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The effects of perceived severity of skull deformation on the treatment preference of youth health care physicians and paediatricians in the Netherlands

Vinkers, G.J.H. (2013) The effects of perceived severity of skull deformation on the treatment preference of youth health care physicians and paediatricians in the Netherlands.

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Abstract:Goal: The goal of this study is to determine which factor of the perceived severity of skull deformation is most defining and in what manner this perceived severity of skull deformation is influencing the treatment preferences of youth health care physicians (YHCP) and paediatricians. Design: Clinical vignettes were used in a conjoint analysis setting where both respondent groups gave their opinion on severity and treatment preference. Each question contained a set of attributes (Oblique Diameter Difference Index, Cranio Proportional Index, Occipital Lift, Ear Deviation and Gender) which were depicted as stylized deformed heads. The vignettes were accompanied by a questionnaire on experience with plagiocephaly and its treatments. Results: The results from the multivariate regression analysis showed that the ODDI is the largest contributing factor with a β=0.367 (P<0.05) for YHCP and β=0.461 (P<0.05) for Paediatricians in the Severity. This model for Severity with ODDI, CPI, OL, ED and Gender had a goodness-of-fit of R2 =0.392 for YCHPs and R2 =0.298 a a Paediatricians. The severity was also a major factor in the formation of a treatment preference, correlating with treatment preference with a R=0.717 for YHCPs and R=0.633 for Paediatricians. Considering that additional variables contribute to the treatment preference, for example the physicians personal preference resulted in an R=0.243 for YHCP and R=0.434 for the Paediatricians. This combined model had a goodness-of-fit of R2 =0.572 for YHCP and R2 =0.505 for Paediatricians. Conclusion: It is unclear if more levels of OL would a a have made a difference in this model. The Severity is likely a modifier for the personal treatment preference a physician might have. This would explain the overall gravitation to the ‘wait-and-see’ treatment in both the respondent groups. Additional factors for severity and treatment preference should be explored. The influence of additional variables on Severity, Treatment Preference and subsequent Advice given to the parents was not explored in this study but would be crucial in understanding the general decision-making process a physician has to go though when dealing with plagiocephaly.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/63714
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