1105 Relevance of Attributes and Preferences for At-home Diagnostic Testing Differ Among Patients with Sleep Disorders

Abstract Introduction The diagnostic workup for assessment of sleep disorders commonly involves an overnight test to assess sleep patterns and identify pathological events. So far, little is known about preferences for the provision of home sleep tests to patients with disturbed sleep. This study aims to close this gap by eliciting preferences and relative importance of attributes of home sleep testing using a discrete choice experiment (DCE). Methods A DCE with seven attributes of at-home overnight sleep testing and three levels per attribute, which were selected based on previous qualitative research, was developed using a fractional factorial design. Patients with and without previous sleep testing experience were recruited from two large third-level sleep centers in Germany. The DCE was administered to patients with paper-based forms during their visits to the outpatient clinics. Coefficients for attribute levels were calculated using a conditional logit model with effects coding to estimate their influence on choice decisions and calculate the relative importance of each attribute. Results 305 patients (age 54.5 ± 13,1 years, male gender 65.3% were enrolled), and 288 surveys with complete data were included for analysis, which resulted in 1,152 choice decisions available for analysis. All of the attributes, except "Diagnostic accuracy" of sleep study had statistically significant influence on choice decisions. Attributes with the greatest relevance were "Waiting time to discuss sleep study results"; "Waiting time to conduct sleep study", and "Sleep quality during measurement". Of lowest importance was "Diagnostic accuracy" of sleep study, followed by "Effort to apply sleep study device", and "Device logistics". Significant heterogeneity in choice behavior was found, including differences by gender, willingness-to-pay for sleep studies, preferred sleep study location, and previous experience with sleep studies. Preferred location for conducting the sleep test was at-home in 50.7% and in-lab in 46.9%. Conclusion Preferences and relative importance of home sleep test attributes vary among different subgroups. Considering those preferences and their relevance is important for clinicians and policy-makers when designing individual patient-centric care pathways and high-level planning of diagnostic testing policies for sleep disorders. Support (if any)