基于离散选择实验的试管婴儿治疗偏好属性及水平开发研究

Research on the Development of Preferences and Attribute Levels of the In Vitro Fertilization Treatment Based on Discrete Choice Experiment

目的:本研究以试管婴儿治疗偏好研究为例详述其属性及水平确定的全过程,为国内离散选择实验(discrete choice experiment,DCE)研究属性及水平开发工作提供借鉴。方法:系统检索试管婴儿治疗偏好相关文献,确定概念属性与访谈提纲;于2022年7月,招募20名相关患者与医生进行一对一访谈,根据访谈内容提取主要属性;邀请5名专家,通过专家咨询明确属性及水平;开展预实验检验属性及水平的合理性。结果:通过文献回顾梳理12篇相关文献,确定5个概念属性;利用定性访谈提取8个情景属性;借助专家咨询排除就诊距离、医生的态度和治疗连续性,并根据既往文献和开发原则为纳入的5个属性分配合理的水平范围;运用预实验最终确定5个属性,分别为每周期就诊次数、副作用、每周期治疗费用、医患信息告知和临床妊娠率。结论:确定属性及水平是实施DCE的重要环节,但国内研究有限,学界尚未达成共识,今后有必要制定相关手册或专家共识,逐步提高DCE研究的质量。

Objective:To report the entire process of developing attributes and levels for preference studies on in vitro fertilization(IVF)treatment,and to provide a reference for the development of preferences and attribute levels of the discrete choice experiment(DCE)research in China.Methods:Conduct a systematic review of literature related to preferences for in vitro fertilization(IVF)treatments to determine conceptual attributes and interview outlines.In July 2022,recruit 20 relevant patients and doctors for one-on-one interviews to extract key attributes from the interview content.Invite 5 experts to clarify the attributes and levels through expert consultation.Conduct a pilot study to test the reasonableness of the attributes and levels.Results:Through literature review,12 relevant literatures were reviewed and 5 conceptual attributes were identified.8 situational attributes were determined in the stage of qualitative interviews.Travel time,the attitude of doctors,and the continuity of doctors were excluded with the help of expert consultations.Based on the previous literature and development principles,a reasonable level range was assigned to the 5 included attributes.5 attributes were identified through a pilot study,including the number of visits per cycle,side effects,treatment cost per cycle,doctor-patient information communication,and clinical pregnancy rate.Conclusion:Developing attributes and levels is a crucial and indispensable step of DCE studies.However,relevant studies are limited in China and no consensus for developing attributes and levels has yet been formed in the field of DCE.Therefore,it is necessary to develop relevant manuals or expert consensus in the future to gradually improve the quality of DCE studies.