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IP80-16 PATIENT PREFERENCES FOR TREATMENT OF INTERMEDIATE-RISK PROSTATE CANCER: A DISCRETE CHOICE EXPERIMENT
Abstract   Peer reviewed

IP80-16 PATIENT PREFERENCES FOR TREATMENT OF INTERMEDIATE-RISK PROSTATE CANCER: A DISCRETE CHOICE EXPERIMENT

Avanish Madhavaram, Jacob Whitman, Polly McCracken, Cailey J. Sanborn, Cameron A. Jones, Aniket Asees, Kathryn A. Marchetti, Benjamin J. Davies, Janel Hanmer and Bruce L. Jacobs
The Journal of urology, Vol.215(5S), p.e1591
05/2026
DOI: 10.1097/01.JU.0001191764.50307.1e.16

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Abstract

INTRODUCTION AND OBJECTIVES: Prior evidence suggests that prostate cancer treatment decisions are shaped more by clinician specialty (radiation oncologist vs. urologist) rather than by a patients’ originally stated preference. To address this gap, we developed a prospective discrete choice experiment (DCE) to clarify which aspects of treatment matter most to patients. DCEs are economics- and marketing-based tools used to assess how respondents assign relative importance to various treatment attributes. METHODS: We recruited patients with intermediate-risk prostate cancer from a single-center academic urology clinic. We designed the discrete choice experiment to include eight attributes with 3-4 levels each. For the primary analysis, we estimated patient preferences for alternative treatment options using a conditional logit model. We conducted a latent class analysis to identify unobserved subgroups with distinct choice behavior patterns. We used a multivariable linear probability model to assess the association between patient demographics and latent class membership. RESULTS: A total of 87 patients completed the survey. In our primary analysis, patients had a significant preference towards avoiding bowel symptoms, erectile dysfunction, use of a urinary catheter, or frequent trips to the facility (Table 1). Bowel symptoms were considered the most important (loose bowel movements: odds ratio (OR)= 0.29; 95% confidence interval (CI), 0.21-0.39, vs. no symptoms), while urinary symptoms did not significantly influence choices (leaking urine: OR=1.00; 95% CI, 0.80-1.24, vs. no symptoms). LCA revealed 2 groups based on survey response patterns: (1) patients averse to surgery and a catheter and (2) patients averse to erectile and bowel symptoms. Older patients were more likely to be members of the surgery and catheter-averse class (Table 2). CONCLUSIONS: Patients prioritized avoiding bowel over urinary symptoms when choosing between treatment options. A subset of older patients placed the greatest emphasis on avoiding surgery and urinary catheter use. These findings may help inform shared decision-making conversations regarding surgery versus radiation.

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