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Showing content from https://pubmed.ncbi.nlm.nih.gov/29611458/ below:

A Personalized Approach of Patient-Health Care Provider Communication Regarding Colorectal Cancer Screening Options

. 2018 Jul;38(5):601-613. doi: 10.1177/0272989X18763802. Epub 2018 Apr 3. A Personalized Approach of Patient-Health Care Provider Communication Regarding Colorectal Cancer Screening Options

Affiliations

¹ College of Business, Clemson University, Clemson, SC, USA.
² University of Rochester Medical Center, Rochester, NY, USA.
³ The Joseph M. Katz Graduate School of Business, University of Pittsburgh, Pittsburgh, PA, USA.

PMID: 29611458
PMCID: PMC6112617
DOI: 10.1177/0272989X18763802

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A Personalized Approach of Patient-Health Care Provider Communication Regarding Colorectal Cancer Screening Options

M Gabriela Sava et al. Med Decis Making. 2018 Jul.

. 2018 Jul;38(5):601-613. doi: 10.1177/0272989X18763802. Epub 2018 Apr 3. Affiliations

¹ College of Business, Clemson University, Clemson, SC, USA.
² University of Rochester Medical Center, Rochester, NY, USA.
³ The Joseph M. Katz Graduate School of Business, University of Pittsburgh, Pittsburgh, PA, USA.

PMID: 29611458
PMCID: PMC6112617
DOI: 10.1177/0272989X18763802

Item in Clipboard

Abstract

Background: Current colorectal cancer screening guidelines by the US Preventive Services Task Force endorse multiple options for average-risk patients and recommend that screening choices should be guided by individual patient preferences. Implementing these recommendations in practice is challenging because they depend on accurate and efficient elicitation and assessment of preferences from patients who are facing a novel task.

Objective: To present a methodology for analyzing the sensitivity and stability of a patient's preferences regarding colorectal cancer screening options and to provide a starting point for a personalized discussion between the patient and the health care provider about the selection of the appropriate screening option.

Methods: This research is a secondary analysis of patient preference data collected as part of a previous study. We propose new measures of preference sensitivity and stability that can be used to determine if additional information provided would result in a change to the initially most preferred colorectal cancer screening option.

Results: Illustrative results of applying the methodology to the preferences of 2 patients, of different ages, are provided. The results show that different combinations of screening options are viable for each patient and that the health care provider should emphasize different information during the medical decision-making process.

Conclusion: Sensitivity and stability analysis can supply health care providers with key topics to focus on when communicating with a patient and the degree of emphasis to place on each of them to accomplish specific goals. The insights provided by the analysis can be used by health care providers to approach communication with patients in a more personalized way, by taking into consideration patients' preferences before adding their own expertise to the discussion.

Keywords: analytic hierarchy process (AHP); colorectal cancer screening; patient–health care provider communication; personalized medicine; sensitivity and stability analysis for AHP models.

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Figures
Figure 1

The AHP model for ascertaining…

Figure 1

The AHP model for ascertaining patient preferences.<7> Avoid Side Effects – Screening procedure…7>

Figure 1

The AHP model for ascertaining patient preferences.<7> Avoid Side Effects – Screening procedure possible side effects Frequency – How often the screening procedure needs to be performed Minimize False Positives – Screening procedure level of a false alarm Preparation – Length of time and what steps are needed to prepare for the screening procedure Prevent Cancer – Screening procedure level of accuracy in detecting cancer Procedure – Level of complexity and invasiveness of the screening procedure

Figure 2

AHP pairwise comparisons format used…

Figure 2

AHP pairwise comparisons format used to assess the patients preferences.<6>

Figure 2

AHP pairwise comparisons format used to assess the patients preferences.<6>

Figure 3

AHP model steps for eliciting…

Figure 3

AHP model steps for eliciting and synthetizing patient's preferences.

Figure 3

AHP model steps for eliciting and synthetizing patient's preferences.

Figure 4

The steps of the new…

Figure 4

The steps of the new sensitivity and stability analysis for AHP models.

Figure 4

The steps of the new sensitivity and stability analysis for AHP models.

Figure 5

Patient A pairwise stability matrix…

Figure 5

Patient A pairwise stability matrix of preferences. A3 – dark grey color; A5…

Figure 5

Patient A pairwise stability matrix of preferences. A3 – dark grey color; A5 – dark light grey color; A10 – light grey color.

Figure 6

Patient B pairwise stability matrix…

Figure 6

Patient B pairwise stability matrix of preferences. A1 – dark light grey color;…

Figure 6

Patient B pairwise stability matrix of preferences. A1 – dark light grey color; A3 – dark grey color; A10 – light grey color.

Figure 7

Perturbation space for Patient A's…

Figure 7

Perturbation space for Patient A's pair of criteria C1–C2.

Figure 7

Perturbation space for Patient A's pair of criteria C1–C2.