human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The currently recommended approach for preventing malaria in pregnancy ( MiP ) , intermittent preventive treatment with sulphadoxine-pyrimethamine ( SP-IPT ) , has been question ed due to the spread of resistance to SP . Whilst trials are underway to test the efficacy of future alternative approaches , it is important to start exploring the feasibility of their implementation . Methods and Findings This study uses a discrete choice experiment ( DCE ) method to assess the potential resistance of health workers to changing strategies for control of MiP. In Ashanti region in Ghana , 133 antenatal clinic health workers were presented with 16 choice sets of two alternative policy options , each consisting of a bundle of six attributes representing certain clinical guidelines for controlling MiP ( type of approach and drug used ) , possible associated maternal and neo-natal outcomes , workload and financial incentives . The data were analysed using a r and om effects logit model . Overall , staff showed a preference for a curative approach with pregnant women tested for malaria parasites and treated only if positive , compared to a preventive approach ( OR 1.6 ; p = 0.001 ) . Increasing the incidence of low birth weight or severe anaemia by 1 % would reduce the odds of preferring an approach by 18 % and 10 % respectively . Midwives were more resistant to potential changes to current guidelines than lower-level cadres . Conclusions In Ashanti Region , resistance to change by antenatal clinic workers from a policy of SP-IPT to IST would generally be low , and it would disappear amongst midwives if health outcomes for the mother and baby were improved by the new strategy . DCEs are a promising approach to identifying factors that will increase the likelihood of effective implementation of new interventions immediately after their efficacy has been proven Background Bacterial and fungal infections in pediatric oncology patients cause morbidity and mortality . The clinical utility of antimicrobial prophylaxis  in children is uncertain and the personal utility of these agents is disputed . Objectives were to use a discrete choice experiment to : ( 1 ) describe the importance of attributes to parents and healthcare providers when deciding between use and non-use of antibacterial and antifungal prophylaxis ; and ( 2 ) estimate willingness-to-pay for prophylactic strategies . Methods Attributes were chances of infection , death and side effects , route of administration and cost of pharmacotherapy . Respondents were r and omized to a discrete choice experiment outlining hypothetical treatment options to prevent antibacterial or antifungal infections . Each respondent was presented 16 choice tasks and was asked to choose between two unlabeled treatment options and an opt-out alternative ( no prophylaxis ) . Results 102 parents and 60 healthcare providers participated . For the antibacterial discrete choice experiment , frequency of administration was significantly associated with utility for parents but not for healthcare providers . Increasing chances of infection , death , side effects and cost were all significantly associated with decreased utility for parents and healthcare providers in both the antibacterial and antifungal discrete choice experiment . Parental willingness-to-pay was higher than healthcare providers for both strategies . Conclusion Chances of infection , death , side effects and costs were all significantly associated with utility . Parents have higher willingness-to-pay for these strategies compared with healthcare providers . This knowledge can help to develop prophylaxis programs Study Design . Survey to all orthopedic and neurosurgeons , a r and om sample of family physicians ( FPs ) and patients in Ontario , Canada . Objective . To identify the dominant clinical factors influencing patient and physician preferences for lumbar spinal surgery .  Summary of Background Data . Surgery on the degenerative lumbar spine offers significant benefit for patients with moderate-severe symptoms failing nonoperative treatment . Referring FPs have little appreciation of factors that identify the ideal surgical c and i date . Differences in preferences may lead to wide variation in referrals and impedes the shared decision-making process . Methods . We used conjoint analysis , a rigorous method for eliciting preferences , to determine the importance that respondents place on decisions for lumbar spinal surgery . We identified 6 clinical factors ( walking tolerance , pain duration , severity , neurologic symptoms , typical onset , and dominant location of pain ) and presented hypothetical vignettes to participants who rated their preference for surgery . Data were analyzed using r and om-effects ordered probit regression models and the importance of each clinical factor relative to the others was determined . Results . We obtained responses from 131 surgeons , 202 FPs , and 164 patients . We found that FPs had the highest overall preferences for surgery and surgeons had the lowest . Surgeons placed the highest importance on the location of pain . FPs considered neurologic symptoms , walking tolerance , and severity to be of similar importance . Pain severity , walking tolerance , and duration of pain were the most important factors for patients in deciding for surgery . Orthopedic ( over neurosurgical ) surgeons had a lower preference for surgery ( P < 0.05 ) . Older patients ( P < 0.03 ) and previous surgical consultation ( P < 0.03 ) had greater patient preferences for surgery . Conclusion . Different preferences for surgery