UNASSIGNED: Discrete choice experiment (DCE) and profile case (case 2) best-worst scaling (BWS) present uncertainties regarding the acceptability of quantifying individual healthcare preferences, which may adversely affect the validity of responses and impede the reflection of true healthcare preferences. This study aimed to assess the acceptability of these two methods from the perspective of patients with type 2 diabetes mellitus (T2DM) and examine their association with specific characteristics of the target population.
UNASSIGNED: This cross-sectional study was based on a nationally representative survey; data were collected using a multistage stratified cluster-sampling procedure between September 2021 and January 2022. Eligible adults with confirmed T2DM voluntarily participated in this study. Participants completed both the DCE and case 2 BWS (BWS-2) choice tasks in random order and provided self-reported assessments of acceptability, including task completion difficulty, comprehension of task complexity, and response preference. Logistic regression and random forest models were used to identify variables associated with acceptability.
UNASSIGNED: In total, 3286 patients with T2DM were included in the study. Respondents indicated there was no statistically significant difference in completion difficulty between the DCE and BWS-2, although the DCE scores were slightly higher (3.07 ± 0.68 vs 3.03 ± 0.67, P = 0.06). However, 1979 (60.2%) respondents found the DCE easier to comprehend. No significant preferences were observed between the two methods (1638 (49.8%) vs 1648 (50.2%)). Sociodemographic factors, such as residence, monthly out-of-pocket costs, and illness duration were significantly associated with comprehension complexity and response preference.
UNASSIGNED: This study yielded contrasting results to most of previous studies, suggesting that DCE may be less cognitively demanding and more suitable for patients with T2DM from the perspective of self-reported acceptability of DCE and BWS. This study promotes a focus on patient acceptability in quantifying individual healthcare preferences to inform tailored optimal stated-preference method for a target population.
Stated preference methodologies such as the discrete choice experiment (DCE) and case 2 best-worst scaling (BWS-2) are gaining popularity as methods for quantifying individual preferences in healthcare. However, the acceptability of the two methods to participants must be considered in practice to reduce cognitive burden and ensure the validity of preference elicitation.DCE was perceived to be less cognitively burdensome than BWS-2. In contrast to patients who thought that DCE was more acceptable, BWS-2 was more accepted by rural patients, patients who lived with the disease for a longer period, and those who had lower monthly out-of-pocket costs.These findings demonstrate potential differences in the acceptability of DCE and BWS-2 for patients with type 2 diabetes mellitus. To improve efficiency, it would be useful for researchers to consider the optimal stated preference method for identifying target populations according to sociodemographic and disease-related characteristics.

Realizing the market value of grassland resources is of great significance to finding a balance between ecological protection and economic development. As a unique livestock animal that is native to the Qinghai-Xizang Plateau, the yak plays an important role in maintaining ecosystem stability, ensuring the livelihoods of herdsmen, promoting socio-economic development, and preserving ethnic cultural traditions. However, given its small market share, little is known about the factors that drive Chinese consumer preferences for yak meat. This study aimed to investigate consumer preferences for yak meat by means of an online survey involving a sample of 2999 respondents from five cities in China. The best-worst scaling method was employed to measure the relative importance of different attributes of yak meat by using a purchasing scenario. The results indicated that quality-safety certification, freshness, and production sustainability were regarded as the most preferred attributes, whereas animal welfare, brand, and the purchasing channel were found to be the least preferred. In addition, significant heterogeneity was detected in consumer preferences. Consumers were divided into three classes, namely \'Price Sensitive Consumers,\' \'Environmentally Friendly Consumers,\' and \'Yak Meat Inclined Consumers,\' respectively. Our findings might be helpful for policymakers and yak meat producers to develop targeted strategies to facilitate the sale of yak meat and then restore degraded grasslands.

