Parental Preferences for Vesicoureteral Reflux Treatment: a Crowd-sourced, Best-worst Scaling Study.
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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.
Published Version (Please cite this version)10.1016/j.urology.2019.01.045
Publication InfoWiener, John; Routh, Jonathan; Dionise, Zachary R; Gonzalez, Juan Marcos; Garcia-Roig, Michael L; Kirsch, Andrew J; ... Purves, J Todd (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.
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Paul H. Sherman, M.D. Associate Professor of Surgery
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
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