Provider preferences for resolving uncertainty and avoiding harms in precision medicine: a discrete choice experiment
Part-worth utility of the two attributes measuring the uncertainty around genomic tests in the discrete choice experiment.Abstract
Background
Substantial uncertainty exists about how providers assess the value of genomic testing.
Materials & methods
We developed and administered a discrete choice experiment to a national sample of providers. We analyzed responses using an error components mixed logit model
Results
We received responses from 356 providers. The attributes important to providers were patient health and function, life expectancy, cost, expert agreement, and biomarker prevalence. Providers significantly valued reducing uncertainty only when it eliminated the possibility of decreased life expectancy. Providers valued improving certainty about life expectancy gains from 12 ± 18 to 12 ± 6 months at US$400 (US$200–600) versus US$200 (-US$60–500) for 4 ± 4 to 4 ± 2 years
Conclusion
Providers value resolving uncertainty most when it eliminates the possibility of substantial harm.
