Background
Methods
Attribute | Attribute label | Levels |
---|---|---|
Probability of optimal laboratory values | Chance that the treatment keeps your labs within their recommended ranges | ▪ 80 out of 100 (80%) ▪ 60 out of 100 (60%) ▪ 25 out of 100 (25%) |
Probability of symptom relief | Chance that the treatment relieves your SHPT symptoms | ▪ 75 out of 100 (75%) ▪ 35 out of 100 (35%) ▪ 5 out of 100 (5%) |
Risk of hypocalcemia | Risk of low blood calcium | ▪ 0 out of 100 (0%) ▪ 2 out of 100 (2%) ▪ 10 out of 100 (10%) |
Severity of nausea and vomiting | Nausea and vomiting (medication alternatives only) | ▪ None ▪ Mild ▪ Moderate |
Mode of administration | How you receive the medicine (medication alternatives only) | ▪ Given through dialysis line during your regular dialysis treatment ▪ Pill once a week ▪ Pill once a day |
Cost | Out-of-pocket cost of treatment | ▪ $50 per month (medication alternatives only) ▪ $100 per month (medication alternatives only) ▪ $200 per month (medication alternatives only) ▪ $500 one time (surgery only) |
Survey instrument development
Attributes | |
---|---|
Having a cut from 1 to 2 in. long on your neck | |
Needing to stay in the hospital overnight after the operation | |
Being under general anesthesia during the operation | |
1 out of 300 (0.3%) risk of serious bleeding during the operation | |
1 out of 100 (1%) risk of damage to the nerves that control the vocal cords because of the operation | |
5 out of 100 (5%) risk of having a hoarse voice for up to six months after the operation | |
1 out of 100 (1%) risk of dying because of the operation | |
2 out of 100 (2%) risk of having a seizure or convulsions | |
10 out of 100 (10%) risk of having low blood calcium | |
Needing to take a pill every day |
Study population
Statistical analyses
Discrete-choice experiment analyses
Best-worst scaling analyses
Qualitative analyses
Results
Respondent characteristics
Characteristic | Statistic or category | Overall (N = 200) |
---|---|---|
Demographic characteristics
| ||
Age | Mean (SD) | 54.2 (14.0) |
Missing | 2 | |
What is your gender? | Female | 102 (51.0%) |
Male | 96 (48.0%) | |
Prefer not to answer | 2 (1.0%) | |
How would you describe your race or ethnicity? | White or Caucasian | 120 (60.0%) |
Black or African American | 52 (26.0%) | |
Other | 27 (13.5%) | |
Prefer not to answer | 6 (3.0%) | |
What is your marital status? | Married / living as married / civil partnership | 89 (44.5%) |
Not married | 109 (54.5%) | |
Prefer not to answer | 2 (1.0%) | |
What is the highest level of education you have completed? | High school or equivalent (e.g., GED) or less | 40 (20.0%) |
More than high school | 156 (78.0%) | |
Prefer not to answer | 4 (2.0%) | |
Which of the following best describes your employment status? | Employed full-time | 24 (12.0%) |
Retired | 53 (26.5%) | |
Disabled / unable to work | 96 (48.0%) | |
Other | 26 (13.0%) | |
Prefer not to answer | 1 (0.5%) | |
What was your total household income before tax and other deductions in 2014? | Less than $20,000 | 57 (28.5%) |
$20,000 to $29,999 | 41 (20.5%) | |
More than $29,999 | 75 (37.5%) | |
Don’t know / not sure | 2 (1.0%) | |
Prefer not to answer | 25 (12.5%) | |
Clinical characteristics
| ||
How long have you been receiving dialysis? | Less than 6 months | 2 (1.0%) |
6 months to less than 1 year | 26 (13.0%) | |
