An investigation of the stability of patients’ treatment preferences over the course of a clinical trial

Paul F. Allanson*, Eric A. Brown, Daniel Kopasker, Andrzej Kwiatkowski

*Corresponding author for this work

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The usefulness of DCEs to inform clinical guidelines rests on the assumption that patients facing the same treatment choice at different points in time will express the same preferences. This study provides the first investigation to our knowledge to specifically focus on the stability of patients’ treatment preferences over the course of a clinical trial.


The same Decision Choice Experiment (DCE) was completed by participants at baseline and final post-treatment assessment in a trial of the efficacy of alternative topical treatments for actinic keratosis as a means for the prevention of skin cancer. The study assesses both the consistency of stated treatment choices and the stability of population-level preference parameter estimates, and analyses how the former is influenced by design aspects of the DCE.


No evidence is found of population-level preference parameter instability over the course of the trial despite only a moderate strength of choice consistency. Choice consistency is negatively related to task difficulty with weak evidence of the existence of ordering effects over the sequence of choice tasks.


The results provide no evidence that the timing of a DCE within a clinical trial significantly influences population-level treatment preference estimates.
Original languageEnglish
Pages (from-to)775-781
Number of pages7
JournalValue in Health
Issue number6
Early online date10 Mar 2020
Publication statusPublished - Jun 2020

Bibliographical note

Acknowledgements: Catherine Harwood, PhD as chief investigator and Charlotte Proby, MA, John Lear, MD, Adele Green, PhD, and Keith Wheatley, DPhil as co-investigators were responsible for the original concept and design of the main clinical trial and, together with other members of the trial team, supervised the collection of the data for this sub-study. The Cancer Research UK Clinical Trials Unit provided trial coordination. We thank the anonymous reviewers for their valuable comments.

Source of financial support: The study was funded by the National Institute for Health Research (NIHR) Research for Patient Benefit programme (PB-PG-010-21244).


  • clinical trial
  • DCE
  • preference stability
  • TIME


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