Scoping review of values elicitation tools for treatment decisions in hepatocellular carcinoma

Gabrielle Ritaccio; A Sidney Barritt Iv; Jamie L Conklin; Daniel R Richardson; Donna M Evon; Hanna K Sanoff; Ethan Basch; Stephanie B Wheeler; Andrew M Moon

doi:10.1186/s12876-024-03167-1

Scoping review of values elicitation tools for treatment decisions in hepatocellular carcinoma

BMC Gastroenterol. 2024 Feb 28;24(1):90. doi: 10.1186/s12876-024-03167-1.

Authors

Gabrielle Ritaccio¹, A Sidney Barritt Iv^{1

2}, Jamie L Conklin³, Daniel R Richardson^{4

5}, Donna M Evon^{1

2}, Hanna K Sanoff^{5

6}, Ethan Basch^{5

6}, Stephanie B Wheeler^{5

7

8}, Andrew M Moon^{9

10

11}

Affiliations

¹ Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill School of Medicine, 8009 Burnett Womack Bldg, CB#7584, Chapel Hill, NC, 27599-7584, USA.
² UNC Liver Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
³ Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁴ Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
⁵ Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
⁶ Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
⁷ Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁸ Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
⁹ Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill School of Medicine, 8009 Burnett Womack Bldg, CB#7584, Chapel Hill, NC, 27599-7584, USA. Andrew.Moon@unchealth.unc.edu.
¹⁰ UNC Liver Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA. Andrew.Moon@unchealth.unc.edu.
¹¹ Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA. Andrew.Moon@unchealth.unc.edu.

Abstract

Background: Treatment choices in hepatocellular carcinoma (HCC) involve consideration of tradeoffs between the benefits, toxicities, inconvenience, and costs. Stated preference elicitation methods have been used in the medical field to help evaluate complex treatment decision-making. The aim of this study was to conduct a scoping review to assess the evidence base for the use of preference elicitation tools or willingness to pay/willingness to accept methods for HCC treatment decision-making from both the patient and provider perspective.

Methods: We performed a scoping review to identify abstracts or manuscripts focused on the role preference elicitation tools or willingness to pay/willingness to accept methods for HCC treatment options among patients, caregivers, and/or providers. Two researchers independently screened full-text references and resolved conflicts through discussion. We summarized key findings, including the type and setting of preference-elicitation tools used for HCC treatment decisions.

Results: Ten published abstracts or manuscripts evaluated the role of preference elicitation tools for HCC treatments. The studies revealed several attributes that are considered by patients and providers making HCC treatment decisions. Many of the studies reviewed suggested that while patients place the most value on extending their overall survival, they are willing to forgo overall survival to avoid risks of treatments and maintain quality of life. Studies of physicians and surgeons found that provider preferences are dependent on patient characteristics, provider specialty, and surgeon or hospital-related factors.

Conclusion: This scoping review explored both patient and physician preferences towards treatment modalities in all stages of HCC. The studies revealed a large scope of potential attributes that may be important to patients and that many patients are willing to forgo survival to maintain quality of life. Further research should explore both preference elicitation of currently available and emerging therapies for HCC as well as the use of this data to develop patient-facing tools to assist in navigating treatment options.

Keywords: Decision aids; Discrete choice experiment; Hepatocellular carcinoma; Probability trade-off; Shared decision making.

Publication types

Systematic Review

MeSH terms

Carcinoma, Hepatocellular* / therapy
Humans
Liver Neoplasms* / therapy
Patient Preference
Quality of Life
Surgeons*