exist between surgeons , FPs , and patients . FPs may reduce over- and under-referrals by appreciating surgeons ' importance on location of pain ( leg vs. back ) . Surgeons and FPs may improve the shared decision-making process by underst and ing that patients place high importance on quality of life symptoms Health systems worldwide are grappling with the need to control costs to maintain system viability . With the combination of worsening economic conditions , an aging population and reductions in tax revenues , the pressures to make structural changes are expected to continue growing . Common cost control mechanisms , e.g. curtailment of patient access and treatment prioritization , are likely to be adversely viewed by citizens . It seems therefore wise to include them in the decision making processes that lead up to policy changes . In the context of a multilevel iterative mixed- method design a quantitative survey representative of the German population ( N = 2031 ) was conducted to probe the acceptance of priority setting in medicine and to explore the practicability of direct public involvement . Here we focus on preferences for patients ' characteristics ( medical aspects , lifestyle and socio-economic status ) as possible criteria for prioritizing medical services . A question naire with closed response options was fielded to gain insight into attitudes toward broad prioritization criteria of patient groups . Furthermore , a discrete choice experiment was used as a rigorous approach to investigate citizens ' preferences toward specific criteria level in context of other criteria . Both the question naire and the discrete choice experiment were performed with the same sample . The citizens ' own health and social situation are included as explanatory variables . Data were evaluated using corresponding analysis , contingency analysis , logistic regression and a multinomial exploded logit model . The results show that some medical criteria are highly accepted for prioritizing patients whereas socio-economic criteria are rejected Abstract Objectives : The purpose was to quantify patient and parent preferences for administration attributes of  immunoglobulin ( IG ) treatments ; and determine which administration attributes were most important to users of IG treatment and whether patients and parents have similar preferences for administration attributes . Methods : US adult patients and parents of children with a self-reported physician diagnosis of a primary immunodeficiency disorder completed a best- practice web-enabled choice-format conjoint survey that presented a series of 12 choice questions , each including a pair of hypothetical IG-treatment profiles . After review ing current therapies , each profile was defined by mode of administration , frequency , location , number of needle sticks , and treatment duration . Before answering the choice questions , respondents were told to assume all treatments worked equally well . Choice questions were based on a D-efficient experimental design . Preference weights for attribute levels were estimated using r and om-parameters logit for each sample ( adult patients and parents ) . Tests were performed to determine potential interactions among the administration attributes . All respondents provided online informed consent . Results : In total , 252 patients and 66 parents completed the choice questions appropriately . Overall , both groups preferred a home setting , monthly frequency , fewer needle sticks , and shorter treatment duration s of IG treatment relative to alternative choices ( p < 0.05 ) . Mode of administration was the least important attribute to both sample s ; however , parents strongly preferred  self-administration  to an appointment with a healthcare professional ( p < 0.05 ) , whereas patients slightly preferred self-administration but were indifferent to the two modes . Limitations : Respondents evaluate hypothetical treatments and differences can arise between stated and actual choices . Conclusions : Considering the hypothetical treatments evaluated , IG treatments that provide the option of a home setting , monthly frequency , fewer needle sticks , and shorter treatment duration s may address the needs of both patients and parents . Patients and parents have different preferences for administration attributes of IG treatments Purpose : To quantify gastrointestinal stromal tumor ( GIST ) patients ’ preferences for reducing treatment toxicities and the likely effect of toxicities on patients ’ stated adherence . Methods : English-speaking members of the Life Raft Group , a GIST patient advocacy and research organization , aged 18 years and older , completed a web-enabled survey including a series of treatment-choice questions , each presenting a pair of hypothetical GIST medication toxicity profiles . Each profile was defined by common or concerning toxicities verified via pretest interviews including : severity of edema , diarrhea , nausea , fatigue , rash , h and -foot syndrome , and heart failure ; and risk of serious infection . Each subject answered 13 choice-format questions based on a predetermined experimental design with known statistical properties . Subjects were asked to rate the likelihood that they would miss or skip doses of medications with different toxicity profiles . R and om-parameters logit was used to estimate a relative preference weight for each level of toxicity . Results : 173 subjects completed the survey . Over the ranges of toxicity levels included in the study , heart failure was the most important toxicity . Edema was the least important . For all toxicities , reducing