# Using Patients' Stated Preferences to Inform and Support Proxy Decision-making during Palliative Treatment: Instrument Development and Evaluation

> **NIH NIH F31** · JOHNS HOPKINS UNIVERSITY · 2022 · $39,964

## Abstract

Project Summary
We will develop a discrete choice experiment (DCE) instrument to measure the trade-offs that advanced prostate
cancer patients make when deciding among palliative anti-cancer treatment options. Only one out of three
patients diagnosed with advanced prostate cancer is alive after five years. During disease progression, patient’s
capacity for treatment decision making often wanes and decision partners undertake increased treatment
decision making responsibility. This can result in elevated burden for decision partners, especially when there is
uncertainty regarding the patients’ treatment preferences. Our proposed DCE will be designed to elicit patient
treatment preferences to serve as a tangible guide to decision partners and the clinical team for future palliative
anti-cancer treatment decision making. Importantly, the development process will focus on the inclusion of
minority patients by oversampling African Americans and following models of decision making informed by
research with African American participants. In Aim 1, Q methodology and qualitative interview techniques will
be applied with patients and their decision partner to identify the important attributes of palliative anti-cancer
treatment options and explore decision partners role in decision making. In Aim 2, a DCE instrument will be
created and a subsequent sample of dyads (patient and decision partner) will be interviewed to engage patients
and their decision partner in instrument development and initial piloting for validity and reliability. We will
undertake a rigorous process to develop the DCE instrument following published best-practice guidelines. The
output of this research project will include a DCE instrument to quantify patient’s palliative anti-cancer treatment
preferences. This project will impact clinical practice by providing an objective measure of patients’ palliative
anti-cancer treatment preferences to decision partners and the clinical team that can help guide treatment
decisions. Future research will investigate the potential role of DCEs in decision support. This award will support
the research, training, and professional development necessary for the Applicant to transition into a career
advancing decision support research to mitigate health disparities and reduce negative outcomes for patients
and their decision partners, including stress, anxiety, guilt, and depression. Upon completion of this Fellowship,
the Applicant will have a solid foundation for future research to investigate decision support, beginning with a
career development award to test the developed DCE instrument in larger samples to derive generalizable
results. This application is aligned with the National Cancer Institute Scientific Priority Area of preventing,
understanding, and mitigating cancer health disparities due to our unique focus on inclusive sampling. The
Applicant is well supported to accomplish this goal with a Sponsor and Cosponsor who have a long history of
w...

## Key facts

- **NIH application ID:** 10469320
- **Project number:** 5F31CA254663-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Winter Maxwell Thayer
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $39,964
- **Award type:** 5
- **Project period:** 2021-08-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10469320

## Citation

> US National Institutes of Health, RePORTER application 10469320, Using Patients' Stated Preferences to Inform and Support Proxy Decision-making during Palliative Treatment: Instrument Development and Evaluation (5F31CA254663-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10469320. Licensed CC0.

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