背景:了解服务用户的偏好对于有效的医疗保健决策和有效的资源分配至关重要。在高风险患者的管理中,预测性基因检测可以改变健康结果,这一点尤其重要。
目的:本综述旨在确定遗传性癌症综合征中基因检测的相对重要性和支付意愿。
方法:在Medline进行搜索,Embase,PsycINFO,HMIC,WebofScience,和EconLit使用离散选择实验(DCE)术语结合与遗传性癌症综合征相关的术语,恶性肿瘤同义词,和基因检测。
方法:经过3名评审员的独立筛选,7项研究符合纳入标准,作为一名DCE,调查与遗传性癌症综合征的预测性基因检测相关的患者或公众偏好。
方法:提取的数据包括研究和受访者特征,DCE属性和级别,数据分析和解释方法,和关键研究结果。
结果:研究涵盖结直肠,乳房,和卵巢癌综合征。结果在叙事综合中进行了总结,并使用Lancsar和Louviere框架评估了质量。
结论:这篇综述仅关注遗传性癌症综合征的DCE设计和测试,而不是其他复杂疾病。挑战也来自属性和级别的异质性。
结论:测试有效性和检出率对受访者来说一直很重要,因此政策制定者应该优先考虑。准确性,成本,和等待时间,虽然也很重要,显示了研究之间的差异,虽然成本的整体降低可能会改善摄取。患者和公众愿意为改善检测和临床医生而不是保险公司的参与付费。未来的研究应该通过考虑社会人口统计学特征的影响来寻求将发现情境化,卫生系统覆盖范围,和优惠保险单。
结论:在遗传性癌症综合征的基因检测中,检测有效性和检出率对受访者来说始终很重要。降低遗传性癌症综合征基因检测的成本可能会改善吸收。个人最愿意为提高检出率的测试付费,识别多种癌症,结果与医生分享,而不是与保险提供者分享。
BACKGROUND: Understanding service user preferences is key to effective health care decision making and efficient resource allocation. It is of particular importance in the management of high-risk patients in whom predictive genetic testing can alter health outcomes.
OBJECTIVE: This
review aims to identify the relative importance and willingness to pay for attributes of genetic testing in hereditary cancer syndromes.
METHODS: Searches were conducted in Medline, Embase, PsycINFO, HMIC, Web of Science, and EconLit using discrete choice experiment (DCE) terms combined with terms related to hereditary cancer syndromes, malignancy synonyms, and genetic testing.
METHODS: Following independent screening by 3 reviewers, 7 studies fulfilled the inclusion criteria, being a DCE investigating patient or public preferences related to predictive genetic testing for hereditary cancer syndromes.
METHODS: Extracted data included study and respondent characteristics, DCE attributes and levels, methods of data analysis and interpretation, and key study findings.
RESULTS: Studies covered colorectal, breast, and ovarian cancer syndromes. Results were summarized in a narrative synthesis and the quality assessed using the Lancsar and Louviere framework.
CONCLUSIONS: This
review focuses only on DCE design and testing for hereditary cancer syndromes rather than other complex diseases. Challenges also arose from heterogeneity in attributes and levels.
CONCLUSIONS: Test effectiveness and detection rates were consistently important to respondents and thus should be prioritized by policy makers. Accuracy, cost, and wait time, while also important, showed variation between studies, although overall reduction in cost may improve uptake. Patients and the public would be willing to pay for improved detection and clinician over insurance provider involvement. Future studies should seek to contextualize findings by considering the impact of sociodemographic characteristics, health system coverage, and insurance policies on preferences.
CONCLUSIONS: Test effectiveness and detection rates are consistently important to respondents in genetic testing for hereditary cancer syndromes.Reducing the cost of genetic testing for hereditary cancer syndromes may improve uptake.Individuals are most willing to pay for a test that improves detection rates, identifies multiple cancers, and for which results are shared with a doctor rather than with an insurance provider.