Development of a Discrete Choice Experiment (DCE) questionnaire to elicit values by pregnant women and decision-makers for the expansion of a NIPS-based prenatal screening program

Abstract

BackgroundIn an accountable world, being able to take into account the value given by relevant stakeholders to an intervention that could be offered to the population is considered as desirable. DCE is an approach particularly suited for the measurement of such values in the field of prenatal care. Yet, DCE studies in the field of prenatal screening have focused mainly on pregnant women and their care providers but have neglected another key actor, the decision-makers. The objective of the study was to develop a DCE instrument applicable to pregnant women and decision-makers, for the evaluation of new conditions to be added to a screening program for fetal chromosomal anomalies.MethodsAn instrument development study was undertaken. Methods employed included a literature review, a qualitative study performed on pregnant women and decision-makers, and a pilot project to validate the developed instrument and test the feasibility of its administration through an online survey platform. ResultsAn initial list of ten attributes and levels were built from the information provided by the literature review and the qualitative research component of the study. Seven attributes were built based on responses provided by participants from both groups. Two attributes were built from what was said by women only and one from what was said by decision-makers only. Search for consensus through consultations and a focus group discussion led to the retention of eight attributes. A pilot project was then performed with 33 pregnant women. This led to the exclusion of one attribute that showed poor influence on the choice making. The final version of the instrument contains seven attributes.ConclusionThis paper presents the construction of a DCE instrument that can be administered to pregnant women on the demand side, and decision-makers on the supply side. Such an instrument to measure the social desirability of an intervention could be an added value to the decision-making process of Health Technology Assessment agencies.

Pregnant women's and policymakers' preferences for the expansion of noninvasive prenatal screening: A discrete choice experiment approach study

“…The development of the DCE questionnaire consisted of sequential mixed methods 16 . We conducted a systematic literature review on the use of DCE in prenatal screening for chromosomal anomalies.…”

“…The development of the DCE questionnaire consisted of sequential mixed methods. 16 We conducted a systematic literature review on the use of DCE in prenatal screening for chromosomal anomalies. This review identified potential attributes that have been found to influence preferences for undertaking screening tests for new conditions in a NIPS-based prenatal screening program.…”