loading page

Treatment preferences for medication or surgery in patients with deep endometriosis and bowel involvement -- A Discrete Choice Experiment
  • +6
  • Jeroen Metzemaekers,
  • M. Elske Akker-van Marle ,
  • Jonathan Sampat ,
  • Mathilde J.G.H. Smeets,
  • James English,
  • Elke Thijs,
  • Jacques W.M. Maas,
  • Frank Willem Jansen,
  • Brigitte Essers
Jeroen Metzemaekers
LUMC
Author Profile
M. Elske Akker-van Marle
LUMC
Author Profile
Jonathan Sampat
Maastricht UMC+
Author Profile
Mathilde J.G.H. Smeets
Medisch Centrum Haaglanden
Author Profile
James English
Medisch Centrum Haaglanden
Author Profile
Elke Thijs
Maastricht UMC+
Author Profile
Jacques W.M. Maas
Maastricht UMC+
Author Profile
Frank Willem Jansen
LUMC
Author Profile
Brigitte Essers
Maastricht UMC+
Author Profile

Abstract

Objective To study the preferences and risk tolerance of women suffering from deep endometriosis (DE) with bowel involvement when they have to choose between conservative or surgical. Design Labelled Discrete Choice Experiment (DCE). Setting Dutch academic and non-academic hospitals and online recruitment. Population or Sample A total of 169 patients diagnosed with DE of the bowel. Methods Baseline characteristics and the fear for surgery were collected. Women were asked to rank attributes and choose between hypothetical conservative (medication) or surgical treatment in different choice sets (scenarios). Each choice set offered different levels of all treatment attributes. Data were analysed by using multinomial logistic regression. Main Outcome Measures The following attributes; effect/or risk on pain, fatigue, pregnancy, endometriosis lesions, mood swings, osteoporosis, temporary stoma and permanent intestinal symptoms were used in this DCE. Results In the ranking osteoporosis is the least important attribute, while in the DCE, a lower chance of osteoporosis is one of the most important drivers when choosing a conservative treatment. Women with previous surgery show less fear for surgery compared to women without surgery. The low anterior resection syndrome is almost equally important for patients as the chance of pain reduction. Pain reduction has higher importance than improving fertility chances even in women with a future child wish. Conclusions The risk of suffering from LARS as a result of treatment is almost equally important as the reduction of pain symptoms. Women with previous surgery experience less fear for surgery compared to women without a surgical history.

Peer review status:IN REVISION

23 Jul 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
26 Jul 2021Assigned to Editor
26 Jul 2021Submission Checks Completed
29 Jul 2021Reviewer(s) Assigned
22 Aug 2021Review(s) Completed, Editorial Evaluation Pending
21 Sep 2021Editorial Decision: Revise Major