Qualitative and Quantitative Analysis of Interviewer Help Answering the Time Tradeoff

Edelaar-Peeters, Yvette; Stiggelbout, Anne M.

doi:10.1177/0272989x14524989

Cited by 11 publications

(11 citation statements)

References 32 publications

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“…C-TTO exercises are complex, and the sequential nature of the task is subject to challenges that affect comparability [ 16 – 18 ]. It has been shown that the majority of participants completing TTO tasks need interviewer help [ 19 ] and, as most individuals have never previously completed a C-TTO exercise, the level of understanding is expected to vary between individuals. Interviewers play an important role in explaining the task to participants, but it is expected that the cognitive ability of the person also contributes to this understanding.…”

Section: Introductionmentioning

confidence: 99%

Assessing the Use of a Feedback Module to Model EQ-5D-5L Health States Values in Hong Kong

Wong

Ramos-Goñi

Cheung

et al. 2017

Patient

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BackgroundAn international valuation protocol exists for obtaining societal values for each of the 3125 health states of the five-level EuroQol-five dimensions (EQ-5D-5L) questionnaire. A feedback module (FM) that can be related to theoretical models used in behavioral economics was recently included in this protocol.ObjectivesOur objective was to assess the impact of using an FM to estimate an EQ-5D-5L value set in Hong Kong.MethodsEQ-5D-5L health states were elicited using a composite time trade-off (C-TTO) and a discrete-choice (DC) experiment. Use of the FM according to participant characteristics and the impact of the FM on the number of inconsistent C-TTO responses were assessed. We employed a main-effects hybrid model that combined data from both elicitation techniques.ResultsIn total, 1014 individuals completed the survey. The sample was representative of the general Chinese Hong Kong population in terms of sex, educational attainment, marital status, and most age groups but not for employment status. The use of the FM reduced the number of C-TTO inconsistencies. Participant characteristics differed significantly between those who used and did not use the FM. The model without a constant resulted in logical consistent coefficients and was therefore selected as the model to produce the value set. The predicted EQ-5D-5L values ranged from −0.864 to 1.ConclusionsThe use of an FM to allow participants to exclude C-TTO responses reduced the number of inconsistent responses and improved the quality of the data when estimating an EQ-5D-5L value set in Hong Kong.Electronic supplementary materialThe online version of this article (doi:10.1007/s40271-017-0278-0) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Assessing the Use of a Feedback Module to Model EQ-5D-5L Health States Values in Hong Kong

Wong

Ramos-Goñi

Cheung

et al. 2017

Patient

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“…that respondents often have difficulty distinguishing between the health states to be valued, understanding the hypothetical nature of health states, and conceptualizing being dead; the research also points out that the respondents may have their own religious or spiritual beliefs about being dead [85][86][87]. These cognitive distortions include those relating to the framing of issues, anchoring, time inconsistency, making choices in the presence of uncertainty (what will be happening after the 10/20 years of the TTO representation?…”

Section: Cognitive Understandingmentioning

confidence: 99%

An overview of the time trade-off method: concept, foundation, and the evaluation of distorting factors in putting a value on health

Lugnér¹,

Krabbe

2020

Expert Review of Pharmacoeconomics & Outcomes Research

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Introduction: Preference-based instruments measuring health status express the value of specific health states in a single number. One method used is time trade-off (TTO). Health-status values are key elements in calculating quality-adjusted life years (QALYs) and are pertinent for resource allocation. Since they are used in economic evaluations of healthcare, searching for a theoretical foundation of TTO in economics is justified. Area covered: This paper provides an overview of TTO, including its relation to economic theory, and discusses biases and distortions, compiled from recent and older research. Inconsistencies between TTO and random utility theory were detected; The TTO is confounded by time preferences and by respondents' life expectancies. TTO is cognitively challenging, therefore guidance during the interviews is needed, producing interview effects. TTO does not measure one thing at a time, nor are the values independent of other states that are being valued in the same task. That is, TTO does not exhibit theoretical measurement properties such as unidimensionality and the invariance principle. Expert opinion: We conclude that the TTO may be a pragmatic method of eliciting health state values, but the limitations in regard to measurement theory and practical elicitation problems makes it prone to inconsistencies and arbitrariness.

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“…This face-to-face elicitation of preferences has been refined and may be considered the de facto standard to ensure respondent attendance/engagement with an understanding of the task. However, such a process is resource and timeintensive [1][2][3][4]. Additional shortcomings of in-person studies include potential social desirability bias in respondent answers, difficulty recruiting certain populations, and respondent unwillingness to answer sensitive questions, which may contribute to missing data, increase bias, and limit generalizability [3,5].…”

Section: Introductionmentioning

confidence: 99%

Comparison of online and face-to-face valuation of the EQ-5D-5L using composite time trade-off

et al. 2020

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Objective The aim of this study was to compare online, unsupervised and face-to-face (F2F), supervised valuation of EQ-5D-5L health states using composite time trade-off (cTTO) tasks. Methods The official EuroQol experimental design and valuation protocol for the EQ-5D-5L of 86 health states were implemented in interviewer-assisted, F2F and unsupervised, online studies. Validity of preferences was assessed using prevalence of inconsistent valuations and expected patterns of TTO values. Respondent task engagement was measured using number of trade-offs and time per task. Trading patterns such as better-than-dead only was compared between modes. Value sets were generated using linear regression with a random intercept (RILR). Value set characteristics such as range of scale and dimension ranking were evaluated between modes. Results Five hundred one online and 1,134 F2F respondents completed the surveys. Mean elicited TTO values were higher online than F2F when compared by health state severity. Compared to F2F, a larger proportion of online respondents did not assign the poorest EQ-5D-5L health state (i.e., 55555) the lowest TTO value ([Online] 41.3% [F2F] 12.2%) (p < 0.001). A higher percentage of online cTTO tasks were completed in 3 trade-offs or fewer ([Online] 15.8% [F2F] 3.7%), (p < 0.001). When modeled using the RILR, the F2F range of scale was larger than online ([Online] 0.600 [F2F] 1.307) and the respective dimension rankings differed. Conclusions Compared to F2F data, TTO tasks conducted online had more inconsistencies and decreased engagement, which contributed to compromised data quality. This study illustrates the challenges of conducting online valuation studies using the TTO approach.

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Qualitative and Quantitative Analysis of Interviewer Help Answering the Time Tradeoff

Cited by 11 publications

References 32 publications

Assessing the Use of a Feedback Module to Model EQ-5D-5L Health States Values in Hong Kong

Assessing the Use of a Feedback Module to Model EQ-5D-5L Health States Values in Hong Kong

An overview of the time trade-off method: concept, foundation, and the evaluation of distorting factors in putting a value on health

Comparison of online and face-to-face valuation of the EQ-5D-5L using composite time trade-off

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