Parental Preferences for Vesicoureteral Reflux Treatment: a Crowd-sourced, Best-worst Scaling Study.
Abstract
OBJECTIVE:To quantitatively evaluate parental preferences for the various treatments
for vesicoureteral reflux using crowd-sourced best-worst scaling, a novel technique
in urologic preference estimation. METHODS:Preference data were collected from a community
sample of parents via two best-worst scaling survey instruments published to Amazon's
Mechanical Turk online community. Attributes and attribute levels were selected following
extensive review of the reflux literature. Respondents completed an object case best-worst
scaling exercise to prioritize general aspects of reflux treatments and multi-profile
case best-worst scaling to elicit their preferences for the specific differences in
reflux treatments. Data were analyzed using multinomial logistic regression. Results
from the object-case provided probability scaled values (PSV) that reflected the order
of importance of attributes. RESULTS:We analyzed data for 248 and 228 respondents
for object and multi-profile case BWS, respectively. When prioritizing general aspects
of reflux treatment, effectiveness (PSV=20.37), risk of future urinary tract infection
(PSV=14.85) and complication rate (PSV=14.55) were most important to parents. Societal
cost (PSV=1.41), length of hospitalization (PSV=1.09), and cosmesis (PSV=0.91) were
least important. Parents perceived no difference in preference for the cosmetic outcome
of open versus minimally invasive surgery (p=0.791). Bundling attribute preference
weights, parents in our study would choose open surgery 74.9% of the time. CONCLUSIONS:High
treatment effectiveness was the most important and preferred attribute to parents.
Alternatively, cost and cosmesis were among the least important. Our findings serve
to inform shared parent-physician decision-making for vesicoureteral reflux.
Type
Journal articlePermalink
https://hdl.handle.net/10161/18193Published Version (Please cite this version)
10.1016/j.urology.2019.01.045Publication Info
Dionise, Zachary R; Gonzalez, Juan Marcos; Garcia-Roig, Michael L; Kirsch, Andrew
J; Scales, Charles D; Wiener, John S; ... Routh, Jonathan C (2019). Parental Preferences for Vesicoureteral Reflux Treatment: a Crowd-sourced, Best-worst
Scaling Study. Urology. 10.1016/j.urology.2019.01.045. Retrieved from https://hdl.handle.net/10161/18193.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
Collections
More Info
Show full item recordScholars@Duke
Zachary Dionise
House Staff
Juan Marcos Gonzalez
Associate Professor in Population Health Sciences
Dr. Gonzalez is an Associate Professor in the Department of Population Health Sciences.
He is an expert in the design of stated-preference survey instruments and the use
of advanced statistical tools to analyze stated-preference data. His research has
focused on the transparency in benefit-risk evaluations of medical interventions,
and the elicitation of health preferences from multiple stakeholders to support shared
decision making.
Dr. Gonzalez co-led the first FDA-sponsored prefere
J Todd Purves
Associate Professor of Surgery
Jonathan Charles Routh
Paul H. Sherman, M.D. Distinguished Associate Professor of Surgery
Charles Douglas Scales Jr.
Associate Professor of Surgery
John Samuel Wiener
Professor of Surgery
As a general pediatric urologist, Dr. Wiener is involved with all aspects of pediatric
urology as a clinician and researcher. His research interests are most focused, however,
on the urologic management of neurogenic bladder and spina bifida and the molecular
biology involving development of the genitourinary tract and disorders.Dr. Wiener
is the principal investigator at Duke for The National Spina Bifida Patient Registry
and Urologic Management of Young Children with
Alphabetical list of authors with Scholars@Duke profiles.

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy
Rights for Collection: Scholarly Articles
Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info