Shared decision-making is widely recognized as an essential part of good healthcare. When people are choosing between treatment options with trade-offs between benefits, risks and side effects, understanding their preferences is crucial for successful treatment. But which method for expressing their preferences do patients find easiest, clearest and most suitable?
A recent study set out to answer this question by comparing five commonly used methods for eliciting patient preferences. The findings were clear: the PAPRIKA method was most preferred by participants.
Comparing methods for eliciting preferences
In the study, over 120 participants – including both healthy individuals and people living with acute or chronic illness – completed an online survey. They were asked to imagine a realistic treatment decision involving three options that differed in effectiveness, side effects and how the treatment was administered.
Participants then used five preferences elicitation methods to provide their relative preferences regarding the attributes (effectiveness, side effects and application route) of the treatment options. The preferences elicitation methods were:
- Direct weighting
- Best-worst scaling
- PAPRIKA (Potentially All Pairwise RanKings of all Possible Alternatives)
- Time trade-off
- Standard gamble
After completing each method, participants rated how clear, usable and helpful the method was, and whether it allowed them to meaningfully express what mattered to them.
PAPRIKA rated highest overall
Across clarity, usability and overall satisfaction, 1000minds' PAPRIKA method performed the best.
Participants felt that PAPRIKA helped them think carefully about trade-offs while striking a good balance between nuance and cognitive ease, compared to other methods.
Importantly, participants also felt that PAPRIKA allowed them to actively contribute to decision-making by making it easier to express which aspects of treatment they cared about most and how they balanced competing considerations.
These results were remarkably stable across different demographic and health-related subgroups. Age, gender, health status and recent experiences with the healthcare system had little influence on how the methods were perceived.
Conclusion
Overall, the findings suggest that PAPRIKA’s interactive, trade-off-based approach strikes an effective balance between detail and usability. Participants were willing to engage with the method, found it meaningful and felt it reflected their preferences more accurately than the other methods tested.
This study provides strong evidence that how people are asked about their preferences matters – and that well-designed, transparent methods can make that process clearer and more engaging for patients.
Further reading
Fusiak, J., Wolkenstein, A., & Hoffmann, V. S. (2025). Assessing patient preferences for medical decision making: A comparison of different methods. Frontiers in Digital Health, 7. https://doi.org/10.3389/fdgth.2025.1641765
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