A Systematic Review of Discrete-Choice Experiments and Conjoint Analysis Studies in People with Multiple Sclerosis

Edward J. D. Webb (), David Meads, Ieva Eskyte, Natalie King, Naila Dracup, Jeremy Chataway, Helen L. Ford, Joachim Marti, Sue H. Pavitt, Klaus Schmierer and Ana Manzano
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Edward J. D. Webb: University of Leeds
David Meads: University of Leeds
Ieva Eskyte: University of Leeds
Natalie King: University of Leeds
Naila Dracup: University of Leeds
Jeremy Chataway: University College London
Helen L. Ford: Leeds Teaching Hospitals NHS Trust
Joachim Marti: Université de Lausanne
Sue H. Pavitt: University of Leeds
Klaus Schmierer: Queen Mary University of London
Ana Manzano: University of Leeds

The Patient: Patient-Centered Outcomes Research, 2018, vol. 11, issue 4, No 3, 402 pages

Abstract: Abstract Background Multiple sclerosis (MS) is a chronic disabling, inflammatory, and degenerative disease of the central nervous system that, in most cases, requires long-term disease-modifying treatment (DMT). The drugs used vary in efficacy and adverse effect profiles. Several studies have used attribute-based stated-preference methods, primarily to investigate patient preferences for initiating or escalating DMT. Objectives To conduct a systematic review of attribute-based stated-preference studies in people with MS to identify common methods employed and to assess study quality, with reference to the specific challenges of this disease area. Methods We conducted a systematic search for studies related to attribute-based stated-preference and MS in multiple databases, including Cochrane and MEDLINE. Studies were included if they were published in a peer-reviewed journal, were on the topic of MS, and used a survey methodology that measured stated preferences for attributes of a whole. Analysis was conducted using narrative synthesis and summary statistics. Study quality was judged against the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) conjoint analysis checklist. Results We identified 16 relevant articles reporting 17 separate studies, all but one focusing on DMTs. Most studies were discrete-choice experiments. Study quality was generally high, but we recommend the following: (1) that consideration of sample sizes be improved, (2) that survey design choices be justified and documented, (3) that qualitative approaches for attribute and level selection be incorporated to better involve patients, and (4) that reporting of experimental practice be improved. The effects of DMTs on reproduction and the impact of how risk and uncertainty are presented were identified as neglected research topics. The ISPOR conjoint analysis checklist was found to be unsuitable for the assessment of study quality. Conclusion Attribute-based stated preference is a useful method with which to examine the preferences of people with MS in their choice of DMT. However, further research embracing the methodological recommendations identified, particularly greater use of qualitative methods in attribute development, is needed.

Date: 2018
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DOI: 10.1007/s40271-017-0296-y

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