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A Simulation-Based Discrete Choice Experiment Framework for Alzheimer’s Disease-Modifying Therapy Implementation: Methodology and Interactive Decision Support Tool
Sen SE.. Research Square, 2026-04-14
Topic: Health services, long-term care and technology
Under calibrated simulation parameters, slowing of cognitive decline emerged as the most important attribute (relative importance 25.7%), followed by annual cost (17.6%), ARIA risk (15.4%), and travel to treatment centre (13.0%). Implementation-related attributes collectively accounted for 42.5% of total attribute importance, exceeding treatment characteristics alone (35.9%). Simulated willingness-to-pay for a 10-percentage-point improvement in cognitive decline slowing was €12,857 per year. Latent class analysis identified three illustrative preference segments: efficacy-driven (42%), access-prioritising (35%), and risk-averse (23%). Sensitivity analysis across a wide range of plausible parameter values confirmed the robustness of the finding that implementation factors rival treatment characteristics in importance. This simulation-based framework provides a methodologically rigorous, immediately deployable platform for preference elicitation in Alzheimer’s DMT implementation. The interactive dashboard enables national DMT working groups and HTA bodies to adopt the framework for real-world data collection, replacing simulated parameters with empirical estimates while retaining the validated analytical infrastructure. The framework is designed for direct adoption by national DMT working groups and HTA bodies globally.
Key findings
- Under calibrated simulation parameters, slowing of cognitive decline emerged as the most important attribute (relative importance 25.7%), followed by annual cost (17.6%), ARIA risk (15.4%), and travel to treatment centre (13.0%).
- Implementation-related attributes collectively accounted for 42.5% of total attribute importance, exceeding treatment characteristics alone (35.9%).
- Simulated willingness-to-pay for a 10-percentage-point improvement in cognitive decline slowing was €12,857 per year.
- Latent class analysis identified three illustrative preference segments: efficacy-driven (42%), access-prioritising (35%), and risk-averse (23%).
- Sensitivity analysis across a wide range of plausible parameter values confirmed the robustness of the finding that implementation factors rival treatment characteristics in importance.
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Study details
- Effect size25.7%; 17.6%; 15.4%
- Evidence strengthLow
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 24 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for study design, sample size, studied in people and randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 15 of the 62 points we could judge it on, which is 24 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (Research Square) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 15 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 15 of the 62 points we could judge it on is 24 out of 100. |
| Total | 24 / 100 | Capped to 16 because this is not a peer-reviewed article. |
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Sen, S. E. (2026). A Simulation-Based Discrete Choice Experiment Framework for Alzheimer’s Disease-Modifying Therapy Implementation: Methodology and Interactive Decision Support Tool. Research Square. https://doi.org/10.21203/rs.3.rs-9404461/v1
Vancouver
Sen SE. A Simulation-Based Discrete Choice Experiment Framework for Alzheimer’s Disease-Modifying Therapy Implementation: Methodology and Interactive Decision Support Tool. Research Square. 2026. doi:10.21203/rs.3.rs-9404461/v1.
BibTeX
@article{sen2026-0a617270,
author = {Sen, S. E.},
title = {{A Simulation-Based Discrete Choice Experiment Framework for Alzheimer’s Disease-Modifying Therapy Implementation: Methodology and Interactive Decision Support Tool}},
journal = {Research Square},
year = {2026},
doi = {10.21203/rs.3.rs-9404461/v1},
url = {https://doi.org/10.21203/rs.3.rs-9404461/v1}
}