TABLE I.
Characteristics and Levels of the Discrete Choice Experiment*
| Characteristic | Characteristic Description | Level | Level Description |
|---|---|---|---|
| QoL change | QoL change compared with situation before BAP, on a scale from 0 to 10. Patient’s starting point does not matter, and all steps are equal in effect | 3-point increase | Increase of 3 points in QoL after OI surgery compared with situation before BAP |
| 1-point increase | Increase of 1 point in quality of life after OI surgery compared with situation before BAP | ||
| No difference | There is no difference in quality of life before and after OI surgery (reference level) | ||
| 1-point decrease | Decrease of 1 point in quality of life after OI surgery compared with situation before BAP | ||
| Short-term complications | In the first year, intensive follow-up is provided, in part because of complications that could occur. Patients are made aware of what complications could occur, and the chances, and how they are resolved or treated | No major complications | No complications or adverse events that need therapy or follow-up (reference level) |
| 33% stoma infection, nonsurgical therapy | 33% chance of having a low-grade soft-tissue infection, which can be resolved using oral antibiotics | ||
| 15% stoma infection, surgical therapy | 15% chance of having a soft-tissue infection, which only can be treated with a surgical intervention | ||
| 6% hypergranulation | 6% chance of having hypergranulation, which is excessive granulation that rises above the wound surface or stoma, and needs debridement | ||
| 6% bone fracture | 6% chance of having a bone fracture (periprosthetic fracture) | ||
| Long-term complications | Complications that could occur after the first year and up to one’s lifetime. No chances are given as no time period is provided. | No complications | No complications or adverse events that need therapy or follow-up (reference level) |
| Bone infection | Bone infection (osteomyelitis)of any sort, that can be resolved without surgery | ||
| Implant removal | Surgical removal of the osseointegrated material | ||
| Chronic stoma problems | Chronic stoma problems that need regular check-up, visits, and treatments | ||
| External component replacement | External component replacement including a visit to the instrument maker. External components are the dual-cone adaptor, height or gait adjustment of the outer mechanism, or anything that the instrument maker can change or fix | ||
| OI implant survival | It is unknown how long the implant can survive or will get loose. Knowing this information, what is the least amount of time that is still accepted by patients? | 5 yr | 5 yr (reference level) |
| 10 yr | 10 yr | ||
| 20 yr | 20 yr | ||
| Out-of-pocket-contributions | BAP treatment is expensive; if full reimbursement is not possible, how much is a patient willing to pay to have BAP treatment? | No contribution | No personal monetary contribution (reference level) |
| €5,000 | A contribution of €5,000 | ||
| €10,000 | A contribution of €10,000 | ||
| €15,000 | A contribution of €15,000 | ||
| €20,000 | A contribution of €20,000 | ||
| €25,000 | A contribution of €25,000 | ||
| No BAP | Patient does not want BAP treatment | Opting out | Opting out of BAP treatment and thus staying at status quo |
*
These are the characteristics and levels for osseointegrated implant (OI) options in a choice task. Reference levels were utilized as the base level for the statistical analysis. BAP = bone-anchored prothesis, and QoL = quality of life.