1 year to less than 2 years | 41 (20.5%) | |
2 years to less than 5 years | 78 (39.0%) | |
5 years to less than 10 years | 37 (18.5%) | |
10 years or more | 16 (8.0%) | |
Have you previously received a kidney transplant? | Yes | 20 (10.0%) |
No | 180 (90.0%) | |
Are you on a kidney transplant waiting list? | I am currently on a kidney transplant waiting list | 63 (31.5%) |
I am in the process of getting on a kidney transplant waiting list | 53 (26.5%) | |
I am not on a kidney transplant waiting list | 84 (42.0%) | |
Which of the following problems have you ever experienced because of your kidney disease? | Anemia (low hemoglobin) | 155 (77.5%) |
Bleeding in the stomach or intestines | 9 (4.5%) | |
Bone, joint, or muscle pain | 97 (48.5%) | |
Muscle weakness | 115 (57.5%) | |
Weakening of bones or bone fractures | 19 (9.5%) | |
Changes in blood sugar (glucose) | 50 (25.0%) | |
Fluid buildup in the lungs | 54 (27.0%) | |
Hepatitis B, hepatitis C, or liver failure | 3 (1.5%) | |
High blood pressure, heart attack, or heart failure | 112 (56.0%) | |
High potassium levels | 91 (45.5%) | |
Lack of appetite or poor nutrition | 76 (38.0%) | |
Nerve damage or nervous system problems (such as restless legs syndrome) | 68 (34.0%) | |
Seizures | 9 (4.5%) | |
Skin infection | 20 (10.0%) | |
Stroke | 5 (2.5%) | |
Swelling or edema | 97 (48.5%) | |
None of the above | 5 (2.5%) | |
Has a doctor or other health care professional ever told you that you have secondary hyperparathyroidism (SHPT)?a
| Yes | 49 (24.5%) |
No | 104 (52.0%) | |
Don’t know / not sure | 47 (23.5%) | |
If all SHPT medicines worked equally well, how would you choose to receive the medicine? | Pill once a day | 30 (15.0%) |
Pill once a week | 19 (9.5%) | |
Given through dialysis line during your regular dialysis treatment | 151 (75.5%) |
Preference weights and conditional relative importance of treatment attributes
Preference shares
Surgery or Medication | Chance That the Treatment Keeps Your Labs Within Their Recommended Ranges | Chance that the Treatment Relieves Your HPT Symptoms | Risk of Low Blood Calcium | Nausea and Vomiting | How You Receive the Medicine | Out-of-Pocket Cost of Treatment per Month | Predicted Preference Share (95% CI) | |
---|---|---|---|---|---|---|---|---|
Scenario 1: two medications, $15 out-of-pocket cost | ||||||||
Treatment profile 1 | Medication | 60 out of 100 (60%) | 35 out of 100 (35%) | 2 out of 100 (2%) | Mild | Given through dialysis line during your regular dialysis treatment | $15 | 60.8% (54.6%–67.0%) |
Treatment profile 2 | Medication | 60 out of 100 (60%) | 35 out of 100 (35%) | 2 out of 100 (2%) | Mild | Pill once a day | $15 | 39.2% (33.0%–45.4%) |
Scenario 2: two medications and surgery, $15 out-of-pocket cost of medications | ||||||||
Treatment profile 1 | Medication | 60 out of 100 (60%) | 35 out of 100 (35%) | 2 out of 100 (2%) | Mild | Given through dialysis line during your regular dialysis treatment | $15 | 60.0% (53.8%–66.2%) |
Treatment profile 2 | Medication | 60 out of 100 (60%) | 35 out of 100 (35%) | 2 out of 100 (2%) | Mild | Pill once a day | $15 | 38.7% (32.6%–44.8%) |
Treatment profile 3 | Surgery | 60 out of 100 (60%) | 35 out of 100 (35%) | 2 out of 100 (2%) | [Not applicable] | [Not applicable] | $0 (surgery is defined as a one-time cost of $500, which is reflected in the preference weight for surgery) | 1.3% (0.1%–2.5%) |