• Jorien Veldwijk, Groothuis-OudshoornCatharina G MCGMHealth Technology and Services Research, University of Twente, Enschede, the Netherlands., Ulrik Kihlbom, Sophie Langenskiöld, Evelien Dekker, Frank G J Kallenberg, G Ardine de Wit, and Mattijs S Lambooij.
• Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, the Netherlands, veldwijk@eshpm.eur.nl.
• Patient Prefer Adher. 2019 Jan 1; 13: 273-282.

PurposeThe purpose of this study was to investigate to what extent the outcomes of a discrete choice experiment (DCE) differ based on respondents' psychological distance to the decision at hand.MethodsA DCE questionnaire regarding individuals' preferences for genetic screening for colorectal cancer (CRC) within the Dutch national CRC screening program was created. The DCE contained nine D-efficient designed choice tasks and was distributed among two populations that differ in their psychological distance to the decision at hand: 1) a representative sample of the Dutch general population aged 55-65 years, and 2) a sample of Dutch individuals who attended an information appointment regarding colonoscopies following the detection of blood in their stool sample in the CRC screening program. The DCE consisted of four attributes related to the decision whether to participate in genetic screening for CRC: 1) risk of being genetically predisposed, 2) risk of developing CRC, 3) frequency of follow-up colonoscopies, and 4) survival. Direct attribute ranking, dominant decision-making behavior, and relative importance scores (based on panel MIXL) were compared between the two populations. Attribute level estimates were compared with the Swait and Louviere test.ResultsThe proportion of respondents who both ranked survival as the most important attribute, and showed dominant decision-making behavior for this attribute, was significantly higher in the screened population compared to the general population. The relative importance scores of the attributes significantly differed between populations. Finally, the Swait and Louviere test also revealed significant differences in attribute level estimates in both the populations.ConclusionThe study outcomes differed between populations depending on their psychological distance to the decision. This study shows the importance of adequate sample selection; therefore, it is advocated to increase attention to study sample selection and reporting in DCE studies.

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