Objective
The objective was to determine whether a paired-comparison/leaning scale method: a) could feasibly be used to elicit strength-of-preference scores for elective health care options in large community-based survey settings; and b) could reveal preferential sub-groups that would have been overlooked if only a categorical-response format had been used.
Study Design
Medicare beneficiaries in four different regions of the United States were interviewed in person. Participants considered 8 clinical scenarios, each with 2 to 3 different health care options. For each scenario, participants categorically selected their favored option, then indicated how strongly they favored that option relative to the alternative on a paired-comparison bi-directional Leaning Scale.
Results
Two hundred and two participants were interviewed. For 7 of the 8 scenarios, a clear majority (> 50%) indicated that, overall, they categorically favored one option over the alternative(s). However, the bi-directional strength-of-preference Leaning Scale scores revealed that, in 4 scenarios, for half of those participants, their preference for the favored option was actually “weak” or “neutral”.
Conclusion
Investigators aiming to assess population-wide preferential attitudes towards different elective health care scenarios should consider gathering ordinal-level strength-of-preference scores and could feasibly use the paired-comparison/bi-directional Leaning Scale to do so.