ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Treatment preferences in low-risk papillary thyroid microcarci-noma: a discrete choice experiment
Provisionally accepted
- 1Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
- 2Zhongnan Hospital of Wuhan University, Wuhan, China
- 3School of Nursing, Henan University of Science and Technology, Luoyang, China
- 4Beijing University of Chinese Medicine Center for Evidence-Based Chinese Medicine, Beijing, China
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Objective: This study aims to assess treatment preferences among newly diagnosed low-risk papillary thyroid microcarcinoma (PTMC) patients and analyse the trade-offs they make in treatment decisions. Design: Cross-sectional study. Methods: Conducted at the Fourth Affiliated Hospital of Harbin Medical University from June 2023 to April 2024, this study employed a discrete choice experiment. Participants were asked to choose among three treatment options with varying levels across seven attributes. A mixed logit model was used to analyse patient preferences, calculate the relative importance (RI) of attributes, and estimate marginal willingness to pay (mWTP). Subgroup analyses were also performed. Results: The final sample of 418 participants yielded 11286 observations. The most influential attribute affecting treatment choice was the 10-year risk of disease recurrence or progression (RI=58.4%), fol-lowed by the risk of short-term complications (RI=8.9%), treatment type (RI=8.5%), length of hospital stay (RI=7.7%), need for lifelong thyroid medication (RI=7.3%), and out-of-pocket treatment costs (RI=6.9%). The risk of permanent voice change had minimal impact (RI=2.4%). Regarding treatment type, participants significantly preferred thermal ablation over open surgery, while endoscopic thyroid-ectomy was less preferred, and active surveillance was the least favoured option. The mWTP analysis reinforced these priorities. Additionally, sociodemographic and psychological factors also influenced preferences. Conclusions: These findings highlight the need for healthcare providers to clearly communicate the long-term impacts of different treatment options to support informed decision-making. They also under-score the importance of improving patient-centred care, enhancing health education, and addressing the issue of overtreatment in PTMC.
Keywords: Treatment preferences, papillary thyroid microcarcinoma, Discrete choice experiment, partial thyroidectomy, Thermal ablation, active surveillance
Received: 15 Aug 2025; Accepted: 21 Nov 2025.
Copyright: © 2025 Wang, Feng, Yue, Niu, He, Yang, Zhang and Miao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jingbo Zhang, zjb952528@126.com
Kuo Miao, 782730639@qq.com
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