Do patients prefer mesh or anterior colporrhaphy for primary correction of anterior vaginal wall prolapse: a labelled discrete choice experiment
Objective We investigated patients’ preferences for anterior colporrhaphy or mesh surgery as surgical correction of anterior vaginal wall prolapse. Design Labelled discrete choice experiment. Setting Three Dutch teaching hospitals. Population Women with anterior vaginal wall prolapse Pelvic Organ Pr...
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| Veröffentlicht in: | BJOG : an international journal of obstetrics and gynaecology 2015-05, Vol.122 (6), p.873-880 |
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| container_title | BJOG : an international journal of obstetrics and gynaecology |
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| creator | Notten, KJB Essers, BA Weemhoff, M Rutten, AGH Donners, JJAE Gestel, I Kruitwagen, RFPM Roovers, JPWR Dirksen, CD |
| description | Objective
We investigated patients’ preferences for anterior colporrhaphy or mesh surgery as surgical correction of anterior vaginal wall prolapse.
Design
Labelled discrete choice experiment.
Setting
Three Dutch teaching hospitals.
Population
Women with anterior vaginal wall prolapse Pelvic Organ Prolapse Quantification stage 2 or more, indicated for anterior colporrhaphy (n = 100).
Methods
Discrete choice experiments are an attribute‐based survey method for measuring preferences. In this experiment, women were asked to choose between two treatment scenarios, mesh surgery or anterior colporrhaphy. These surgical treatments differed in four treatment attributes: (i) recurrence rate, (ii) exposure rate, (iii) infection rate, (iv) dyspareunia. Data were analysed using a multinomial logit model.
Main outcome measures
Women's preferences for anterior colporrhaphy or mesh surgery for the repair of vaginal wall prolapse.
Results
All treatment attributes, i.e. recurrence, exposure, infection and dyspareunia, proved to be significant in the woman's decision to choose mesh surgery (P |
| doi_str_mv | 10.1111/1471-0528.12924 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1832254975</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3657914351</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4784-fdfe04f87b690fc6efb3582666dbce6a5b3ad8fb8c9a066d57a8e72ae61fa2893</originalsourceid><addsrcrecordid>eNqFkUtv1TAQhS0EoqWwZocssekmrR-x47CD8qwqdVPW1sQZc1M5cbBzae-_4Cfj-6BIbOqNRzPfHB3NIeQ1Z2e8vHNeN7xiSpgzLlpRPyHHD52nu5pVTApzRF7kfMsY14LJ5-RIKFZzZsQx-f0x0hmWAacl0zmhx0RHzCsaE4VpwTSUwsUwx5RWMK821JfGnIYR0qYMUkK3DHGi0f_jf8GPYYJA7yCEwsYAc8Z3FGiADkPAnvZDdgkXpG4VB4cU7-eyOhYXL8kzDyHjq8N_Qr5__nRz8bW6uv7y7eL9VeXqxtSV7z2y2pum0y3zTqPvpDJCa913DjWoTkJvfGdcC6w0VQMGGwGouQdhWnlCTve6xd_PNebFjsVTcQcTxnW23EghVN026nFUN7U2rZKyoG__Q2_jOpVb7CjZSqGEKNT5nnIp5lyObg8HtZzZba52m6Ldpmh3uZaNNwfddTdi_8D_DbIAag_cDQE3j-nZD5fXe-E_TzavUw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1673932522</pqid></control><display><type>article</type><title>Do patients prefer mesh or anterior colporrhaphy for primary correction of anterior vaginal wall prolapse: a labelled discrete choice experiment</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Notten, KJB ; Essers, BA ; Weemhoff, M ; Rutten, AGH ; Donners, JJAE ; Gestel, I ; Kruitwagen, RFPM ; Roovers, JPWR ; Dirksen, CD</creator><creatorcontrib>Notten, KJB ; Essers, BA ; Weemhoff, M ; Rutten, AGH ; Donners, JJAE ; Gestel, I ; Kruitwagen, RFPM ; Roovers, JPWR ; Dirksen, CD</creatorcontrib><description>Objective
We investigated patients’ preferences for anterior colporrhaphy or mesh surgery as surgical correction of anterior vaginal wall prolapse.
Design
Labelled discrete choice experiment.
Setting
Three Dutch teaching hospitals.
Population
Women with anterior vaginal wall prolapse Pelvic Organ Prolapse Quantification stage 2 or more, indicated for anterior colporrhaphy (n = 100).
Methods
Discrete choice experiments are an attribute‐based survey method for measuring preferences. In this experiment, women were asked to choose between two treatment scenarios, mesh surgery or anterior colporrhaphy. These surgical treatments differed in four treatment attributes: (i) recurrence rate, (ii) exposure rate, (iii) infection rate, (iv) dyspareunia. Data were analysed using a multinomial logit model.
