Open Access Study protocol

Community Preferences for the Allocation & Donation of Organs - The PAraDOx Study

Kirsten Howard1*, Stephen Jan2, John Rose3, Steven Chadban45, Richard DM Allen56, Michelle Irving17, Allison Tong17, Germaine Wong17, Jonathan C Craig17 and Alan Cass12

Author Affiliations

1 School of Public Health, University of Sydney, NSW, 2006, Australia

2 The George Institute for Global Health, Camperdown, NSW, Australia

3 Institute for Transport and Logistics Studies, University of Sydney, NSW, 2006, Australia

4 Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia

5 Sydney Medical School, University of Sydney, Sydney, Australia

6 Director of Transplantation Services, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia

7 Centre for Kidney Research, Westmead, NSW, Australia

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BMC Public Health 2011, 11:386  doi:10.1186/1471-2458-11-386

Published: 25 May 2011



Transplantation is the treatment of choice for people with severe organ failure. However, demand substantially exceeds supply of suitable organs; consequently many people wait months, or years to receive an organ. Reasons for the chronic shortage of deceased organ donations are unclear; there appears to be no lack of 'in principle' public support for organ donation.


The PAraDOx Study examines community preferences for organ donation policy in Australia. The aims are to 1) determine which factors influence decisions by individuals to offer their organs for donation and 2) determine the criteria by which the community deems the allocation of donor organs to be fair and equitable. Qualitative and quantitative methods will be used to assess community preferences for organ donation and allocation.

Focus group participants from the general community, aged between 18-80, will be purposively sampled to ensure a variety of cultural backgrounds and views on organ donation. Each focus group will include a ranking exercise using a modified nominal group technique. Focus groups of organ recipients, their families, and individuals on a transplant waiting list will also be conducted.

Using the qualitative work, a discrete choice study will be designed to quantitatively assess community preferences. Discrete choice methods are based on the premise that goods and services can be described in terms of a number of separate attributes. Respondents are presented with a series of choices where levels of attributes are varied, and a mathematical function is estimated to describe numerically the value respondents attach to different options. Two community surveys will be conducted in approximately 1000 respondents each to assess community preferences for organ donation and allocation. A mixed logit model will be used; model results will be expressed as parameter estimates (β) and the odds of choosing one option over an alternative. Trade-offs between attributes will also be calculated.


By providing a better understanding of current community preferences in relation to organ donation and allocation, the PAraDOx study will highlight options for firstly, increasing the rate of organ donation and secondly, allow for more transparent and equitable policies in relation to organ allocation.