This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Heckerling, P. S. Articles by Albert, N. Search for Related Content PubMed PubMed Citation Articles by Heckerling, P. S. Articles by Albert, N. Social Bookmarking                         What's this?

Patient or Physician Preferences for Decision Analysis

The Prenatal Genetic Testing Decision

Marion S. Verp, MD

Nancy Albert

The choice between amniocentesis and chononic villus sampling for prenatal genetic testing involves tradeoffs of the benefits and risks of the tests. Decision analysis is a method of explicitly weighing such tradeoffs. The authors examined the relationship between prenatal test choices made by patients and the choices prescribed by deci sion-analytic models based on their preferences, and separate models based on the preferences of their physicians. Preferences were assessed using written scenarios describing prenatal testing outcomes, and were recorded on linear rating scales. After adjustment for sociodemographic and obstetric confounders, test choice was signifi cantly associated with the choice of decision models based on patient preferences (odds ratio 4.44; CI, 2.53 to 7.78), but not with the choice of models based on the preferences of the physicians (odds ratio 1.60; CI, 0.79 to 3.26). Agreement between decision analyses based on patient preferences and on physician preferences was little better than chance (kappa = 0.085 ± 0.063). These results were robust both to changes in the decision-analytic probabilities and to changes in the model structure itself to simulate non-expected utility decision rules. The authors conclude that patient but not physician preferences, incorporated in decision models, correspond to the choice of amniocentesis or chorionic villus sampling made by the patient. Nevertheless, because patient preferences were assessed after referral for genetic testing, prospec tive preference-assessment studies will be necessary to confirm this association. Key words: decision analysis; patient preferences; physician preferences; prenatal genetic testing. (Med Decis Making 1999;19:66-77)

Medical Decision Making, Vol. 19, No. 1, 66-77 (1999)
DOI: 10.1177/0272989X9901900109


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M.A. Durand, J. Boivin, and G. Elwyn A review of decision support technologies for amniocentesis Hum. Reprod. Update, November 1, 2008; 14(6): 659 - 668. [Abstract] [Full Text] [PDF]

				M.S. van Roosmalen, P.F.M. Stalmeier, L.C.G. Verhoef, J.E.H.M. Hoekstra-Weebers, J.C. Oosterwijk, N. Hoogerbrugge, U. Moog, and W.A.J. van Daal Randomized Trial of a Shared Decision-Making Intervention Consisting of Trade-Offs and Individualized Treatment Information for BRCA1/2 Mutation Carriers J. Clin. Oncol., August 15, 2004; 22(16): 3293 - 3301. [Abstract] [Full Text] [PDF]

				L. G. Singer, J. Theodore, and M. K. Gould Validity of Standard Gamble Utilities as Measured by Transplant Readiness in Lung Transplant Candidates Med Decis Making, September 1, 2003; 23(5): 435 - 440. [Abstract] [PDF]

				J Dowie and M Wildman Choosing the surgical mortality threshold for high risk patients with stage Ia non-small cell lung cancer: insights from decision analysis Thorax, January 1, 2002; 57(1): 7 - 10. [Abstract] [Full Text] [PDF]

				I. Unic, L. C.G. Verhoef, P. F.M. Stalmeier, and W. A.J. Van Daal Prophylactic Mastectomy or Screening in Women Suspected to Have the BRCA1/2 Mutation: A Prospective Pilot Study of Women's Treatment Choices and Medical and Decision-analytic Recommendations Med Decis Making, July 1, 2000; 20(3): 251 - 262. [Abstract] [PDF]

				E. T. Matloff, H. Shappell, K. Brierley, B. A. Bernhardt, W. McKinnon, and B. N. Peshkin What Would You Do? Specialists' Perspectives on Cancer Genetic Testing, Prophylactic Surgery, and Insurance Discrimination J. Clin. Oncol., June 12, 2000; 18(12): 2484 - 2492. [Abstract] [Full Text] [PDF]