PIH66 – A Systematic Review To Identify the Use of Preference Elicitation Methods in Health Care Decision Making

Objectives: Preference elicitation methods (PEMs) offer the potential to increase patient-centered medical decision-making (MDM), by offering a measure of benefit along with a measure of value. Preferences can be applied in decisions on: reimbursement, including health technology assessment (HTA); market access, including benefit-risk assessment (BRA), and clinical care. The three decision contexts have different requirements for use and elicitation of preferences. The aim of this systematic review was to identify studies that used PEMs to represent the patient view and identify the types of health care decisions addressed by PEMs. Additionally, PEMs were described by methodological and practical characteristics within the three contexts’ requirements. Methods: Search terms included those related to MDM and patient preferences. Only articles with original data from quantitative PEMs were included. Results: Articles (n=322) selected included 379 PEMs, comprising matching methods (MM) (n=71,18.7%), discrete choice experiments (DCE) (n=96,25.3%), multi-criteria decision analysis (n=12,3. 2%), and other methods (i. e. rating scales), which provide estimates inconsistent with utility theory (n=200,52.8%). Most publications of PEMs had an intended use for clinical decisions (n=134,40%), HTA (n=68,20%), or BRA (n=12,4%). However, many did not specify an intended use (n=156,41.1%). In clinical decisions, rating, ranking, visual analogue scales and direct choice are used most often. In HTA, DCEs and MM are both used frequently, and the elicitation of preferences in BRA was limited to DCEs. Conclusions: Relatively simple preference methods are often adequate in clinical decisions, because they are easy to administer, give fast results, place low cognitive burden on the patient, and low analytical burden on the provider. MM and DCE fulfill the requirements of HTA and BRA but are more complex for the respondents. There were no PEMs that had low cognitive burden, and strong methodological underpinnings which could deliver adequate information to inform HTA and BRA decisions

Athlete experiences of disordered eating in sport

To date, research into disordered eating in sport has focused on the prevalence and the identification of putative risk factors. Findings suggest that elite female athletes participating in sports with a focus on leanness or aesthetics are at greatest risk. A paucity of research remains as to the period after onset and how existing sufferers manage their illness over time. In line with the principles of interpretative phenomenological analysis (IPA), this study 'gives voice' to four athletes who have experienced disordered eating, documenting their personal accounts and interpreting these accounts from a psychological perspective. In‐depth, semi‐structured interviews were conducted and verbatim transcripts were analysed according to the procedures of IPA. Three superordinate themes emerged from the data: the struggle to disclose, social support needs and identity challenges. Athletes' stories provided rich descriptions of their subjective disordered eating experiences. Their accounts give critical insight into the impact of eating disturbance on the lives of athletes. Future research should continue to identify athletes with existing eating problems in order to improve understanding as to how such individuals can best be helped

Sporting embodiment: sports studies and the (continuing) promise of phenomenology

Whilst in recent years sports studies have addressed the calls ‘to bring the body back in’ to theorisations of sport and physical activity, the ‘promise of phenomenology’ remains largely under-realised with regard to sporting embodiment. Relatively few accounts are grounded in the ‘flesh’ of the lived sporting body, and phenomenology offers a powerful framework for such analysis. A wide-ranging, multi-stranded, and interpretatively contested perspective, phenomenology in general has been taken up and utilised in very different ways within different disciplinary fields. The purpose of this article is to consider some selected phenomenological threads, key qualities of the phenomenological method, and the potential for existentialist phenomenology in particular to contribute fresh perspectives to the sociological study of embodiment in sport and exercise. It offers one way to convey the ‘essences’, corporeal immediacy and textured sensuosity of the lived sporting body. The use of Interpretative Phenomenological Analysis (IPA) is also critically addressed. Key words: phenomenology; existentialist phenomenology; interpretative phenomenological analysis (IPA); sporting embodiment; the lived-body; Merleau-Pont

The role of the Dotson Ice Shelf and Circumpolar Deep Water as driver and source of dissolved and particulate iron and manganese in the Amundsen Sea polynya, Southern Ocean

Coastal areas around Antarctica such as the Amundsen Sea are important sources of trace metals and biological hotspots, but are also experiencing the effects of climate change, including the rapid thinning of ice sheets. In the central Amundsen Sea Polynya (ASP), both bio-essential dissolved Fe (DFe) and dissolved Mn (DMn) were found to be depleted at the surface, indicating substantial biological uptake and/or precipitation. Close to the Dotson Ice Shelf (DIS) there were elevated surface concentrations of DMn (>3 nM) but surprisingly not for DFe (100 m depth). We compared different uptake ratios, underlining that uptake ratio estimates do not necessarily capture natural variability and it is likely better to use a range of values. In the future, climate change may increase the heat flux of mCDW and thereby the melting of the DIS. This will most likely cause an increased input of Fe and Mn into the ASP, which may fuel increased levels of primary productivity in the ASP