For a study, researchers sought to give the previously identified quality measures (QMs) a higher priority among parents who had lost a child to cancer. They used a discrete choice experiment with maximum difference scaling to recruit grieving parents from the United States to participate in an online survey. About 4 QMs were offered in each survey question, and parent were asked to choose the most and least important measures. Each of the 26 QMs was shown an equal number of times in various configurations. They employed hierarchical Bayesian multinomial logistic regression to calculate average significance ratings for each QM, representing the overall likelihood of a QM being chosen as most important. Importance scores were graded from 0 to 100, with a score of 5 being deemed 5× more important than a score of 1. The method allowed the relative relevance of QMs to be interpreted.

About 61 bereaved parents took part. Having a child’s symptoms relieved (average importance score 9.3 [95% CI 9.1, 9.4]), feeling like a child’s needs are heard by the healthcare team (8.4 [8.1, 8.7]), and having an end-of-life care experience that matches a family’s goals and preferences were among the highest-priority QMs (7.4 [6.8, 8.1]). Avoiding chemotherapy (0.3 [0.2, 0.5]), providing psychological assistance to parents (1.0 [0.6, 1.5]), and avoiding the critical care unit were the lowest-priority QMs (1.1 [0.7, 1.4]). 

Bereaved parents valued end-of-life QMs that focused on symptom management and goal-concordant care over their own psychosocial well-being. However, parents also rated QMs that measure or limit healthcare consumption as much less important.