Martina Vandebroek

Background: Shared decision making (SDM) is increasingly promoted in inflammatory bowel disease (IBD) care, yet evidence on its implementation in routine practice and influencing factors remains limited. This study aimed to examine SDM in IBD by assessing: (1) knowledge of SDM; (2) preferences and experiences regarding involvement in decision‐making, including alignment between preferred and experienced roles and decision‐related outcomes; and (3) perceived barriers and facilitators to SDM implementation. Methods: A cross‐sectional, multi‐stakeholder survey was conducted among patients with IBD and healthcare professionals (HCPs) in Belgium. Validated instruments were used (SDM‐Q‐9, SDM‐Q‐Doc, CollaboRATE, incorpoRATE, Control Preferences Scale, and Decision Regret Scale) alongside study‐specific items. Results: A total of 255 patients and 36 HCPs completed the survey. Patients reported lower self‐perceived SDM knowledge than HCPs (mean 3.69 vs. 6.86; p < 0.001), as well as lower objective knowledge (6.15 vs. 8.69; p < 0.001). Most patients considered involvement in decision‐making important (96.0%), with 56.1% favoring a shared role. Concordance between preferred and experienced roles was 53.7%, with 36.1% experiencing a more passive role than desired. Patients reported moderate levels of SDM during consultations (SDM‐Q‐9 mean 61.8), whereas gastroenterologists reported higher levels (SDM‐Q‐Doc mean 84.2). Only 18.8% of patients reported the highest possible level of SDM during consultations. Greater perceived SDM was associated with higher satisfaction and lower decision regret (both p < 0.001), while patients who experienced less involvement than preferred reported higher decision regret than those whose experienced role matched their preference. Key barriers included time constraints and communication challenges; trust and communication quality were key facilitators. Conclusion: Despite patients' strong preference for involvement in decision‐making, SDM in IBD care remains inconsistently implemented, with discrepancies between patient and clinician perspectives. Furthermore, alignment between patients' preferred and experienced involvement was only moderate and was associated with more favorable decision‐related outcomes, including lower decision regret. Improving SDM therefore requires actively exploring how patients want to be involved in decisions, strengthening communication skills, and addressing structural barriers, including time constraints and interprofessional support.

In this article, we describe the mixrandregret command, which extends the randregret command introduced in Gutiérrez-Vargas, Meulders, and Vandebroek (2021, Stata Journal 21: 626–658) by allowing random coefficients in random regret minimization models. The newly developed mixrandregret command allows the user to specify a combination of fixed and random coefficients in the regret function of the classical random regret minimization model introduced in Chorus (2010, European Journal of Transport and Infrastructure Research 10: 181–196). In addition, the user can specify normal and lognormal distributions for the random coefficients using the appropriate command’s options. The models are fit by maximum simulated likelihood estimation using numerical integration to approximate the choice probabilities.

For health, environmental, and animal welfare reasons, an increase in the consumption of meat in our diet is of great concern in today’s society. Meat substitutes have been advocated for a long time as a solution to these problems and are evolving continuously with technological advancements. Despite these efforts, it is remarkable that meat alternatives only account for a small portion of the global meat market. As a result, we examined the factors that affect Flemish consumers’ preferences for meat substitutes in Belgium using a discrete choice experiment. We also examined consumers’ preferences after providing additional information, as well as the impact of color-coding certain attribute levels on their preferences. The study was conducted using a sample size of 162 participants selected via convenience sampling. The findings show that it is important to keep the sensory properties of meat substitutes similar to those of actual meat. The results also indicate that additional information regarding the environmental and health impact of meat consumption can help to promote meat substitutes. The traffic light color coding of the levels of saturated fat and ecofootprint attributes increases the preference for healthy and environmentally friendly alternatives. Finally, we observed that individual-level variations in the utility attributed to meat substitutes are explained significantly by age, gender, education, current diet group, and attitudinal factors. Overall, we can conclude that the promotion of meat substitutes can be achieved via a combined strategy that focuses on improving the taste, appearance, and nutritional profile of meat substitutes, as well as raising consumers’ awareness of the environmental and health impact of meat consumption.