severity from severe to moderate was more important to subjects than reducing severity from moderate to mild . Reducing heart failure from moderate to mild and diarrhea from severe to moderate had the largest effects on subjects ’ evaluation of adherence . Conclusions : All toxicities included in the study are important to patients . Treating or reducing severe toxicities is much more important to patients than treating or reducing moderate toxicities . Focused reductions of certain toxicities may improve treatment adherence Summary In Spain , various treatments are available to prevent osteoporotic fractures . A discrete choice experiment ( DCE ) was used to investigate the importance of different treatment aspects and its influence on patients ’ preferences . All attributes included as type and place of drug administration as well as costs showed to be significant predictors of choice . Spanish osteoporosis patients have well-defined preferences and accept trade-offs among attributes . Introduction This study was design ed to identify patient preferences for different aspects of osteoporosis treatments in Spain . Methods Main attributes of severe osteoporosis treatments were determined by literature review and consultations with nurses . The discrete choice experiment included three attributes : type of drug administration , place of administration , plus a cost attribute in order to estimate willingness to pay for improvements in attribute levels . A pilot study with 50 patients was performed to identify the areas of misunderst and ing . One hundred sixty-six patients with a diagnosis of osteoporosis and severe osteoporosis were presented with pairs of hypothetical treatment profiles with different type of administration levels , places of administration and costs . Questions to collect socio-demographic and disease-related treatment data were also included . Data were analysed using a r and om effects probit model . Results All attributes had the expected polarity and were significant predictors of choice . Patients were willing to pay 183 € /month to have a subcutaneous injection once per day rather than an intravenous injection once per year . Patients with osteoporosis were willing to pay 121 € /month to have medical support when administering the drug treatment at home rather than being admitted several hours to a hospital for drug administration . ConclusionS panish osteoporosis patients have well-defined preferences among treatment attributes and are willing to accept trade-offs among attributes . Participants indicated that they are willing to accept self medication with medical support rather than being hospitalised for several hours . The perspective of the patients should be taken into account when making treatment decisions Introduction . The implementation of mass colorectal cancer ( CRC ) screening is a public health priority . Population participation is fundamental for the success of CRC screening as for any cancer screening program . The preferences of the population may influence their likelihood of participation . Objectives . The authors sought to elicit population preferences for CRC screening test characteristics to improve the design of CRC screening campaigns . Methods . A discrete choice experiment was used . Question naires were compiled with a set of pairs of hypothetical CRC screening scenarios . The survey was conducted by mail from June 2006 to October 2006 on a representative sample of 2000 inhabitants , aged 50 to 74 years from the northwest of France , who were r and omly selected from electoral lists . Question naires were sent to 2000 individuals , each of whom made 3 or 4 discrete choices between hypothetical tests that differed in 7 attributes : how screening is offered , process , sensitivity , rate of unnecessary colonoscopy , expected mortality reduction , method of screening test result transmission , and cost . Results . Complete responses were received from 656 individuals ( 32.8 % ) . The attributes that influenced population preferences included expected mortality reduction , sensitivity , cost , and process . Participants from high social classes were particularly influenced by sensitivity . Conclusions . The results demonstrate that the discrete choice experiment provides information on patient preferences for CRC screening : improving screening program effectiveness , for instance , by improving test sensitivity ( the most valued attribute ) would increase satisfaction among the general population with regard to CRC screening programs . Additional studies are required to study how patient preferences actually affect adherence to regular screening programs Background The SINS trial ( Controlled Clinical Trials IS RCT N48755084 ; Eudract No. 2004 - 004506 - 24 ) is a r and omised controlled trial evaluating long term success of excisional surgery vs. imiquimod 5 % cream for low risk nodular and superficial basal cell carcinoma ( BCC ) . The 
    Output:
    
agent
We found a continuing trend towards conducting DCEs across a broader range of countries .
However , the trend towards including fewer attributes was reversed , whilst the trend towards interview-based DCEs reversed because of increased computer administration .
The trend towards using more flexible econometric models , including mixed logit and latent class , has also continued .
Reporting of monetary values has fallen compared with earlier periods , but the proportion of studies estimating trade-offs between health outcomes and experience factors , or valuing outcomes in terms of utility scores , has increased , although use of odds ratios and probabilities has declined .
