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Treatment preferences for medication or surgery in patients with deep endometriosis and bowel involvement -- A Discrete Choice Experiment
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  • Jeroen Metzemaekers,
  • M. Elske Akker-van Marle ,
  • Jonathan Sampat ,
  • Mathilde J.G.H. Smeets,
  • James English,
  • Elke Thijs,
  • Jacques W.M. Maas,
  • Frank Willem Jansen,
  • Brigitte Essers
Jeroen Metzemaekers
LUMC

Corresponding Author:j.metzemaekers@lumc.nl

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M. Elske Akker-van Marle
LUMC
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Jonathan Sampat
Maastricht UMC+
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Mathilde J.G.H. Smeets
Medisch Centrum Haaglanden
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James English
Medisch Centrum Haaglanden
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Elke Thijs
Maastricht UMC+
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Jacques W.M. Maas
Maastricht UMC+
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Frank Willem Jansen
LUMC
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Brigitte Essers
Maastricht UMC+
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Abstract

Objective To study the preferences and risk tolerance of women suffering from deep endometriosis (DE) with bowel involvement when they have to choose between conservative or surgical. Design Labelled Discrete Choice Experiment (DCE). Setting Dutch academic and non-academic hospitals and online recruitment. Population or Sample A total of 169 patients diagnosed with DE of the bowel. Methods Baseline characteristics and the fear for surgery were collected. Women were asked to rank attributes and choose between hypothetical conservative (medication) or surgical treatment in different choice sets (scenarios). Each choice set offered different levels of all treatment attributes. Data were analysed by using multinomial logistic regression. Main Outcome Measures The following attributes; effect/or risk on pain, fatigue, pregnancy, endometriosis lesions, mood swings, osteoporosis, temporary stoma and permanent intestinal symptoms were used in this DCE. Results In the ranking osteoporosis is the least important attribute, while in the DCE, a lower chance of osteoporosis is one of the most important drivers when choosing a conservative treatment. Women with previous surgery show less fear for surgery compared to women without surgery. The low anterior resection syndrome is almost equally important for patients as the chance of pain reduction. Pain reduction has higher importance than improving fertility chances even in women with a future child wish. Conclusions The risk of suffering from LARS as a result of treatment is almost equally important as the reduction of pain symptoms. Women with previous surgery experience less fear for surgery compared to women without a surgical history.
23 Jul 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
26 Jul 2021Submission Checks Completed
26 Jul 2021Assigned to Editor
29 Jul 2021Reviewer(s) Assigned
22 Aug 2021Review(s) Completed, Editorial Evaluation Pending
21 Sep 2021Editorial Decision: Revise Major
25 Oct 20211st Revision Received
27 Oct 2021Submission Checks Completed
27 Oct 2021Assigned to Editor
27 Oct 2021Review(s) Completed, Editorial Evaluation Pending
05 Nov 2021Editorial Decision: Accept
27 Dec 2021Published in BJOG: An International Journal of Obstetrics & Gynaecology. 10.1111/1471-0528.17053