Development of a discrete choice experiment questionnaire to elicit preferences by pregnant women and policymakers for the expansion of non-invasive prenatal screening

PLoS One. 2023 Jun 23;18(6):e0287653. doi: 10.1371/journal.pone.0287653. eCollection 2023.

Abstract

Objective: An instrument for measuring intervention preferences applicable to both patients and policymakers would make it possible to better confront the needs of the supply and demand sides of the health care system. This study aimed to develop a discrete choice experiments (DCE) questionnaire to elicit the preferences of patients and policymakers. The instrument was specifically developed to estimate preferences for new conditions to be added to a screening program for fetal chromosomal anomalies.

Methods: A DCE development study was conducted. The methods employed included a literature review, a qualitative study (based on individual semi-structured interviews, consultations, and a focus group discussion) with pregnant women and policymakers, and a pilot project with 33 pregnant women to validate the first version of the instrument and test the feasibility of its administration.

Results: An initial list of 10 attributes was built based on a literature review and the qualitative research components of the study. Five attributes were built based on the responses provided by the participants from both groups. Eight attributes were consensually retained. A pilot project performed on 33 pregnant women led to a final instrument containing seven attributes: 'conditions to be screened', 'test performance', 'moment at gestational age to obtain the test result', 'degree of test result certainty to the severity of the disability', 'test sufficiency', 'information provided from test result', and 'cost related to the test'.

Conclusion: It is possible to reach a consensus on the construction of a DCE instrument intended to be administered to pregnant women and policymakers. However, complete validation of the consensual instrument is limited because there are too few voting members of health technology assessment agencies committees to statistically ascertain the relevance of the attributes and their levels.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Choice Behavior*
  • Female
  • Humans
  • Patient Preference
  • Pilot Projects
  • Pregnancy
  • Pregnant Women*
  • Prenatal Diagnosis / methods
  • Surveys and Questionnaires

Grants and funding

Financial support for this study was provided entirely by a grant from the PEGASUS2 project funded by Génome Canada (with Génome Québec; Génome BC; Génome Alberta; the Québec Ministère de l’Enseignement supérieur, de la recherche, de la science et de la technologie; the Fonds de recherche Québec – Santé; la Fondation de l’Université Laval; and the Centre de recherche du CHU de Québec) – Grant number: LSARP2012-4523, and the Canadian Institutes for Health Research - Grant number: GPH129342. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Jason R Guertin is a FRQS Research Scholar Junior 1 (Award #266460).