PURPOSE: Despite evidence from clinical guideline development that physicians and patients show discordance in what they consider important in outcome selection and prioritization, it is unclear to what extent outcome preferences are concordant between experts and citizens when it comes to the context of primary prevention. Therefore, the objective of this study was to assess whether expert judgments about the importance of beneficial and harmful outcomes differ from citizen preferences when considering intervention options for a periodic health examination (PHE) program. PARTICIPANTS AND METHODS: We conducted an online survey using a modified Delphi approach. The target population for the survey consisted of citizens who had attended the PHE (n=18) and experts who made evidence-based recommendations (n=11). Citizens and experts assigned a score on a 9-point Likert scale for each outcome of 14 interventions. We analyzed the intragroup agreement based on Krippendorff's alpha and the intergroup agreement using the cube root product measure (CRPm). We further tested for significant differences between the groups using the Mann U-test. RESULTS: Agreements within the groups of citizens and experts varied across the interventions and tended to be poor (α ≤0 to 0.20) or fair (α = 0.21 to 0.40), with three exceptions showing moderate agreement (α = 0.44 to 0.55). The agreements between the citizens and experts across the interventions was fair (CRPm = 0.28) during the first Delphi rating round. The mean differences between the citizens and experts on the Likert scale ranged from 0.0 to 3.8 during the first rating round and from 0.0 to 3.3 during the second. Across interventions, the citizens rated the outcomes as more important than the experts did (p<0.01). Individual participants' ratings varied substantially. CONCLUSION: Because experts generally underestimated the outcomes' importance to citizens, the involvement of citizens in guideline panels for preventive services is important.
PURPOSE: Despite evidence from clinical guideline development that physicians and patients show discordance in what they consider important in outcome selection and prioritization, it is unclear to what extent outcome preferences are concordant between experts and citizens when it comes to the context of primary prevention. Therefore, the objective of this study was to assess whether expert judgments about the importance of beneficial and harmful outcomes differ from citizen preferences when considering intervention options for a periodic health examination (PHE) program. PARTICIPANTS AND METHODS: We conducted an online survey using a modified Delphi approach. The target population for the survey consisted of citizens who had attended the PHE (n=18) and experts who made evidence-based recommendations (n=11). Citizens and experts assigned a score on a 9-point Likert scale for each outcome of 14 interventions. We analyzed the intragroup agreement based on Krippendorff's alpha and the intergroup agreement using the cube root product measure (CRPm). We further tested for significant differences between the groups using the Mann U-test. RESULTS: Agreements within the groups of citizens and experts varied across the interventions and tended to be poor (α ≤0 to 0.20) or fair (α = 0.21 to 0.40), with three exceptions showing moderate agreement (α = 0.44 to 0.55). The agreements between the citizens and experts across the interventions was fair (CRPm = 0.28) during the first Delphi rating round. The mean differences between the citizens and experts on the Likert scale ranged from 0.0 to 3.8 during the first rating round and from 0.0 to 3.3 during the second. Across interventions, the citizens rated the outcomes as more important than the experts did (p<0.01). Individual participants' ratings varied substantially. CONCLUSION: Because experts generally underestimated the outcomes' importance to citizens, the involvement of citizens in guideline panels for preventive services is important.
Authors: Talia Gutman; Pamela Lopez-Vargas; Karine E Manera; Jonathan C Craig; Martin Howell; David Tunnicliffe; Laura J James; Rob MacGinley; Emily See; Jeffrey Wong; David Voss; John Saunders; Solomon Menahem; Shilpanjali Jesudason; Allison Tong; Paul Champion de Crespigny Journal: Nephrology (Carlton) Date: 2019-04 Impact factor: 2.506
Authors: Simone A van Dulmen; Sue Lukersmith; Josephine Muxlow; Elaine Santa Mina; Maria W G Nijhuis-van der Sanden; Philip J van der Wees Journal: Health Expect Date: 2013-10-14 Impact factor: 3.377
Authors: Sean Grant; Glen S Hazlewood; Holly L Peay; Ann Lucas; Ian Coulter; Arlene Fink; Dmitry Khodyakov Journal: Patient Date: 2018-04 Impact factor: 3.883
Authors: Pablo Alonso-Coello; Victor M Montori; M Gloria Díaz; Philip J Devereaux; Gemma Mas; Ana I Diez; Ivan Solà; Mercè Roura; Juan C Souto; Sven Oliver; Rafael Ruiz; Blanca Coll-Vinent; Ignasi Gich; Holger J Schünemann; Gordon Guyatt Journal: Health Expect Date: 2014-05-12 Impact factor: 3.377