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The Application of Preference Elicitation Methods in Clinical Trial Design to Quantify Trade-Offs: A Scoping Review

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Abstract

Background and Objective

Patients can express preferences for different treatment options in a healthcare context, and these can be measured with quantitative preference elicitation methods.

Objective

Our objective was to conduct a scoping review to determine how preference elicitation methods have been used in the design of clinical trials.

Methods

We conducted a scoping review to identify primary research studies, involving any health condition, that used quantitative preference elicitation methods, including direct utility-based approaches, and stated preference studies, to value health trade-offs in the context of clinical trial design. Studies were identified by screening existing systematic and scoping reviews and with a primary literature search in MEDLINE from 2010 to the present. We extracted study characteristics and the application of preference elicitation methods to clinical trial design according to the SPIRIT checklist from primary studies and summarized the findings descriptively.

Results

We identified 18 eligible studies. The included studies applied patient preferences to five areas of clinical trial design: intervention selection (n = 1), designing N-of-1 trials (n = 1), outcome selection and weighting composite and ordinal outcomes (n = 12), sample size calculations (n = 2), and recruitment (n = 2). Using preference elicitation methods led to different decisions being made, such as using preference-weighted composite outcomes instead of equally weighted composite outcomes.

Conclusion

Preference elicitation methods are infrequently used to design clinical trials but may lead to changes throughout the trial that could affect the evidence generated. Future work should consider measurement challenges and explore stakeholder perceptions.

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Authors and Affiliations

  1. Department of Community Health Sciences, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada

    Megan Thomas, Deborah A. Marshall & Glen S. Hazlewood

  2. Department of Medicine, University of Calgary, Calgary, AB, Canada

    Deborah A. Marshall, Daksh Choudhary & Glen S. Hazlewood

  3. Department of Medicine, McGill University, Montreal, QC, Canada

    Susan J. Bartlett

  4. Centre for Outcomes Research & Evaluation, Research Institute McGill University Health Centre, Montreal, QC, Canada

    Susan J. Bartlett

  5. Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada

    Adalberto Loyola Sanchez

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  1. Megan Thomas
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  3. Daksh Choudhary
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  6. Glen S. Hazlewood
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Corresponding author

Correspondence to Glen S. Hazlewood.

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Funding

This work was supported by a Grant from the Canadian Institutes of Health Research (CIHR) [FRN 156267].

Conflicts of interest

Dr. Glen Hazlewood is supported by a Canadian Institutes of Health Research New Investigator Award. Dr. Deborah Marshall is supported by the Arthur J.E. Child Chair in Rheumatology Research. Megan Thomas, Dr. Daksh Choudhary, Dr. Susan J. Bartlett, and Dr. Adalberto Loyola Sanchez have no conflicts of interest that are directly relevant to the content of this article.

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MT and GS planned and conducted the study; MT and DC collected the data; MT, GS, and DM interpreted the data; and all authors drafted the manuscript and approved the final draft submitted. Megan Thomas is the guarantor of the article.

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Thomas, M., Marshall, D.A., Choudhary, D. et al. The Application of Preference Elicitation Methods in Clinical Trial Design to Quantify Trade-Offs: A Scoping Review. Patient 15, 423–434 (2022). https://doi.org/10.1007/s40271-021-00560-w

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