. AIM: To investigate the diagnostic testing preferences of the Australian public for symptoms associated with oesophagogastric (OG), bowel, or lung cancer. DESIGN AND SETTING: One of three discrete-choice experiments (DCEs) related to either OG, bowel, or lung cancer were administered to a nationally representative sample of Australians aged ≥40 years. METHOD: Each DCE comprised three scenarios with symptom positive predictive values (PPVs) for undiagnosed cancer ranging from 1% to 3%. The numerical risk was concealed from participants. DCE attributes encompassed the testing strategy, GP familiarity, test and result waiting times, travel duration, and test cost. Preferences were estimated using conditional and mixed logit models. RESULTS: A total of 3013 individuals participated in one of three DCEs: OG (n = 1004), bowel (n = 1006), and lung (n = 1003). Preferences were chiefly driven by waiting time and test cost, followed by the test type. There was a preference for more invasive tests. When confronted with symptoms carrying an extremely low risk (symptom PPV of ≤1%), participants were more inclined to abstain from testing. CONCLUSION: Access-related factors, particularly waiting times and testing costs, emerged as the most pivotal elements influencing preferences, underscoring the substantial impact of these systemic factors on patient choices regarding investigations.
dc.format	Electronic-Print
dc.language	eng
dc.publisher	ROYAL COLL GENERAL PRACTITIONERS
dc.relation.ispartof	Br J Gen Pract
dc.relation.isbasedon	10.3399/BJGP.2023.0583
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services
dc.subject.classification	Public Health
dc.subject.classification	4203 Health services and systems
dc.subject.mesh	Humans
dc.subject.mesh	Patient Preference
dc.subject.mesh	Australia
dc.subject.mesh	Male
dc.subject.mesh	Female
dc.subject.mesh	General Practice
dc.subject.mesh	Middle Aged
dc.subject.mesh	Early Detection of Cancer
dc.subject.mesh	Choice Behavior
dc.subject.mesh	Adult
dc.subject.mesh	Lung Neoplasms
dc.subject.mesh	Aged
dc.subject.mesh	Neoplasms
dc.subject.mesh	Esophageal Neoplasms
dc.subject.mesh	Humans
dc.subject.mesh	Neoplasms
dc.subject.mesh	Esophageal Neoplasms
dc.subject.mesh	Lung Neoplasms
dc.subject.mesh	Choice Behavior
dc.subject.mesh	Adult
dc.subject.mesh	Aged
dc.subject.mesh	Middle Aged
dc.subject.mesh	Australia
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Early Detection of Cancer
dc.subject.mesh	Patient Preference
dc.subject.mesh	General Practice
dc.title	Patient preferences for investigating cancer-related symptoms in Australian general practice: a discrete-choice experiment.
dc.type	Journal Article
utslib.citation.volume	74
utslib.location.activity	England
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	University of Technology Sydney/Faculty of Health/Centre for Health Economics Research and Evaluation
pubs.organisational-group	University of Technology Sydney/All Manual Groups
pubs.organisational-group	University of Technology Sydney/All Manual Groups/Centre for Health Economics Research and Evaluation (CHERE)
pubs.organisational-group	University of Technology Sydney/All Manual Groups/Centre for Health Technologies (CHT)
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2024-08-21T03:33:53Z
pubs.issue	745
pubs.publication-status	Published online
pubs.volume	74
utslib.citation.issue	745

Abstract:

BACKGROUND: Striking the right balance between early cancer diagnosis and the risk of excessive testing for low-risk symptoms is of paramount importance. Patient-centred care must also consider patient preferences for testing. AIM: To investigate the diagnostic testing preferences of the Australian public for symptoms associated with oesophagogastric (OG), bowel, or lung cancer. DESIGN AND SETTING: One of three discrete-choice experiments (DCEs) related to either OG, bowel, or lung cancer were administered to a nationally representative sample of Australians aged ≥40 years. METHOD: Each DCE comprised three scenarios with symptom positive predictive values (PPVs) for undiagnosed cancer ranging from 1% to 3%. The numerical risk was concealed from participants. DCE attributes encompassed the testing strategy, GP familiarity, test and result waiting times, travel duration, and test cost. Preferences were estimated using conditional and mixed logit models. RESULTS: A total of 3013 individuals participated in one of three DCEs: OG (n = 1004), bowel (n = 1006), and lung (n = 1003). Preferences were chiefly driven by waiting time and test cost, followed by the test type. There was a preference for more invasive tests. When confronted with symptoms carrying an extremely low risk (symptom PPV of ≤1%), participants were more inclined to abstain from testing. CONCLUSION: Access-related factors, particularly waiting times and testing costs, emerged as the most pivotal elements influencing preferences, underscoring the substantial impact of these systemic factors on patient choices regarding investigations.

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http://hdl.handle.net/10453/180431