Main outcome measures
Women's preferences for anterior colporrhaphy or mesh surgery for the repair of vaginal wall prolapse.
Results
All treatment attributes, i.e. recurrence, exposure, infection and dyspareunia, proved to be significant in the woman's decision to choose mesh surgery (P < 0.001), while only two attributes out of three, recurrence and infection, were significant for anterior colporrhaphy (P < 0.001). The relative importance data showed that with regards to the four statistically significant attributes for mesh, dyspareunia was the most important attribute, and of the two significant attributes for anterior colporrhaphy, the risk of infection. Based on the attributes and levels in our discrete choice experiment, anterior colporrhaphy was preferred in 74% as a primary correction of anterior vaginal wall prolapse, followed by a preference for mesh in 26% of all choices.
Conclusion
This study showed that next to the risk of recurrence, other aspects like risk of infection, dyspareunia and exposure play a role in the woman's preference for a surgical treatment. In addition, our results indicate that anterior colporrhaphy is preferred in the majority of the choices, followed by a preference for mesh surgery in a quarter of all choice sets. However, these results represent the average preference of a sample of women and cannot be taken as the preference of each individual. In the medical decision‐making context, information from the current study should be personalised to fit patient's unique circumstances. For patients to construct their own, individual preferences, they should be well informed about the existence and magnitude of the potential benefits and risks related to either anterior colporrhaphy or mesh surgery.</description><identifier>ISSN: 1470-0328</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/1471-0528.12924</identifier><identifier>PMID: 25041082</identifier><identifier>CODEN: BIOGFQ</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Anterior colporrhaphy ; anterior vaginal wall prolapse ; Choice Behavior ; discrete choice experiment ; Female ; Gynecologic Surgical Procedures - instrumentation ; Gynecologic Surgical Procedures - methods ; Health Care Surveys ; Humans ; Logistic Models ; Medical disorders ; mesh related complications ; mesh surgery ; Patient Preference - psychology ; Patient Preference - statistics & numerical data ; Patients ; patients’ preferences ; Postoperative Complications ; Preferences ; Recurrence ; Risk ; Surgical Mesh ; Surgical techniques ; Urogenital system ; Uterine Prolapse - surgery ; Vagina - surgery</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2015-05, Vol.122 (6), p.873-880</ispartof><rights>2014 Royal College of Obstetricians and Gynaecologists</rights><rights>2014 Royal College of Obstetricians and Gynaecologists.</rights><rights>Copyright © 2015 Royal College of Obstetricians and Gynaecologists</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4784-fdfe04f87b690fc6efb3582666dbce6a5b3ad8fb8c9a066d57a8e72ae61fa2893</citedby><cites>FETCH-LOGICAL-c4784-fdfe04f87b690fc6efb3582666dbce6a5b3ad8fb8c9a066d57a8e72ae61fa2893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1471-0528.12924$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1471-0528.12924$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25041082$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Notten, KJB</creatorcontrib><creatorcontrib>Essers, BA</creatorcontrib><creatorcontrib>Weemhoff, M</creatorcontrib><creatorcontrib>Rutten, AGH</creatorcontrib><creatorcontrib>Donners, JJAE</creatorcontrib><creatorcontrib>Gestel, I</creatorcontrib><creatorcontrib>Kruitwagen, RFPM</creatorcontrib><creatorcontrib>Roovers, JPWR</creatorcontrib><creatorcontrib>Dirksen, CD</creatorcontrib><title>Do patients prefer mesh or anterior colporrhaphy for primary correction of anterior vaginal wall prolapse: a labelled discrete choice experiment</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description>Objective
We investigated patients’ preferences for anterior colporrhaphy or mesh surgery as surgical correction of anterior vaginal wall prolapse.
Design
Labelled discrete choice experiment.
Setting
Three Dutch teaching hospitals.
Population
Women with anterior vaginal wall prolapse Pelvic Organ Prolapse Quantification stage 2 or more, indicated for anterior colporrhaphy (n = 100).
Methods
Discrete choice experiments are an attribute‐based survey method for measuring preferences. In this experiment, women were asked to choose between two treatment scenarios, mesh surgery or anterior colporrhaphy. These surgical treatments differed in four treatment attributes: (i) recurrence rate, (ii) exposure rate, (iii) infection rate, (iv) dyspareunia. Data were analysed using a multinomial logit model.
Main outcome measures
Women's preferences for anterior colporrhaphy or mesh surgery for the repair of vaginal wall prolapse.
