Feasibility of Measuring Preferences for Chemotherapy Among Early-Stage Breast Cancer Survivors Using a Direct Rank Ordering Multicriteria Decision Analysis Versus a Time Trade-Off

Laura Panattoni, Charles E. Phelps, Tracy A. Lieu, Stacey Alexeeff, Suzanne O’Neill, Jeanne S. Mandelblatt and Scott D. Ramsey ()
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Laura Panattoni: Fred Hutchinson Cancer Research Center
Charles E. Phelps: University of Rochester
Tracy A. Lieu: Kaiser Permanente Northern California
Stacey Alexeeff: Kaiser Permanente Northern California
Suzanne O’Neill: Georgetown University Medical Center
Jeanne S. Mandelblatt: Georgetown University Medical Center
Scott D. Ramsey: Fred Hutchinson Cancer Research Center

The Patient: Patient-Centered Outcomes Research, 2020, vol. 13, issue 5, No 4, 557-566

Abstract: Abstract Objectives Chemotherapy is increasingly a preference-based choice among women diagnosed with early-stage breast cancer. Multicriteria decision analysis (MCDA) is a promising but underutilized method to facilitate shared decision making. We explored the feasibility of conducting an MCDA using direct rank ordering versus a time trade-off (TTO) to assess chemotherapy choice in a large population-based sample. Methods We surveyed 904 early-stage breast cancer survivors who were within 5 years of diagnosis and reported to the Western Washington State Cancer System and Kaiser Permanente Northern California registries. Direct rank ordering of 11 criteria and TTO surveys were conducted from September 2015 to July 2016; clinical data were obtained from registries or medical records. Multivariable regressions estimated post hoc associations between the MCDA, TTO, and self-reported chemotherapy receipt, considering covariates. Results Survivors ranged in age from 25 to 74 years and 73.9% had stage I tumors. The response rate for the rank ordering was 81.0%; TTO score was 94.2%. A one-standard deviation increase in the difference between the chemotherapy and no chemotherapy MCDA scores was associated with a 75.1% (95% confidence interval 43.9–109.7%; p

Date: 2020
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DOI: 10.1007/s40271-020-00423-w

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