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The Voice of the Patient Methodology: A Novel Mixed-Methods Approach to Identifying Treatment Goals for Men with Prostate Cancer

The Patient - Patient-Centered Outcomes Research volume 10, pages 345–352 (2017)Cite this article

Abstract

Background

Many guidelines advocate the use of shared decision making for men with newly diagnosed prostate cancer. Decision aids can facilitate the process of shared decision making. Implicit in this approach is the idea that physicians understand which elements of treatment matter to patients. Little formal work exists to guide physicians or developers of decision aids in identifying these attributes. We use a mixed-methods technique adapted from marketing science, the ‘Voice of the Patient’, to describe and identify treatment elements of value for men with localized prostate cancer.

Methods

We conducted semi-structured interviews with 30 men treated for prostate cancer in the urology clinic of the West Los Angeles Veteran Affairs Medical Center. We used a qualitative analysis to generate themes in patient narratives, and a quantitative approach, agglomerative hierarchical clustering, to identify attributes of treatment that were most relevant to patients making decisions about prostate cancer.

Results

We identified five ‘traditional’ prostate cancer treatment attributes: sexual dysfunction, bowel problems, urinary problems, lifespan, and others’ opinions. We further identified two novel treatment attributes: a treatment’s ability to validate a sense of proactivity and the need for an incision (separate from risks of surgery).

Conclusions

Application of a successful marketing technique, the ‘Voice of the Customer’, in a clinical setting elicits non-obvious attributes that highlight unique patient decision-making concerns. Use of this method in the development of decision aids may result in more effective decision support.

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Author contributions

Christopher Saigal and Ely Dahan contributed to the concept, methods, and design of the study. Sylvia Lambrechts contributed to the collection and acquisition of patient data. Ely Dahan, V. Seenu Srinivasan, Christopher Saigal, and Sylvia Lambrechts contributed to the analysis and interpretation of the data. All authors were involved in the drafting and revising of the manuscript. Christopher Saigal acts as the overall guarantor of this work and intellectual content.

Ackowledgements

Professor Dahan, a key participant in this research who helped greatly in its translation from marketing to health care applications, tragically passed away during the manuscript preparation. This is one of his final publications, which represents work that made him very proud.

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Affiliations

  1. Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

    Christopher S. Saigal, Sylvia I. Lambrechts & Ely Dahan

  2. Anderson School of Management, University of California, Los Angeles, CA, USA

    Ely Dahan

  3. West Los Angeles Veteran Affairs Medical Center, Los Angeles, CA, USA

    Christopher S. Saigal

  4. Graduate School of Business, Stanford University, Stanford, CA, USA

    V. Seenu Srinivasan

Authors
  1. Christopher S. Saigal
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  2. Sylvia I. Lambrechts
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  3. V. Seenu Srinivasan
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  4. Ely Dahan
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Corresponding author

Correspondence to Christopher S. Saigal.

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Funding

Financial support was provided by a grant from the National Cancer Institute and American Recovery and Reinvestment Act (ARRA) funds. The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.

Conflict of interest

Christopher Saigal declares consulting payments and stock ownership in WiserCare, a company that makes software for shared decision making. V. Seenu Srinivasan declares consulting payments from Wisercare. Sylvia Lambrechts has no conflicts of interest to report.

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Additional information

E. Dahan passed away during the final stages of the preparation of the manuscript.

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Saigal, C.S., Lambrechts, S.I., Seenu Srinivasan, V. et al. The Voice of the Patient Methodology: A Novel Mixed-Methods Approach to Identifying Treatment Goals for Men with Prostate Cancer. Patient 10, 345–352 (2017). https://doi.org/10.1007/s40271-016-0203-y

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  • DOI: https://doi.org/10.1007/s40271-016-0203-y

Keywords

  • Prostate Cancer
  • Localize Prostate Cancer
  • Agglomerative Hierarchical Cluster
  • Treatment Attribute
  • Prostate Cancer Treatment