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.

Publication
Personalized Medicine
Nathaniel Hendrix
Nathaniel Hendrix
Postdoctoral Research Fellow

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