Evidence map›Paper›PMID 41183132›Full record

ArticlePloS one2025

What matters most to older adults in treatment decision making: A discrete choice experiment.

Vera C Hanewinkel, Hanneke van der Wal-Huisman, Suzanne Festen, Richte Cl Schuurmann, Goudje L van Leeuwen, Maria-Annette Kooijman, Marijke J Nogarede, Barbara L van Leeuwen, Daan Brandenbarg

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In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Review
  2. Review
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

9 authors.

Vera C HanewinkelDepartment of Policy, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0002-2608-050X
Hanneke van der Wal-HuismanDepartment of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Suzanne FestenUniversity Center for Geriatric Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Richte Cl SchuurmannDepartment of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Goudje L van LeeuwenDepartment of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Maria-Annette KooijmanDepartment of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0002-9197-7209
Marijke J NogaredeDepartment of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Barbara L van LeeuwenDepartment of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Daan BrandenbargDepartment of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMedical decision making is often guided bydisease-specific outcomes such as life extension or survival. Especially for older adults other outcomes like maintaining independence can be equally vital or more important. Enhanced insight into the priorities of community dwelling older adults can optimize treatment decision making and refine healthcare policy. The aim of this study was is to identify which outcomes are prioritized by adults of 50 years and older when choosing between treatment options with various outcomes in a hypothetical case of a life-threatening disease.

methodsWe conducted a Discrete Choice Experiment (DCE) with individuals aged ≥50, comparing six pairs of hypothetical treatmentoptions with five attributes: life expectancy, independence, pain, memory complaints and societal costs. Attribute utility was analyzed using a conditional logit model, and latent class analyses were employed to explore preferences in groups. Data collection took place at a four-day national fair for people aged 50 or older in Utrecht, Netherlands.

resultsIn total 333 volunteers (233 female, mean 70 yr, SD 7.7) completed the DCE. Most participants prioritized maintaining independence, followed by life expectancy and the avoidance of severe physical or cognitive impairments (p < .05). Life expectancy only had a positive impact when it was extended by two years. Avoiding high societal costs also influenced preferences. Latent class analysis identified two subgroups: one (approximately 25% of participants) prioritized life expectancy, willing to compromise on other factors, while the other emphasized independence and minimizing societal costs. Interaction tests between respondents' characteristics and preferences showed no significant differences.

conclusionsWhen confronted with a (possible) life threatening disease, most people aged ≥ 50 yr prioritize remaining independence and the absence of severe pain and severe memory complaints above life expectancy. A smaller subgroup prioritized life expectancy above other attributes. These attributes - including societal costs - should be taken in to account in individual treatment decision making, in clinical guidelines and national healthcare policy.

Indexed as

Choice BehaviorClinical Decision-MakingDecision MakingAgedAged, 80 and overFemaleHumansLife ExpectancyMaleMiddle AgedNetherlands

Identifiers

PMID41183132
PMCPMC12582481

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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.