A descriptive review on methods to prioritize outcomes in a health care context

Health Expect. 2015 Dec;18(6):1873-93. doi: 10.1111/hex.12256. Epub 2014 Aug 25.

Abstract

Background: Evidence synthesis has seen major methodological advances in reducing uncertainty and estimating the sizes of the effects. Much less is known about how to assess the relative value of different outcomes.

Objective: To identify studies that assessed preferences for outcomes in health conditions.

Search strategy: we searched MEDLINE, EMBASE, PsycINFO and the Cochrane Library in February 2014.

Inclusion criteria: eligible studies investigated preferences of patients, family members, the general population or healthcare professionals for health outcomes. The intention of this review was to include studies which focus on theoretical alternatives; studies which assessed preferences for distinct treatments were excluded.

Data extraction: study characteristics as study objective, health condition, participants, elicitation method, and outcomes assessed in the study were extracted.

Main results: One hundred and twenty-four studies were identified and categorized into four groups: (1) multi criteria decision analysis (MCDA) (n = 71), (2) rating or ranking (n = 25), (3) utility eliciting (n = 5) and (4) studies comparing different methods (n = 23). The number of outcomes assessed by method group varied. The comparison of different methods or subgroups within one study often resulted in different hierarchies of outcomes.

Conclusions: A dominant method most suitable for application in evidence syntheses was not identified. As preferences of patients differ from those of other stakeholders (especially medical professionals), the choice of the group to be questioned is consequential. Further research needs to focus on validity and applicability of the identified methods.

Keywords: evidence synthesis; health interventions; patient perspective; preference assessment; prioritising outcomes; review.

Publication types

  • Review

MeSH terms

  • Decision Support Techniques*
  • Delivery of Health Care*
  • Health Personnel
  • Humans
  • Outcome Assessment, Health Care / methods*