The reassuring trend towards the use of more flexible and appropriate DCE design s and econometric methods has been reinforced by the increased use of qualitative methods to inform DCE processes and results .
However , qualitative research methods are being used less often to inform attribute selection , which may make DCEs more susceptible to omitted variable bias if the decision framework is not known prior to the research project .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The currently recommended approach for preventing malaria in pregnancy ( MiP ) , intermittent preventive treatment with sulphadoxine-pyrimethamine ( SP-IPT ) , has been question ed due to the spread of resistance to SP . Whilst trials are underway to test the efficacy of future alternative approaches , it is important to start exploring the feasibility of their implementation . Methods and Findings This study uses a discrete choice experiment ( DCE ) method to assess the potential resistance of health workers to changing strategies for control of MiP. In Ashanti region in Ghana , 133 antenatal clinic health workers were presented with 16 choice sets of two alternative policy options , each consisting of a bundle of six attributes representing certain clinical guidelines for controlling MiP ( type of approach and drug used ) , possible associated maternal and neo-natal outcomes , workload and financial incentives . The data were analysed using a r and om effects logit model . Overall , staff showed a preference for a curative approach with pregnant women tested for malaria parasites and treated only if positive , compared to a preventive approach ( OR 1.6 ; p = 0.001 ) . Increasing the incidence of low birth weight or severe anaemia by 1 % would reduce the odds of preferring an approach by 18 % and 10 % respectively . Midwives were more resistant to potential changes to current guidelines than lower-level cadres . Conclusions In Ashanti Region , resistance to change by antenatal clinic workers from a policy of SP-IPT to IST would generally be low , and it would disappear amongst midwives if health outcomes for the mother and baby were improved by the new strategy . DCEs are a promising approach to identifying factors that will increase the likelihood of effective implementation of new interventions immediately after their efficacy has been proven Background Bacterial and fungal infections in pediatric oncology patients cause morbidity and mortality . The clinical utility of antimicrobial prophylaxis  in children is uncertain and the personal utility of these agents is disputed . Objectives were to use a discrete choice experiment to : ( 1 ) describe the importance of attributes to parents and healthcare providers when deciding between use and non-use of antibacterial and antifungal prophylaxis ; and ( 2 ) estimate willingness-to-pay for prophylactic strategies . Methods Attributes were chances of infection , death and side effects , route of administration and cost of pharmacotherapy . Respondents were r and omized to a discrete choice experiment outlining hypothetical treatment options to prevent antibacterial or antifungal infections . Each respondent was presented 16 choice tasks and was asked to choose between two unlabeled treatment options and an opt-out alternative ( no prophylaxis ) . Results 102 parents and 60 healthcare providers participated . For the antibacterial discrete choice experiment , frequency of administration was significantly associated with utility for parents but not for healthcare providers . Increasing chances of infection , death , side effects and cost were all significantly associated with decreased utility for parents and healthcare providers in both the antibacterial and antifungal discrete choice experiment . Parental willingness-to-pay was higher than healthcare providers for both strategies . Conclusion Chances of infection , death , side effects and costs were all significantly associated with utility . Parents have higher willingness-to-pay for these strategies compared with healthcare providers . This knowledge can help to develop prophylaxis programs Study Design . Survey to all orthopedic and neurosurgeons , a r and om sample of family physicians ( FPs ) and patients in Ontario , Canada . Objective . To identify the dominant clinical factors influencing patient and physician preferences for lumbar spinal surgery .  Summary of Background Data . Surgery on the degenerative lumbar spine offers significant benefit for patients with moderate-severe symptoms failing nonoperative treatment . Referring FPs have little appreciation of factors that identify the ideal surgical c and i date . Differences in preferences may lead to wide variation in referrals and impedes the shared decision-making process . Methods . We used conjoint analysis , a rigorous method for eliciting preferences , to determine the importance that respondents place on decisions for lumbar spinal surgery . We identified 6 clinical factors ( walking tolerance , pain duration , severity , neurologic symptoms , typical onset , and dominant location of pain ) and presented hypothetical vignettes to participants who rated their preference for surgery . Data were analyzed using r and om-effects ordered probit regression models and the importance of each clinical factor relative to the others was determined . Results . We obtained responses from 131 surgeons , 202 FPs , and 164 patients . We found that FPs had the highest overall preferences for surgery and surgeons had the lowest . Surgeons placed the highest importance