TY - JOUR
T1 - Patient's preference for sacrospinous hysteropexy or modified Manchester operation
T2 - A discrete choice experiment
AU - Schulten, Sascha F M
AU - Essers, Brigitte
AU - Notten, Kim J B
AU - Enklaar, Rosa A
AU - van Leijsen, Sanne A L
AU - van Eijndhoven, Hugo W F
AU - Kluivers, Kirsten B
AU - Weemhoff, Mirjam
N1 - © 2022 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
PY - 2023/1
Y1 - 2023/1
N2 - OBJECTIVE: To investigate women's preference for modified Manchester (MM) or sacrospinous hysteropexy (SH) as surgery for uterine prolapse.DESIGN: Labelled discrete choice experiment (DCE).SETTING: Eight Dutch hospitals.POPULATION: Women with uterine prolapse, eligible for primary surgery and preference for uterus preservation.METHODS: DCEs are attribute-based surveys. The two treatment options were labelled as MM and SH. Attributes in this survey were treatment success ( levels SH: 84%, 89%, 94%; levels MM: 89%, 93%, 96%), dyspareunia (levels: 0%, 5%, 10%), cervical stenosis (levels: 1%, 6%, 11%) and severe buttock pain (levels: 0%, 1%). A different combination of attribute levels was used in each choice set. Women completed nine choice sets, making a choice based on attribute levels. Data were analysed in multinomial logit models.MAIN OUTCOME MEASURES: Women's preference for MM or SH.RESULTS: 137 DCEs were completed (1233 choice sets). SH was chosen in 49% of the choice sets, MM in 51%. Of all women, 39 (28%) always chose the same surgery. After exclusion of this group, 882 choice sets were analysed, in which women preferred MM, likely associated with a labelling effect, i.e. description of the procedure, rather than the tested attributes. In that group, MM was chosen in 53% of the choice sets and SH in 47%. When choosing MM, next to the label, dyspareunia was relevant for decision-making. For SH, all attributes were relevant for decision-making.CONCLUSIONS: The preference of women for MM or SH seems almost equally divided. The variety in preference supports the importance of individualised healthcare.
AB - OBJECTIVE: To investigate women's preference for modified Manchester (MM) or sacrospinous hysteropexy (SH) as surgery for uterine prolapse.DESIGN: Labelled discrete choice experiment (DCE).SETTING: Eight Dutch hospitals.POPULATION: Women with uterine prolapse, eligible for primary surgery and preference for uterus preservation.METHODS: DCEs are attribute-based surveys. The two treatment options were labelled as MM and SH. Attributes in this survey were treatment success ( levels SH: 84%, 89%, 94%; levels MM: 89%, 93%, 96%), dyspareunia (levels: 0%, 5%, 10%), cervical stenosis (levels: 1%, 6%, 11%) and severe buttock pain (levels: 0%, 1%). A different combination of attribute levels was used in each choice set. Women completed nine choice sets, making a choice based on attribute levels. Data were analysed in multinomial logit models.MAIN OUTCOME MEASURES: Women's preference for MM or SH.RESULTS: 137 DCEs were completed (1233 choice sets). SH was chosen in 49% of the choice sets, MM in 51%. Of all women, 39 (28%) always chose the same surgery. After exclusion of this group, 882 choice sets were analysed, in which women preferred MM, likely associated with a labelling effect, i.e. description of the procedure, rather than the tested attributes. In that group, MM was chosen in 53% of the choice sets and SH in 47%. When choosing MM, next to the label, dyspareunia was relevant for decision-making. For SH, all attributes were relevant for decision-making.CONCLUSIONS: The preference of women for MM or SH seems almost equally divided. The variety in preference supports the importance of individualised healthcare.
U2 - 10.1111/1471-0528.17280
DO - 10.1111/1471-0528.17280
M3 - Article
C2 - 36043332
SN - 1470-0328
VL - 130
SP - 99
EP - 106
JO - Bjog-an International Journal of Obstetrics and Gynaecology
JF - Bjog-an International Journal of Obstetrics and Gynaecology
IS - 1
ER -