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Discrete choice experiments: an insight into what patients prefer
  1. Savitri Fedson1,2
  1. 1 Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, USA
  2. 2 Section of Cardiology, Michael E DeBakey Veterans Administration Medical Center, Houston, Texas, USA
  1. Correspondence to Dr Savitri Fedson, Center for Medical Ethics and Health Policy Section of Cardiology, Department of Medicine Baylor College of Medicine, Houston Tx 77030, USA; savitri.fedson{at}bcm.edu

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Despite advances in both medicine and technology, cardiovascular disease (CVD) remains a leading cause of premature death and disability throughout the world.1 The WHO includes CVD as one of the non-communicable diseases that is linked to common risk factors that include those that are both personal (eg, smoking and obesity) and social (eg, pollution). Clearly, efforts to modify these risk factors and allow for both early identification of disease and for prevention are crucial elements in efforts to decrease CVD morbidity and mortality.2 Part of this challenge is to align screening programmes with patients’ expectations and preferences.

Screening for CVD disease presents several challenges because of its breadth and the fact that CVD risk factors are so common as to be almost universal. Stopping tobacco use is extremely challenging; likewise, most prevention strategies for CVD challenge choices for daily living - what to put in the shopping cart, what to prepare for dinner or whether to take the stairs or take the elevator.

Discrete choice experiments (DCEs), which were initially developed for use in economics research, have been modified for use in healthcare economics.3 They help provide answers to questions that indicate preferences in situations where there are no clear market forces and where the interplay of supply and demand may be not primary. DCEs are based on assumptions: people make choices based on the characteristics of their options; these choices are ranked according …

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