Results
All treatment attributes, i.e. recurrence, exposure, infection and dyspareunia, proved to be significant in the woman's decision to choose mesh surgery (P < 0.001), while only two attributes out of three, recurrence and infection, were significant for anterior colporrhaphy (P < 0.001). The relative importance data showed that with regards to the four statistically significant attributes for mesh, dyspareunia was the most important attribute, and of the two significant attributes for anterior colporrhaphy, the risk of infection. Based on the attributes and levels in our discrete choice experiment, anterior colporrhaphy was preferred in 74% as a primary correction of anterior vaginal wall prolapse, followed by a preference for mesh in 26% of all choices.
Conclusion
This study showed that next to the risk of recurrence, other aspects like risk of infection, dyspareunia and exposure play a role in the woman's preference for a surgical treatment. In addition, our results indicate that anterior colporrhaphy is preferred in the majority of the choices, followed by a preference for mesh surgery in a quarter of all choice sets. However, these results represent the average preference of a sample of women and cannot be taken as the preference of each individual. In the medical decision‐making context, information from the current study should be personalised to fit patient's unique circumstances. For patients to construct their own, individual preferences, they should be well informed about the existence and magnitude of the potential benefits and risks related to either anterior colporrhaphy or mesh surgery.</description><subject>Anterior colporrhaphy</subject><subject>anterior vaginal wall prolapse</subject><subject>Choice Behavior</subject><subject>discrete choice experiment</subject><subject>Female</subject><subject>Gynecologic Surgical Procedures - instrumentation</subject><subject>Gynecologic Surgical Procedures - methods</subject><subject>Health Care Surveys</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Medical disorders</subject><subject>mesh related complications</subject><subject>mesh surgery</subject><subject>Patient Preference - psychology</subject><subject>Patient Preference - statistics & numerical data</subject><subject>Patients</subject><subject>patients’ preferences</subject><subject>Postoperative Complications</subject><subject>Preferences</subject><subject>Recurrence</subject><subject>Risk</subject><subject>Surgical Mesh</subject><subject>Surgical techniques</subject><subject>Urogenital system</subject><subject>Uterine Prolapse - surgery</subject><subject>Vagina - surgery</subject><issn>1470-0328</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtv1TAQhS0EoqWwZocssekmrR-x47CD8qwqdVPW1sQZc1M5cbBzae-_4Cfj-6BIbOqNRzPfHB3NIeQ1Z2e8vHNeN7xiSpgzLlpRPyHHD52nu5pVTApzRF7kfMsY14LJ5-RIKFZzZsQx-f0x0hmWAacl0zmhx0RHzCsaE4VpwTSUwsUwx5RWMK821JfGnIYR0qYMUkK3DHGi0f_jf8GPYYJA7yCEwsYAc8Z3FGiADkPAnvZDdgkXpG4VB4cU7-eyOhYXL8kzDyHjq8N_Qr5__nRz8bW6uv7y7eL9VeXqxtSV7z2y2pum0y3zTqPvpDJCa913DjWoTkJvfGdcC6w0VQMGGwGouQdhWnlCTve6xd_PNebFjsVTcQcTxnW23EghVN026nFUN7U2rZKyoG__Q2_jOpVb7CjZSqGEKNT5nnIp5lyObg8HtZzZba52m6Ldpmh3uZaNNwfddTdi_8D_DbIAag_cDQE3j-nZD5fXe-E_TzavUw</recordid><startdate>201505</startdate><enddate>201505</enddate><creator>Notten, KJB</creator><creator>Essers, BA</creator><creator>Weemhoff, M</creator><creator>Rutten, AGH</creator><creator>Donners, JJAE</creator><creator>Gestel, I</creator><creator>Kruitwagen, RFPM</creator><creator>Roovers, JPWR</creator><creator>Dirksen, CD</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7X8</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope></search><sort><creationdate>201505</creationdate><title>Do patients prefer mesh or anterior colporrhaphy for primary correction of anterior vaginal wall prolapse: a labelled discrete choice experiment</title><author>Notten, KJB ; Essers, BA ; Weemhoff, M ; Rutten, AGH ; Donners, JJAE ; Gestel, I ; Kruitwagen, RFPM ; Roovers, JPWR ; Dirksen, CD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4784-fdfe04f87b690fc6efb3582666dbce6a5b3ad8fb8c9a066d57a8e72ae61fa2893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Anterior colporrhaphy</topic><topic>anterior vaginal wall prolapse</topic><topic>Choice Behavior</topic><topic>discrete choice experiment</topic><topic>Female</topic><topic>Gynecologic Surgical Procedures - instrumentation</topic><topic>Gynecologic Surgical Procedures - methods</topic><topic>Health Care Surveys</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Medical disorders</topic><topic>mesh related complications</topic><topic>mesh surgery</topic><topic>Patient Preference - psychology</topic><topic>Patient Preference - statistics & numerical data</topic><topic>Patients</topic><topic>patients’ preferences</topic><topic>Postoperative Complications</topic><topic>Preferences</topic><topic>Recurrence</topic><topic>Risk</topic><topic>Surgical