Smartphone apps have been beneficial in controlling and preventing the COVID-19 pandemic. However, there is a gap in research surrounding the importance of smartphone app functions from a user\'s perspective. Although the insights and opinions of different stakeholders, such as policymakers and medical professionals, can influence the success of a public health policy, any strategy will face difficulty in achieving the expected effect if it is not based on a method that users can accept.
This study aimed to assess the importance of a hypothetical smartphone app\'s functions for managing health during a pandemic based on the perspective of user preferences.
A cross-sectional and web-based survey using the best-worst scaling (BWS) method was used to investigate the general population\'s preferences for important smartphone app functions. Participants were recruited from a professional surveying company\'s web-based surveying panel. The attributes of the BWS questionnaire were developed based on a robust process, including literature review, interviews, and expert discussion. A balanced incomplete block design was used to construct the choice task to ensure the effectiveness of the research design. Count analysis, conditional logit model analysis, and mixed logit analysis were used to estimate preference heterogeneity among respondents.
The responses of 2153 participants were eligible for analysis. Nearly 55% (1192/2153) were female, and the mean age was 31.4 years. Most participants (1765/2153, 81.9%) had completed tertiary or higher education, and approximately 70% (1523/2153) were urban residents. The 3 most vital functions according to their selection were \"surveillance and monitoring of infected cases,\" \"quick self-screening,\" and \"early detection of infected cases.\" The mixed logit regression model identified significant heterogeneity in preferences among respondents, and stratified analysis showed that some heterogeneities varied in respondents by demographics and COVID-19-related characteristics. Participants who preferred to use the app were more likely to assign a high weight to the preventive functions than those who did not prefer to use it. Conversely, participants who showed lower willingness to use the app tended to indicate a higher preference for supportive functions than those who preferred to use it.
This study ranks the importance of smartphone app features that provide health care services during a pandemic based on the general population\'s preferences in China. It provides empirical evidence for decision-makers to develop eHealth policies and strategies that address future public health crises from a person-centered care perspective. Continued use of apps and smart investment in digital health can help improve health outcomes and reduce the burden of disease on individuals and communities.

This study assesses inpatients\' preferences for participating in medical decision-making and determines the factors\' rankings in order of importance and whether they vary for respondents with different characteristics. Case 1 best-worst scaling (BWS) was used for the study design. Thirteen attributes influencing inpatient medical decision-making participation were identified based on a literature review and interview results. A balanced incomplete block design was used to form choice sets for the BWS questionnaire for a cross-sectional study examining inpatients\' preferences for participating in medical decision-making. Based on results from 814 inpatient participants, the three most important factors influencing inpatients\' medical decision-making participation were inpatients\' trust in physicians, physicians\' professional expertise, and physicians\' attitudes. The mixed logit model results reflect the significant heterogeneity in respondents\' preferences for shared decision-making. To facilitate resource allocation, improve the physician-patient relationship, and encourage patient decision-making participation more actively and effectively, decision-makers should emphasize patients\' trust, enhance physicians\' ability to diagnose and treat diseases, and improve their attitudes toward providing care and communication from the perspectives of patients, physicians, and the social environment. Further research is needed on the heterogeneity of patients\' preferences for participating in medical decision-making and how to improve patient participation.

This study identifies the most important and least important selection attributes in Korean domestic travel during the COVID-19 pandemic. A total of 632 responses were used as the final analysis by conducting a survey of Koreans who have experienced travel in Korea since the outbreak of COVID-19. In order to explain tourists\' domestic travel selection preferences, best-worst scaling was used. As a result of the study, it was found that the destination environment is most important and is considered relatively important in the order of accommodation, major activities, expenditure, and crowdedness. On the other hand, length of stay, transport mode, travel time, and media exposure showed relatively low importance. In a situation where overseas travel is unstable due to the risk of infectious diseases, it is urgent to identify changes in domestic travel trends/factors that are important to tourists and respond to their needs and expectations. This study is academically expanded in that it not only bridges the research gap that previous studies have missed but also considers and ranks the importance of domestic travel factors at the same time.