on the location of pain . FPs considered neurologic symptoms , walking tolerance , and severity to be of similar importance . Pain severity , walking tolerance , and duration of pain were the most important factors for patients in deciding for surgery . Orthopedic ( over neurosurgical ) surgeons had a lower preference for surgery ( P < 0.05 ) . Older patients ( P < 0.03 ) and previous surgical consultation ( P < 0.03 ) had greater patient preferences for surgery . Conclusion . Different preferences for surgery exist between surgeons , FPs , and patients . FPs may reduce over- and under-referrals by appreciating surgeons ' importance on location of pain ( leg vs. back ) . Surgeons and FPs may improve the shared decision-making process by underst and ing that patients place high importance on quality of life symptoms Health systems worldwide are grappling with the need to control costs to maintain system viability . With the combination of worsening economic conditions , an aging population and reductions in tax revenues , the pressures to make structural changes are expected to continue growing . Common cost control mechanisms , e.g. curtailment of patient access and treatment prioritization , are likely to be adversely viewed by citizens . It seems therefore wise to include them in the decision making processes that lead up to policy changes . In the context of a multilevel iterative mixed- method design a quantitative survey representative of the German population ( N = 2031 ) was conducted to probe the acceptance of priority setting in medicine and to explore the practicability of direct public involvement . Here we focus on preferences for patients ' characteristics ( medical aspects , lifestyle and socio-economic status ) as possible criteria for prioritizing medical services . A question naire with closed response options was fielded to gain insight into attitudes toward broad prioritization criteria of patient groups . Furthermore , a discrete choice experiment was used as a rigorous approach to investigate citizens ' preferences toward specific criteria level in context of other criteria . Both the question naire and the discrete choice experiment were performed with the same sample . The citizens ' own health and social situation are included as explanatory variables . Data were evaluated using corresponding analysis , contingency analysis , logistic regression and a multinomial exploded logit model . The results show that some medical criteria are highly accepted for prioritizing patients whereas socio-economic criteria are rejected Abstract Objectives : The purpose was to quantify patient and parent preferences for administration attributes of  immunoglobulin ( IG ) treatments ; and determine which administration attributes were most important to users of IG treatment and whether patients and parents have similar preferences for administration attributes . Methods : US adult patients and parents of children with a self-reported physician diagnosis of a primary immunodeficiency disorder completed a best- practice web-enabled choice-format conjoint survey that presented a series of 12 choice questions , each including a pair of hypothetical IG-treatment profiles . After review ing current therapies , each profile was defined by mode of administration , frequency , location , number of needle sticks , and treatment duration . Before answering the choice questions , respondents were told to assume all treatments worked equally well . Choice questions were based on a D-efficient experimental design . Preference weights for attribute levels were estimated using r and om-parameters logit for each sample ( adult patients and parents ) . Tests were performed to determine potential interactions among the administration attributes . All respondents provided online informed consent . Results : In total , 252 patients and 66 parents completed the choice questions appropriately . Overall , both groups preferred a home setting , monthly frequency , fewer needle sticks , and shorter treatment duration s of IG treatment relative to alternative choices ( p < 0.05 ) . Mode of administration was the least important attribute to both sample s ; however , parents strongly preferred  self-administration  to an appointment with a healthcare professional ( p < 0.05 ) , whereas patients slightly preferred self-administration but were indifferent to the two modes . Limitations : Respondents evaluate hypothetical treatments and differences can arise between stated and actual choices . Conclusions : Considering the hypothetical treatments evaluated , IG treatments that provide the option of a home setting , monthly frequency , fewer needle sticks , and shorter treatment duration s may address the needs of both patients and parents . Patients and parents have different preferences for administration attributes of IG treatments Purpose : To quantify gastrointestinal stromal tumor ( GIST ) patients ’ preferences for reducing treatment toxicities and the likely effect of toxicities on patients ’ stated adherence . Methods : English-speaking members of the Life Raft Group , a GIST patient advocacy and research organization , aged 18 years and older , completed a web-enabled survey including a series of treatment-choice questions , each presenting a pair of hypothetical GIST medication toxicity profiles . Each profile was defined by common or concerning toxicities verified via pretest interviews including : severity of edema , diarrhea , nausea , fatigue , rash , h and -foot syndrome , and heart failure ; and risk