Salimah H. Meghani|Jesse Chittams|Alexandra L. Hanlon|Joseph Curry
Measuring preferences for analgesic treatment for cancer pain: How do African-Americans and Whites perform on choice-based conjoint (CBC) analysis experiments?
University of Pennsylvania|University of Pennsylvania|University of Pennsylvania
conjoint analysis ca serve important tool study health disparities unique factors underlying decisionmaking diverse subgroups however methodological advancements needed exploiting application ca compared internal external predictive validity intertemporal stability choicebasedconjoint cbc analysis africanamericans whites clinical context preferences analgesic treatment cancer painwe conducted prospective study repeatedmeasures two timepoints t1 baseline t2 3months africanamericans n 102 whites n 139 cancerrelated pain recruited outpatient oncology clinics philadelphia informed pilot work computerassisted cbc experiment developed using 5 attributes analgesic treatment type analgesic expected pain relief type sideeffects severity sideeffects outofpocket cost design included 2 choice alternatives 12 random tasks 2 holdout tasks maximum 6 levels per attribute internal external predictive validity cbc estimated using root likelihood rlh mean absolute error mae respectively intertemporal stability assessed using cohens kappawhites predominantly traded based pain relief whereas africanamericans traded based type sideeffects timepoints internal validity rlh slightly higher whites africanamericans rlh africanamericans improved t2 possibly due learning effect lexicographic dominant behavior observed 29 choice datasets whites likely africanamericans engage lexicographic behavior 60 vs 40 external validity mae slightly better africanamericans whites timepoints mae t1 304 africanamericans 402 whites t2 804 africanamericans 1024 whites t2 mae increased groups possibly reflecting increase complexity pain treatment decisionmaking based expectations t1 opposed reality t2 intertemporal stability fair cbc attributes t1 t2 kappa 028 95 ci 024032 predicted demographics including racewhile found slight group differences overall internal external predictive validity cbc comparable africanamericans whites discuss areas investigate improve internal external predictive validity cbc experiments