Objective: To estimate patient preferences for second-line antihyperglycemic medications in China. Methods: A face to face survey with the best-worst scaling (BWS) choices was administered in patients with diagnosed type 2 diabetes mellitus (T2DM). Study participants were asked to indicate which attribute they valued most and which attribute they valued least in 11 choice sets, each of which consisted of five alternatives out of 11 antihyperglycemic medication-specific attributes (treatment efficacy, weight change, hypoglycemic events, gastrointestinal side effects, cardiovascular health, urinary tract infection and genital infection side effects, edema, mode of administration, bone fracture, dosing frequency and out-of-pocket cost). A counting approach, a conditional logit model, and K-means clustering were used to estimate the relative importance of items and preference heterogeneity. Results: A total of 362 participants were included with a mean age of 63.6 (standard deviation: 11.8) years. There were 56.4% of participants were women, and 56.3% being diagnosed with diabetes for at least 5 years. Efficacy, cardiovascular health and hypoglycemic events were valued most, while dosing frequency, mode of administration and bone fracture were valued least. The K-means clustering further showed preference heterogeneity in out-of-pocket cost across the participants. Conclusion: Our study suggests that treatment efficacy, cardiovascular health and hypoglycemic events are valued most by Chinese patients with T2DM when selecting second-line antihyperglycemic medications. The study improves the understanding of patients\' preferences for second-line antihyperglycemic medications in China.

Objective: This study aimed to investigate the importance of providing Internet-based healthcare services based on the preference of a sample of medical students in China. Methods: An online best-worst scaling (BWS) survey with Case 1 design was conducted. Balanced independent block design generated 12 choice task profiles for each participant to answer. Descriptive analysis was used to describe the respondents\' characteristics; Multinomial and mixed logit regression methods were used to investigate the importance of Internet-based services based on respondents\' preferences. Results: A total of 1,296 students completed the online survey and rated \"Clinical Service,\" \"Decision Aids,\" and \"Public health\" as the three most important services that should be provided through an Internet-based healthcare system. Providing \"Medical Education\" via the Internet was chosen as the least important service by the respondents. Subgroup analysis indicated that students studying clinical medicine and non-clinical medicine considered providing \"Medical Education\" and \"Public Health,\" respectively, as more important services than others. Conclusions: This BWS study demonstrated that providing \"Clinical Service,\" \"Decision Aids,\" and \"Public Health\" through the Internet are the three most important services based on medical students\' preferences in China. Further research is needed to investigate how to improve medical students\' skills in using internet-based healthcare services in medical education programs.

BACKGROUND: The objective of this study was to ascertain the importance rankings of factors affecting the implementation of shared decision-making (SDM) in medical students in China and determine whether these factors were consistent across the respondents\' individual characteristics.
METHODS: Students studying clinical medicine were recruited from three medical universities in China. A cross-sectional online survey using best-worst object scaling with a balanced incomplete block design was adopted to investigate their preference towards implementing SDM in China. Count analysis, multinomial logit analysis and mixed logit analysis were used to estimate the preference heterogeneity of the SDM factors among respondents.
RESULTS: A total of 574 medical students completed the online survey. The three most important factors for implementing SDM were trust and respect, (providing) high-quality medical information and multi-disciplinary collaboration. The mixed logit regression model identified significant heterogeneity in SDM preferences among respondents, and sub-group analysis showed that some heterogeneities varied in respondents by sex, study programs and their experience of visiting doctors.
CONCLUSIONS: The importance rankings provide rich information for implementing SDM and facilitate the reform of education in medical schools in China. However, the heterogeneities in SDM preference need further explorations.

BACKGROUND: Primary Care Providers (PCPs), such as internists and general practitioners, have been deemed a way of delivering cost-effective care in an equitable way because PCPs are responsible for providing accessible basic medical care for the general population. This study aims to examine medical students\' preferences for PCP-based specialty choices in the context of an ageing population in China.
METHODS: We implemented a Best-Worst Scaling (BWS) experiment, a recently developed preference elicitation method based on random utility theory. Three hundred and fifty graduating medical students from three medical colleges were randomly recruited to evaluate 11 common medical specialties in China. A counting approach, a conditional logit model, and K-means clustering have been used to analyse the relative importance of items and preference heterogeneity among medical students.
RESULTS: One hundred and ninety of 350 students completed valid questionnaires. General surgery was identified as the most preferred specialty among the overall sample, yet internal medicine shares the same importance as surgery. Both geriatric medicine and psychiatric medicine were found to be the least selected specialties. Finally, the K-means clustering further suggested there was preference heterogeneity across our sample.
CONCLUSIONS: Two aims were fulfilled in this study. First, through our experimental approach the results provide a better understanding of the career desires of medical students in China. Second, the results of this study indicate that despite the fact a non-PCP-based specialty is the most popular among the sampled students; a PCP-based specialty is still an important alternative choice.