Discrete choice experiments for complex health‐care decisions: does hierarchical information integration offer a solution?

Abstract

This paper describes an application of hierarchical information integration (HII) discrete choice experiments. We assessed theoretical and construct validity, as well as internal consistency, to investigate whether HII can be used to investigate complex multi-faceted health-care decisions (objective 1). In addition, we incorporated recent advances in mixed logit modelling (objective 2). Finally, we determined the response rate and predictive ability to study the feasibility of HII to support health-care management (objective 3). The clinical subject was the implementation of the guideline for breast cancer surgery in day care, which is a complex process that involves changes at the organizational and management levels, as well as the level of health-care professionals and that of patients.We found good theoretical and construct validity and satisfactory internal consistency. The proposed mixed logit model, which included repeated measures corrections and subexperiment error scale variations, also performed well. We found a poor response, but the model had satisfactory predictive ability. Therefore, we conclude that HII can be used successfully to study complex multi-faceted health-care decisions (objectives 1 and 2), but that the feasibility of HII to support health-care management, in particular in challenging implementation projects, seems less favourable (objective 3).

Facilitating the implementation of pharmacokinetic‐guided dosing of prophylaxis in haemophilia care by discrete choice experiment

“…Within a DCE, it is possible to consider both health and non‐health outcomes simultaneously . As the study population must choose between different options and make trade‐offs between several attributes and their levels, DCE can be used as a diagnostic tool to prioritize potential barriers and facilitators and to specify implementation strategies . To assess the internal consistency of responses, a rationality test was added consisting of a choice set where one of the two options was clearly superior at all levels.…”

“…Attributes and attribute levels for pharmacokinetic (PK)-guided dosing of prophylaxis with factor concentrate compared to current treatment. be used as a diagnostic tool to prioritize potential barriers and facilitators and to specify implementation strategies [10,21,22]. To assess the internal consistency of responses, a rationality test was added consisting of a choice set where one of the two options was clearly superior at all levels.…”

Investigating the complementary value of discrete choice experiments for the evaluation of barriers and facilitators in implementation research: a questionnaire survey

“…The DCE presented in this paper is described in detail elsewhere [ 8 ]. Therefore, we will now present the DCE method to the extent that the information is relevant for understanding of the present paper.…”

Travelers’ preferences regarding the interior of public buses: a hierarchical information integration approach

“…The large number of possible influential attributes stimulated us to choose the hierarchical information integration (HII) approach as presented by various researchers (e.g., Oppewal et al 1994;Molin and Timmermans 2009;Van Helvoort-Postulart et al (2009); Richter and Keuchel 2012). The approach includes the possibility to handle a large number of attributes by combining attributes into smaller sets of decision constructs.…”

“…The analysis in this paper focuses on the choices made by the respondents. To analyse the stated choices regarding the interiors of public buses standard multinomial logit modeling is used (e.g., Van Helvoort-Postulart et al 2009). As mentioned before, the model includes six constructs, each consisting of five attributes.…”