Explore if scenario-based interactive tools (SBITs) that apply game mechanics have been used to construct or elicit patient preferences regarding treatment, assess how they may support the construction or elicitation of preferences, and formulate a set of design recommendations.
A scoping literature review was performed. In November 2016 several electronic databases were searched using suitable terms in duplicate and triplicate to identify SBITs used in the construction or elicitation of patient preferences regarding treatment.
Of 112 studies identified in the scoping review, only 5 met the inclusion/exclusion criteria. Studies were included if they: (1) were designed to construct or elicit patient preferences in regards to medical treatment, (2) were developed based on gameplay theory or incorporated >3 established game mechanics, and (3) provided information on treatment risks or benefits. Studies were mainly low quality, demonstrated improvements in user education, and mainly focused on addressing education (5/5) as opposed to preference construction (3/5) or measurement (3/5). No clear methodological framework was described in relation to the development of the SBITs nor reference to patient preference guidelines. Due to the small number of studies available, the search scope was adapted to consider design recommendations from the 112 eligible studies. This resulted in recommendations that SBITs should be: (I) interactive, (II) explorative, (III) personalized, (IV) realistic, (V) emotive, (VI) universally understandable, and (VII) time-wise. None of the five SBITs identified in the scoping review were found to address all seven recommendations. The most commonly addressed design recommendations were ‘interactivity’ (5/5) and ‘explorative’ (5/5). The least addressed design recommendation was ‘personalized’ (2/5).
There has been little scientific evidence published on the use of SBITs that apply game mechanics to construct or elicit patient preferences regarding treatment. Although studies included in the scoping review indicated that SBITs led to increased patient understanding, this evidence should be considered with caution due to the low quality of studies that were evaluated. Moreover, there are clear needs for the use of a methodological framework in the development of SBITs and more transparent evaluation of, and reporting on, their effectiveness. The seven design recommendations described could be applied in both the evaluation of SBITs and in their prospective development. Consideration of these elements is thus critical if one is designing an SBIT to construct or elicit patient preferences. Furthermore, SBITs could be of particular value when patients have limited experience with the choice set and related
attributes, especially if they incorporate the seven design recommendations. SBITs that apply these recommendations offer unique potential to support patient preference construction or elicitation.

A scoping review of scenario-based interactive tools used for patient preference construction and/or elicitation