Page 157 - Strategies for non-invasive managementof high-grade cervical intraepithelial neoplasia - prognostic biomarkers and immunotherapy Margot Maria Koeneman
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Table 1. Attributes and levels used in the discrete choice experiment
Chance of successful treatment
Risk of premature birth after treatment
Risk of subfertility after treatment
Side effects*
1. Vaginal pruritus/ pain
2. Abdominal pain 3. Vaginal discharge 4. Vaginal bleeding
5. Flu-like symptoms
Treatment is successful when the entire 95% CIN lesion has resolved after treatment
and no additional treatment is necessary.
Premature birth is the birth of a baby 12% before 37 weeks of gestation. Premature
babies often have to be admitted to a
neonatal ward and experience more health problems.
Subfertility is when the time to conception 16% is longer than 12 months.
Irritation of the vaginal mucosa, which can NA lead to pruritus or pain.
Pain in the lower abdomen. 15%
Bloody or white vaginal discharge. 20%
Vaginal bleeding can be both brown and 25% red blood loss.
Flu-like symptoms include myalgia, NA headache and fever.
55%, 75%, 95% 5,8,12 6%, 12 % 2,3
8%, 16% 4 10%, 25% 5
NA 12 8 10%, 30% 9, 12
NA 12
10%, 25% 5,9
Patient preferences in treatment of high-grade CIN
 Attribute
  Explanation of attribute
  Levels of the attribute for LLETZ treatment
  Levels of the attribute for imiquimod treatment
  Ref.
    * study subjects were informed that the presented levels indicated the levels of moderate to severe complaints, during the first two weeks after LLETZ treatment and during the full period of imiquimod treatment.
CIN = cervical intraepithelial neoplasia; LLETZ = large loop excision of the transformation zone; NA = not applicable
In total, nine choice sets were created (figure 1). The ordering of the attributes was varied over four versions of the questionnaire to control for a potential attribute-ordering effect. To test internal consistency, choice set 5 was repeated at the end of the questionnaire (choice set 10). Internal consistency was evaluated by Cohen’s kappa, in which a kappa value <0.20 denotes poor agreement, 0.21–0.40 fair, 0.41–0.60 moderate, 0.60–0.80 good, and 0.81–1.00 very good agreement.[15]
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