Baird, T, Imaging Preferences of the Patient: A Scoping Review

Imaging preferences of the patient: A scoping review

Trey Baird BS, UCCOM MS2 (medical student)2 and Shireen Hayatghaibi, PhD, Radiology (PI)1

Cincinnati Children’s Hospital Medical Center1, University of Cincinnati College of Medicine1, Cincinnati, Ohio.

Introduction: There continues to be a push for patient centered care within medicine. Yet, a lack of shared decision making persists in the field of imaging. Healthy decisions should be both evidence based and value consistent, the former of which physicians emphasize. We conducted a scoping review to analyze and evaluate the quality of existing literature regarding quantitative patient preference measures for use in future patient preference studies on imaging.

Methods: We selected a scoping review design using the databases Pubmed, Embase, EconLit, and CINAHL to identify studies that met inclusion criteria of both diagnostic imaging and use of quantitative patient preference measures published in English since 2000. We then supplemented this search with hand searching the references of included articles. Studies were excluded for the following reasons: no original data, abstracts only, qualitative studies, investigations that measure “attitudes” with surveys and Likert scales, and measures of provider preferences. Additionally, we excluded studies that involved treatment such as radiotherapy and interventional radiology. Two investigators independently reviewed titles, abstracts, and full-texts to select articles for data abstraction according to the defined inclusion and exclusion criteria. Disagreements were resolved through consensus. Data was abstracted on study country, year, number of participants, preference elicitation methods, number of attributes, and attribute selection methods. The PREFS checklist was used to assess the quality and validity of the preference studies on a 5-point scale.

Results: Of the 4,464 unique articles, 53 met the inclusion criteria. The articles used conjoint analysis (n= 28), contingent valuation (n=16), time trade-off (n=4), best-worst-scaling (n=3), standard gamble (n=1), and qualitative conjoint analysis (n=1). Sample sizes ranged from 26 to 3,469 with an average of 544 participants. One article involved pediatric imaging preferences. Thirty-eight articles involved cancer screening scenarios, with breast cancer being the most prevalent cancer studied in 15 studies. Magnetic resonance imaging was the most studied imaging modality, being included in 18 studies. Most articles were conducted in the USA (n=18), followed by the UK (n=12), and Japan (n=5). A majority of the studies were published since 2015, the greatest number of publications being 2022 with 7 articles. The most common method of attribute selection was via literature review (n=21), followed by articles with multiple methods (n=18). Two studies met all five criteria of the PREFS checklist and 30 met four, with two articles meeting just one criterion. The mean score was 3.5 (SD=0.8).

Conclusions: Our scoping review provides a systematic evaluation of the existing literature in patient preferences for imaging studies. We demonstrated that there are few quantitative patient reference studies in pediatric imaging. Future research must be conducted with an emphasis on pediatric imaging preferences to enhance shared decision making in the field of pediatric radiology.

Contact Information: Trey Baird, bairdty@mail.uc.edu, 614-582-0914

Key Words: patient preferences, quantitative preference measures, patient-centered care, imaging, radiology