Ranking the relative importance of health-related outcomes for periodic health examinations - a comparison of citizens and medical experts

Session: 

Oral session: Patient or healthcare consumers involvement and shared decision-making (5)

Date: 

Sunday 16 September 2018 - 16:50 to 17:00

Location: 

Carrick 2

All authors in correct order:

Sommer I1, Titscher V1, Gartlehner G1
1 Danube University Krems, Austria
Presenting author and contact person

Presenting author:

Isolde Sommer

Contact person:

Isolde Sommer
Abstract text
Background:
Guidelines and recommendations are most trusted if they meet the expectations of patients or those using them. However, there is a lack of empirical evidence about how patients or end-users are best incorporated in the guideline or recommendation development process. One consideration of the GRADE approach is to rank the relative importance of health-related outcomes. These rankings of outcomes are usually performed by expert panels; however, previous research has shown discordance in what physicians and patients consider important.

Objectives:
The aim of this study was to compare the relative importance that citizens and medical experts assign to beneficial and harmful outcomes from periodic health examinations and counselling in the Austrian primary care setting.

Methods:
We collected information on health outcomes by conducting focus groups with a sample of citizens using periodic health examinations, from the literature and from expert input. Focus group participants and the expert panel ranked the outcomes online on a nine-point Likert scale following the Delphi method. They also had the opportunity to identify additional outcomes. We used Universal Agreement R analysis to calculate and compare agreement coefficients between the groups.

Results:
Means of outcome rankings were similar across interventions and groups of citizens (n = 17) and experts (n = 7) (5.1 to 6.0). Citizens only tended to rank outcomes in relation to lifestyle behaviour, such as health awareness (5.9 versus 3.1), change to healthy diet (6.5 versus 4.3) or weight loss (5.4 versus 3.9), higher than experts. The ranking of outcomes showed 11% to 36% agreement within groups (P < 0.01). For three interventions, agreement among experts was higher than among citizens (P < 0.01).

Conclusions:
The two groups ranked the relative importance of outcomes in a similar way, which indicates that experts are able to take the patient or citizen perspective in the context of periodic health examinations.

Patient or healthcare consumer involvement:
This study involves health care consumers by assessing the relative importance they give to health-related outcomes as compared to an expert panel. This issue is particularly relevant to health care consumers as their voice is often represented by expert panels during the guideline or recommendation development process.

Relevance to patients and consumers: 

The study compares the relative importance that citizens and medical experts assign to beneficial and harmful outcomes of the periodic health examinations and counselling in the Austrian primary care setting. This issue is particularly relevant to health care consumers as their voice is often represented by expert panels during a guideline or recommendation process, and previous research has shown that phyisician do not estimate well what is important to patients.