Measuring importance of outcomes to patients: a cross-sectional survey for the German anal cancer guideline

J Clin Epidemiol. 2021 Jan;129:40-50. doi: 10.1016/j.jclinepi.2020.09.026. Epub 2020 Sep 26.


Objective: We aimed to generate evidence on patients' values and preferences to inform the development of the German national Evidence-based Anal Cancer Guideline.

Study design and setting: We developed a list of health outcomes based on a systematic search. We then asked anal cancer patients and experts of the guideline development group in an online survey to (a) rate the relative importance of the outcomes in different clinical situations using a nine-point, three-category scale, and (b) select seven outcomes they considered most important for decision-making in each situation.

Results: Participants rated almost half of the outcomes (45%) as critical for decision-making, and more than half (53%) as important. Only two outcomes (2%) were rated as low in importance. Agreement between expert and patient ratings was low to fair, and we found important discrepancies in how the relative importance of the outcomes was perceived. However, the rankings of outcomes were highly correlated.

Conclusion: Determining the relative importance placed by anal cancer patients on outcomes provided useful information for developing guideline recommendations. Our approach may be useful for guideline developers who aim to include the patient perspective. Moreover, our findings may help health professionals caring for anal cancer patients in joint decision-making.

Keywords: Anal cancer; GRADE approach (MeSH); Guideline development; Health care (MeSH); Outcome assessment; Patient preference (MeSH); Values and preferences.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anus Neoplasms* / epidemiology
  • Anus Neoplasms* / psychology
  • Anus Neoplasms* / therapy
  • Attitude of Health Personnel*
  • Correlation of Data
  • Cross-Sectional Studies
  • Decision Making
  • Decision Making, Shared
  • Evidence-Based Practice
  • Germany / epidemiology
  • Humans
  • Outcome Assessment, Health Care* / methods
  • Outcome Assessment, Health Care* / standards
  • Patient Care Management* / methods
  • Patient Care Management* / standards
  • Patient Preference*
  • Practice Guidelines as Topic / standards*
  • Social Perception