Evidence map›Paper›PMID 37643846›Full record

Trial reportBMJ open2023

Patient preferences for stress urinary incontinence treatments: a discrete choice experiment.

Dwayne Boyers, Mary Kilonzo, Tracey Davidson, David Cooper, Judith Wardle, Kiron Bhal, James N'Dow, Graeme MacLennan, John Norrie, Mohamed Abdel-Fattah

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Dwayne BoyersHealth Economics Research Unit, University of Aberdeen, Aberdeen, UK d.boyers@abdn.ac.uk.ORCID 0000-0002-9786-8118
Mary KilonzoHealth Economics Research Unit, University of Aberdeen, Aberdeen, UK.
Tracey DavidsonHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
David CooperHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.
Judith WardlePatient and Public Lead, Oxford, UK.
Kiron BhalUniversity Hospital of Wales, Cardiff, UK.
James N'DowAcademic Urology Unit, University of Aberdeen, Aberdeen, UK.
Graeme MacLennanHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.ORCID 0000-0002-1039-5646
John NorrieUsher Institute, Edinburgh Clinical Trials Unit, University of Edinburgh No 9 Bioquarter, Edinburgh, UK.ORCID 0000-0001-9823-9252
Mohamed Abdel-FattahAberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, UK.

Funding

Chief Scientist Office HSRU1
6 · The paper itself

Abstract

objectivesTo elicit and value patient preferences for the processes and outcomes of surgical management of stress urinary incontinence in women.

designA discrete choice experiment survey to elicit preferences for type of anaesthesia, postoperative recovery time, treatment success, adverse events, impact on daily activities and cost. An experimental design generated 40 choice tasks, and each respondent completed 1 block of 10 and 2 validity tests. Analysis was by multinomial logistical regression.

settingN=21 UK hospitals.

participantsN=325 adult women who were a subsample of those randomised to the single-incision mini-slings clinical trial. OUTCOMES: Patient preferences; valuation obtained using willingness to pay.

resultsN=227 of 325 (70%) returned a questionnaire, and 94% of those completed all choice tasks. Respondents preferred general anaesthesia, shorter recovery times, improved stress urinary incontinence symptoms and avoidance of adverse events. Women were willing to pay (mean (95% CI)) £76 (£33 to £119) per day of reduction in recovery time following surgery. They valued increases in Patient Global Impression of Improvement, ranging from £8173 (£5459 to £10 887) for 'improved' to £11 706 (£8267 to £15 144) for 'very much improved' symptoms, compared with no symptom improvement. This was offset by negative values attached to the avoidance of complications ranging between £-8022 (£-10 661 to £-5383) and £-10 632 (£-14 077 to £-7187) compared to no complications. Women valued treatments that reduced the need to avoid daily activities, with willingness to pay ranging from £-967 (£-2199 to £266) for rarely avoiding activities to £-5338 (£-7258 to £-3417) for frequently avoiding daily activities compared with no avoidance.

conclusionThis discrete choice experiment demonstrates that patients place considerable value on improvement in stress urinary incontinence symptoms and avoidance of treatment complications. Trade-offs between symptom improvement and adverse event risk should be considered within shared decision-making. The willingness to pay values from this study can be used in future cost-benefit analyses. TRIAL REGISTRATION NUMBER: ISRCTN: 93264234; Post-results.

Indexed as

AnesthesiologyUrinary Incontinence, StressAdultAnesthesia, GeneralCost-Benefit AnalysisFemaleHumansPatient Preferencehealth economicshealth policysurgeryurinary incontinences

Identifiers

PMID37643846
PMCPMC10465896

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.