Please cite this article in press as: Molassiotis A, et al. Applying Best–Worst scaling methodology to establish delivery preferences of a symptom supportive care intervention in patients with lung cancer. Lung Cancer (2012), doi:10.1016/j.lungcan.2012.02.001 ARTICLE IN PRESS G Model LUNG-4020; No. of Pages 6 Lung Cancer xxx (2012) xxx–xxx Contents lists available at SciVerse ScienceDirect Lung Cancer j our na l ho me p age: www.elsevier.com/locate/lungcan Applying Best–Worst scaling methodology to establish delivery preferences of a symptom supportive care intervention in patients with lung cancer Alex Molassiotis a,∗ , Richard Emsley b , Darren Ashcroft c , Ann Caress a , Jackie Ellis d , Richard Wagland e , Chris D. Bailey e , Jemma Haines g , Mari Lloyd Williams d , Paul Lorigan h , Jaclyn Smith f , Carol Tishelman i , Fiona Blackhall h a School of Nursing, Midwifery & Social Work, University of Manchester, M13 9PL, UK b School of Community Medicine, University of Manchester, UK c School of Pharmacy & Pharmaceutical Sciences University of Manchester, UK d Academic Palliative and Supportive Care Studies Group (APSCSG) Division of Primary Care, University of Liverpool, UK e Faculty of Health Sciences, University of Southampton, Highfield, Southampton SO17 1BJ, UK f Respiratory Research Group, School of Translational Medicine, University of Manchester, UK g Medical Directorate, Lancashire Teaching Hospitals, UK h Christie NHS Foundation Trust, UK i Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden a r t i c l e i n f o Article history: Received 22 July 2011 Received in revised form 19 January 2012 Accepted 2 February 2012 Keywords: Preferences Intervention Symptom management Lung cancer Best Worst scaling Discrete Choices Experiment a b s t r a c t Background: Delivering a non-pharmacological symptom management intervention in patients with lung cancer is often challenging due to difficulties with recruitment, high attrition rates, high symptom burden, and other methodological problems. The aim of the present study was to elicit quantitative estimates of utility (benefit) associated with different attribute levels (delivery options) of a symptom management intervention in lung cancer patients. Methods: An application of Best–Worst scaling methodology was used. Effects (attributes) tested included the location of the intervention (home or hospital), type of trainer (health professional or trained volun- teer), caregiver involvement or not, and intervention delivered individually or in groups of patients. Participants were asked to evaluate and compare their preferences (utilities) towards the different attribute levels within scenarios and select the pair of attribute levels that they consider to be furthest apart. Results: Eighty-seven patients with lung cancer participated. The most important preferences for an intervention included the location (being delivered at home) and delivered by a health care professional. The least important preference was the involvement of a caregiver. Gender had an effect on preferences, with females being less inclined than men to prefer to receive an intervention in the home than the hospital and less inclined than men to have no other patients present. Furthermore, older participants and those in advanced stages of their disease were less inclined to have no other patients present compared to younger participants and those with earlier stages of disease, respectively. Conclusion: Considering patient preferences is an important step in developing feasible, patient-centred, appropriate and methodologically rigorous interventions and this study provided indications of such patient preferences. © 2012 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Patients with lung cancer (LC) have a significant number of unmet needs, primarily in relation to physical and daily functioning, followed by psychosocial, informational and patient care support needs [1]. Patients with LC seem willing to attend supportive ∗ Corresponding author at: University of Manchester, School of Nursing, Univer- sity Place, Manchester M13 9PL, UK. Tel.: +44 0161 3067830; fax: +44 0161 3067790. E-mail address: alex.molassiotis@manchester.ac.uk (A. Molassiotis). care interventions to meet some of their unmet needs; one study showed that 91% of the sample expressed an interest in attending at least one supportive care service and another that 53% reported willingness to attend a support group programme [2]. However, participation in supportive care trials within the LC population is hampered by many challenges, leading to a paucity of high quality studies. Such challenges include literacy levels, poor performance status, rapidly fluctuating health status and ‘gate-keeping’ [3]. The patients’ perspective has traditionally been neglected when designing trials (be it pharmacological or non-pharmacological) and trial recruitment is a common problem across studies and 0169-5002/$ – see front matter © 2012 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.lungcan.2012.02.001