A discrete-choice experiment study of physicians’ prioritization of attributes of medical treatments for endometriosis-associated pain

Christine Poulos, Yanqing Xu, Willings Botha, Colton Leach, Kristin Kahle Wrobleski, Keith Gordon, Stacey A Missmer, Stephanie J Estes
Expert review of pharmacoeconomics & outcomes research · 2023 · vol. 23(1) , pp. 111–121 · doi:10.1080/14737167.2023.2152006 · PMID:36625547 · W4315436490
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Obstetrician-gynecologists prioritized avoiding moderate-to-severe hot flashes over pain reduction and other risks when choosing treatments for endometriosis-associated pain.

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Abstract

BACKGROUND: Physicians' preferences for attributes of medical treatments for endometriosis-associated pain have not previously been quantified. METHODS: US obstetrician-gynecologists completed an online discrete-choice experiment survey. In a series of questions, physicians chose a medical treatment for a hypothetical patient with endometriosis experiencing severe, persistent dysmenorrhea, nonmenstrual pelvic pain, and/or dyspareunia. Each question presented two hypothetical medical treatments for endometriosis-associated pain, defined by seven attributes with varying levels. Preferences weights and conditional relative importance (CRI) were calculated using a random-parameters logit model. RESULTS: Respondents (N = 250) had an average age of 53 years; 36% were female. The most important attribute, conditional on the attributes and levels evaluated, was risk of moderate-to-severe hot flashes (CRI, 3.34). In descending order of importance, the CRIs of the other attributes were 2.13 for improvement in nonmenstrual pelvic pain, 2.04 for improvement in dyspareunia, 1.88 for improvement in dysmenorrhea, 1.16 for risk of pregnancy-related complications if pregnancy occurs during treatment, 0.62 for increased risk of bone fracture later in life, and 0.48 for mode of administration. CONCLUSIONS: In addition to valuing pain reduction, respondents prioritized avoiding moderate-to-severe hot flashes, followed by less common and less immediate risks of pregnancy-related complications and bone fracture.

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Condition tags

dysmenorrheadyspareuniaendometriosischronic_pelvic_pain

MeSH descriptors

Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Dyspareunia Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (20)

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