of serious infection . Each subject answered 13 choice-format questions based on a predetermined experimental design with known statistical properties . Subjects were asked to rate the likelihood that they would miss or skip doses of medications with different toxicity profiles . R and om-parameters logit was used to estimate a relative preference weight for each level of toxicity . Results : 173 subjects completed the survey . Over the ranges of toxicity levels included in the study , heart failure was the most important toxicity . Edema was the least important . For all toxicities , reducing severity from severe to moderate was more important to subjects than reducing severity from moderate to mild . Reducing heart failure from moderate to mild and diarrhea from severe to moderate had the largest effects on subjects ’ evaluation of adherence . Conclusions : All toxicities included in the study are important to patients . Treating or reducing severe toxicities is much more important to patients than treating or reducing moderate toxicities . Focused reductions of certain toxicities may improve treatment adherence Summary In Spain , various treatments are available to prevent osteoporotic fractures . A discrete choice experiment ( DCE ) was used to investigate the importance of different treatment aspects and its influence on patients ’ preferences . All attributes included as type and place of drug administration as well as costs showed to be significant predictors of choice . Spanish osteoporosis patients have well-defined preferences and accept trade-offs among attributes . Introduction This study was design ed to identify patient preferences for different aspects of osteoporosis treatments in Spain . Methods Main attributes of severe osteoporosis treatments were determined by literature review and consultations with nurses . The discrete choice experiment included three attributes : type of drug administration , place of administration , plus a cost attribute in order to estimate willingness to pay for improvements in attribute levels . A pilot study with 50 patients was performed to identify the areas of misunderst and ing . One hundred sixty-six patients with a diagnosis of osteoporosis and severe osteoporosis were presented with pairs of hypothetical treatment profiles with different type of administration levels , places of administration and costs . Questions to collect socio-demographic and disease-related treatment data were also included . Data were analysed using a r and om effects probit model . Results All attributes had the expected polarity and were significant predictors of choice . Patients were willing to pay 183 € /month to have a subcutaneous injection once per day rather than an intravenous injection once per year . Patients with osteoporosis were willing to pay 121 € /month to have medical support when administering the drug treatment at home rather than being admitted several hours to a hospital for drug administration . ConclusionS panish osteoporosis patients have well-defined preferences among treatment attributes and are willing to accept trade-offs among attributes . Participants indicated that they are willing to accept self medication with medical support rather than being hospitalised for several hours . The perspective of the patients should be taken into account when making treatment decisions Introduction . The implementation of mass colorectal cancer ( CRC ) screening is a public health priority . Population participation is fundamental for the success of CRC screening as for any cancer screening program . The preferences of the population may influence their likelihood of participation . Objectives . The authors sought to elicit population preferences for CRC screening test characteristics to improve the design of CRC screening campaigns . Methods . A discrete choice experiment was used . Question naires were compiled with a set of pairs of hypothetical CRC screening scenarios . The survey was conducted by mail from June 2006 to October 2006 on a representative sample of 2000 inhabitants , aged 50 to 74 years from the northwest of France , who were r and omly selected from electoral lists . Question naires were sent to 2000 individuals , each of whom made 3 or 4 discrete choices between hypothetical tests that differed in 7 attributes : how screening is offered , process , sensitivity , rate of unnecessary colonoscopy , expected mortality reduction , method of screening test result transmission , and cost . Results . Complete responses were received from 656 individuals ( 32.8 % ) . The attributes that influenced population preferences included expected mortality reduction , sensitivity , cost , and process . Participants from high social classes were particularly influenced by sensitivity . Conclusions . The results demonstrate that the discrete choice experiment provides information on patient preferences for CRC screening : improving screening program effectiveness , for instance , by improving test sensitivity ( the most valued attribute ) would increase satisfaction among the general population with regard to CRC screening programs . Additional studies are required to study how patient preferences actually affect adherence to regular screening programs Background The SINS trial ( Controlled Clinical Trials IS RCT N48755084 ; Eudract No. 2004 - 004506 - 24 ) is a r and omised controlled trial evaluating long term success of excisional surgery vs. imiquimod 5 % cream for low risk nodular and superficial basal cell carcinoma ( BCC ) . The 
    Output:
    