Mesh</topic><topic>Surgical techniques</topic><topic>Urogenital system</topic><topic>Uterine Prolapse - surgery</topic><topic>Vagina - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Notten, KJB</creatorcontrib><creatorcontrib>Essers, BA</creatorcontrib><creatorcontrib>Weemhoff, M</creatorcontrib><creatorcontrib>Rutten, AGH</creatorcontrib><creatorcontrib>Donners, JJAE</creatorcontrib><creatorcontrib>Gestel, I</creatorcontrib><creatorcontrib>Kruitwagen, RFPM</creatorcontrib><creatorcontrib>Roovers, JPWR</creatorcontrib><creatorcontrib>Dirksen, CD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Notten, KJB</au><au>Essers, BA</au><au>Weemhoff, M</au><au>Rutten, AGH</au><au>Donners, JJAE</au><au>Gestel, I</au><au>Kruitwagen, RFPM</au><au>Roovers, JPWR</au><au>Dirksen, CD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Do patients prefer mesh or anterior colporrhaphy for primary correction of anterior vaginal wall prolapse: a labelled discrete choice experiment</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2015-05</date><risdate>2015</risdate><volume>122</volume><issue>6</issue><spage>873</spage><epage>880</epage><pages>873-880</pages><issn>1470-0328</issn><eissn>1471-0528</eissn><coden>BIOGFQ</coden><abstract>Objective
We investigated patients’ preferences for anterior colporrhaphy or mesh surgery as surgical correction of anterior vaginal wall prolapse.
Design
Labelled discrete choice experiment.
Setting
Three Dutch teaching hospitals.
Population
Women with anterior vaginal wall prolapse Pelvic Organ Prolapse Quantification stage 2 or more, indicated for anterior colporrhaphy (n = 100).
Methods
Discrete choice experiments are an attribute‐based survey method for measuring preferences. In this experiment, women were asked to choose between two treatment scenarios, mesh surgery or anterior colporrhaphy. These surgical treatments differed in four treatment attributes: (i) recurrence rate, (ii) exposure rate, (iii) infection rate, (iv) dyspareunia. Data were analysed using a multinomial logit model.
Main outcome measures
Women's preferences for anterior colporrhaphy or mesh surgery for the repair of vaginal wall prolapse.
Results
All treatment attributes, i.e. recurrence, exposure, infection and dyspareunia, proved to be significant in the woman's decision to choose mesh surgery (P < 0.001), while only two attributes out of three, recurrence and infection, were significant for anterior colporrhaphy (P < 0.001). The relative importance data showed that with regards to the four statistically significant attributes for mesh, dyspareunia was the most important attribute, and of the two significant attributes for anterior colporrhaphy, the risk of infection. Based on the attributes and levels in our discrete choice experiment, anterior colporrhaphy was preferred in 74% as a primary correction of anterior vaginal wall prolapse, followed by a preference for mesh in 26% of all choices.
Conclusion
This study showed that next to the risk of recurrence, other aspects like risk of infection, dyspareunia and exposure play a role in the woman's preference for a surgical treatment. In addition, our results indicate that anterior colporrhaphy is preferred in the majority of the choices, followed by a preference for mesh surgery in a quarter of all choice sets. However, these results represent the average preference of a sample of women and cannot be taken as the preference of each individual. In the medical decision‐making context, information from the current study should be personalised to fit patient's unique circumstances. For patients to construct their own, individual preferences, they should be well informed about the existence and magnitude of the potential benefits and risks related to either anterior colporrhaphy or mesh surgery.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>25041082</pmid><doi>10.1111/1471-0528.12924</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1470-0328 |
| ispartof | BJOG : an international journal of obstetrics and gynaecology, 2015-05, Vol.122 (6), p.873-880 |
| issn | 1470-0328 1471-0528 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Anterior colporrhaphy anterior vaginal wall prolapse Choice Behavior discrete choice experiment Female Gynecologic Surgical Procedures - instrumentation Gynecologic Surgical Procedures - methods Health Care Surveys Humans Logistic Models Medical disorders mesh related complications mesh surgery Patient Preference - psychology Patient Preference - statistics & numerical data Patients patients’ preferences Postoperative Complications Preferences Recurrence Risk Surgical Mesh Surgical techniques Urogenital system Uterine Prolapse - surgery Vagina - surgery |
| title | Do patients prefer mesh or anterior colporrhaphy for primary correction of anterior vaginal wall prolapse: a labelled discrete choice experiment |
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