医学
置信区间
多项式logistic回归
出勤
考试(生物学)
入射(几何)
内科学
物理疗法
人口学
光学
经济
古生物学
社会学
物理
机器学习
生物
经济增长
计算机科学
作者
Yonne Peters,Evi van Grinsven,Michelle van de Haterd,Daan van Lankveld,Juul Verbakel,Peter D. Siersema
标识
DOI:10.1016/j.jval.2020.03.013
摘要
ObjectivesThe increasing incidence of esophageal adenocarcinoma (EAC) and the dismal prognosis has stimulated interest in the early detection of EAC. Our objective was to determine individuals’ preferences for EAC screening and to assess to what extent procedural characteristics of EAC screening tests predict willingness for screening participation.MethodsA discrete choice experiment questionnaire was sent by postal mail to 1000 subjects aged 50 to 75 years who were randomly selected from the municipal registry in the Netherlands. Each subject answered 12 discrete choice questions of 2 hypothetical screening tests comprising 5 attributes: EAC-related mortality risk reduction, procedure-related pain and discomfort, screening location, test specificity, and costs. A multinomial logit model was used to estimate individuals’ preferences for each attribute level and to calculate expected rates of uptake.ResultsIn total, 375 individuals (37.5%) completed the questionnaire. Test specificity, pain and discomfort, mortality reduction, and out-of-pocket costs all had a significant impact on respondents’ preferences. The average expected uptake of EAC screening was 62.8% (95% confidence interval [CI] 61.1-64.5). Severe pain and discomfort had the largest impact on screening uptake (–22.8%; 95% CI –26.8 to –18.7). Male gender (β 2.81; P < .001), cancer worries (β 1.96; P = .01), endoscopy experience (β 1.46; P = .05), and upper gastrointestinal symptoms (β 1.50; P = .05) were significantly associated with screening participation.ConclusionsEAC screening implementation should consider patient preferences to maximize screening attendance uptake. Based on our results, an optimal screening test should have high specificity, cause no or mild to moderate pain or discomfort, and result in a decrease in EAC-related mortality.
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