Patients' & healthcare professionals' values regarding true- & false-positive diagnosis when colorectal cancer screening by CT colonography: discrete choice experiment.
<h4>Purpose</h4>To establish the relative weighting given by patients and healthcare professionals to gains in diagnostic sensitivity versus loss of specificity when using CT colonography (CTC) for colorectal cancer screening.<h4>Materials and methods</h4>Following ethical ap...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0080767 |
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| author | Darren Boone Susan Mallett Shihua Zhu Guiqing Lily Yao Nichola Bell Alex Ghanouni Christian von Wagner Stuart A Taylor Douglas G Altman Richard Lilford Steve Halligan |
| author_facet | Darren Boone Susan Mallett Shihua Zhu Guiqing Lily Yao Nichola Bell Alex Ghanouni Christian von Wagner Stuart A Taylor Douglas G Altman Richard Lilford Steve Halligan |
| author_sort | Darren Boone |
| collection | DOAJ |
| description | <h4>Purpose</h4>To establish the relative weighting given by patients and healthcare professionals to gains in diagnostic sensitivity versus loss of specificity when using CT colonography (CTC) for colorectal cancer screening.<h4>Materials and methods</h4>Following ethical approval and informed consent, 75 patients and 50 healthcare professionals undertook a discrete choice experiment in which they chose between "standard" CTC and "enhanced" CTC that raised diagnostic sensitivity 10% for either cancer or polyps in exchange for varying levels of specificity. We established the relative increase in false-positive diagnoses participants traded for an increase in true-positive diagnoses.<h4>Results</h4>Data from 122 participants were analysed. There were 30 (25%) non-traders for the cancer scenario and 20 (16%) for the polyp scenario. For cancer, the 10% gain in sensitivity was traded up to a median 45% (IQR 25 to >85) drop in specificity, equating to 2250 (IQR 1250 to >4250) additional false-positives per additional true-positive cancer, at 0.2% prevalence. For polyps, the figure was 15% (IQR 7.5 to 55), equating to 6 (IQR 3 to 22) additional false-positives per additional true-positive polyp, at 25% prevalence. Tipping points were significantly higher for patients than professionals for both cancer (85 vs 25, p<0.001) and polyps (55 vs 15, p<0.001). Patients were willing to pay significantly more for increased sensitivity for cancer (p = 0.021).<h4>Conclusion</h4>When screening for colorectal cancer, patients and professionals believe gains in true-positive diagnoses are worth much more than the negative consequences of a corresponding rise in false-positives. Evaluation of screening tests should account for this. |
| format | Article |
| id | doaj-art-a923c1a7209e43fa864f6cb22d8675e2 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-a923c1a7209e43fa864f6cb22d8675e22025-08-20T03:46:24ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01812e8076710.1371/journal.pone.0080767Patients' & healthcare professionals' values regarding true- & false-positive diagnosis when colorectal cancer screening by CT colonography: discrete choice experiment.Darren BooneSusan MallettShihua ZhuGuiqing Lily YaoNichola BellAlex GhanouniChristian von WagnerStuart A TaylorDouglas G AltmanRichard LilfordSteve Halligan<h4>Purpose</h4>To establish the relative weighting given by patients and healthcare professionals to gains in diagnostic sensitivity versus loss of specificity when using CT colonography (CTC) for colorectal cancer screening.<h4>Materials and methods</h4>Following ethical approval and informed consent, 75 patients and 50 healthcare professionals undertook a discrete choice experiment in which they chose between "standard" CTC and "enhanced" CTC that raised diagnostic sensitivity 10% for either cancer or polyps in exchange for varying levels of specificity. We established the relative increase in false-positive diagnoses participants traded for an increase in true-positive diagnoses.<h4>Results</h4>Data from 122 participants were analysed. There were 30 (25%) non-traders for the cancer scenario and 20 (16%) for the polyp scenario. For cancer, the 10% gain in sensitivity was traded up to a median 45% (IQR 25 to >85) drop in specificity, equating to 2250 (IQR 1250 to >4250) additional false-positives per additional true-positive cancer, at 0.2% prevalence. For polyps, the figure was 15% (IQR 7.5 to 55), equating to 6 (IQR 3 to 22) additional false-positives per additional true-positive polyp, at 25% prevalence. Tipping points were significantly higher for patients than professionals for both cancer (85 vs 25, p<0.001) and polyps (55 vs 15, p<0.001). Patients were willing to pay significantly more for increased sensitivity for cancer (p = 0.021).<h4>Conclusion</h4>When screening for colorectal cancer, patients and professionals believe gains in true-positive diagnoses are worth much more than the negative consequences of a corresponding rise in false-positives. Evaluation of screening tests should account for this.https://doi.org/10.1371/journal.pone.0080767 |
| spellingShingle | Darren Boone Susan Mallett Shihua Zhu Guiqing Lily Yao Nichola Bell Alex Ghanouni Christian von Wagner Stuart A Taylor Douglas G Altman Richard Lilford Steve Halligan Patients' & healthcare professionals' values regarding true- & false-positive diagnosis when colorectal cancer screening by CT colonography: discrete choice experiment. PLoS ONE |
| title | Patients' & healthcare professionals' values regarding true- & false-positive diagnosis when colorectal cancer screening by CT colonography: discrete choice experiment. |
| title_full | Patients' & healthcare professionals' values regarding true- & false-positive diagnosis when colorectal cancer screening by CT colonography: discrete choice experiment. |
| title_fullStr | Patients' & healthcare professionals' values regarding true- & false-positive diagnosis when colorectal cancer screening by CT colonography: discrete choice experiment. |
| title_full_unstemmed | Patients' & healthcare professionals' values regarding true- & false-positive diagnosis when colorectal cancer screening by CT colonography: discrete choice experiment. |
| title_short | Patients' & healthcare professionals' values regarding true- & false-positive diagnosis when colorectal cancer screening by CT colonography: discrete choice experiment. |
| title_sort | patients amp healthcare professionals values regarding true amp false positive diagnosis when colorectal cancer screening by ct colonography discrete choice experiment |
| url | https://doi.org/10.1371/journal.pone.0080767 |
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