The Illusion of Stable Preferences over Major Life Decisions

Mueller, Maximilian; Hicks, Joan; Johnson‐Hanks, Jennifer; Miguel, Edward

doi:10.3386/w25844

Cited by 7 publications

(8 citation statements)

References 30 publications

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“…The correspondence between timing desires and pregnancy weakens when assessed on a one-year time frame and might deteriorate further over longer time horizons. Women's fertility desires are flexible and sensitive to changing life circumstances (Mueller et al 2019;Trinitapoli and Yeatman 2018). Heightened recognition of the flexibility and contingency of fertility desires, however, does not mean that desires cannot be highly predictive in the short-term.…”

Section: Discussionmentioning

confidence: 99%

The Enduring Case for Fertility Desires

2020

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Persistently high levels of unintended fertility, combined with evidence that over- and underachieved fertility are typical and not exceptional, have prompted researchers to question the utility of fertility desires writ large. In this study, we elaborate this paradox: widespread unintendedness and meaningful, highly predictive fertility desires can and do coexist. Using data from Malawi, we demonstrate the predictive validity of numeric fertility timing desires over both four-month and one-year periods. We find that fertility timing desires are highly predictive of pregnancy and that they follow a gradient wherein the likelihood of pregnancy decreases in correspondence with desired time to next birth. This finding holds despite the simultaneous observation of high levels of unintended pregnancy in our sample. Discordance between desires and behaviors reflects constraints to achieving one’s fertility and the fluidity of desires but not their irrelevance. Fertility desires remain an essential—if sometimes blunt—tool in the demographers’ toolkit.

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Section: Discussionmentioning

confidence: 99%

The Enduring Case for Fertility Desires

2020

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“…Reported be liefs were sig nif cantly shifted by the in ter view ers' knowl edge, with their es ti mated rates de creas ing by about nine per cent age points, or roughly 0.3 stan dard de vi a tions of the con trolgroup be lief dis tri bu tion. This result can help ex plain the puz zling fnd ing that peo ple's pref er ences and be liefs ap pear to be very un sta ble in panel sur veys (Chuang and Schecter 2015;Mueller et al 2019). If recorded re sponses are heavily shaped by in ter view ers' knowl edge and be liefs, then peo ple's an swers may ap pear to be much more un sta ble than they re ally are.…”

Section: Introductionmentioning

confidence: 91%

You Know What I Know: Interviewer Knowledge Effects in Subjective Expectation Elicitation

Kerwin

Reynoso

2021

Demography

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Directly eliciting individuals' subjective beliefs via surveys is increasingly popular in social science research, but doing so via face-to-face surveys has an important downside: the interviewer's knowledge of the topic may spill over onto the respondent's recorded beliefs. Using a randomized experiment that used interviewers to implement an information treatment, we show that reported beliefs are significantly shifted by interviewer knowledge. Trained interviewers primed respondents to use the exact numbers used in the training, nudging them away from higher answers; recorded responses decreased by about 0.3 standard deviations of the initial belief distribution. Furthermore, respondents with stronger prior beliefs were less affected by interviewer knowledge. We suggest corrections for this issue from the perspectives of interviewer recruitment, survey design, and experiment setup.

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“…Few studies assessed the stability of preferences over some duration using repeated assessment of the same individuals [19,29]. To our knowledge, only one study has compared within-person versus betweenperson preferences over time [19]. Although the study population was very different, a comparable pattern was observed.…”

Section: Does the Relative Importance Of Those Domains Change Within ...mentioning

confidence: 99%

“…Two studies have evaluated patient recovery priorities at a single timepoint [7,26]. Few studies assessed the stability of preferences over some duration using repeated assessment of the same individuals [19,29]. To our knowledge, only one study has compared within-person versus betweenperson preferences over time [19].…”

Section: Does the Relative Importance Of Those Domains Change Within ...mentioning

confidence: 99%

Patients Place More of an Emphasis on Physical Recovery Than Return to Work or Financial Recovery

O’Hara

Kringos

Slobogean

et al. 2020

Clin Orthop Relat Res

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Background Value-based healthcare models aim to incentivize healthcare providers to offer interventions that address determinants of health. Understanding patient priorities for physical and socioeconomic recovery after injury can help determine which services and resources are most useful to patients. Questions/purposes (1) Do trauma patients consistently identify a specific aspect/domain of recovery as being most important at 6 weeks, 6 months, and 12 months after an injury? (2) Does the relative importance of those domains change within the first year after injury? (3) Are differences in priorities greater between patients than for a given patient over time? (4) Are different recovery priorities associated with identifiable biopsychosocial factors? Methods Between June 2018 and December 2018, 504 adult patients with fractures of the extremities or pelvis were surgically treated at the study site. For this prospective longitudinal study, we purposefully sampled patients from 6 of the 12 orthopaedic attendings’ postoperative clinics. The participating surgeons surgically treated 243 adult patients with fractures of the extremities or pelvis. Five percent (11 of 243) of patients met inclusion criteria but missed their appointments during the 6-week recruitment window and could not be consented. We excluded 4% (9 of 243) of patients with a traumatic brain injury, 1% (2) of patients with a spinal cord injury, and 5% (12) of non-English-speaking patients (4% Spanish speaking [10]; 1% other languages [2]). Eighty-six percent of eligible patients (209 of 243) were approached for consent, and 5% (11 of 209) of those patients refused to participate. All remaining 198 patients consented and completed the baseline survey; 83% (164 of 198 patients) completed at least 6 months of follow-up, and 68% (134 of 198 patients) completed the 12-month assessment. The study participants’ mean age was 44 ± 17 years, and 63% (125 of 198) were men. The primary outcome was the patient’s recovery priorities, assessed at 6 weeks, 6 months, and 12 months after fracture using a discrete choice experiment. Discrete choice experiments are a well-established method for eliciting decisional preferences. In this technique, respondents are presented with a series of hypothetical scenarios, described by a set of plausible attributes or outcomes, and asked to select their preferred scenario. We used hierarchical Bayesian modeling to calculate individual-level estimates of the relative importance of physical recovery, work-related recovery, and disability benefits, based on the discrete choice experiment responses. The hierarchical Bayesian model improves upon more commonly used regression techniques by accounting for the observed response patterns of individual patients and the sequence of scenarios presented in the discrete choice experiment when calculating the model estimates. We computed the coefficient of variation for the three recovery domains and compared the between-patient versus within-patient differences using asymptotic tests. Separate prognostic models were fit for each of the study’s three recovery domains to assess marginal changes in the importance of the recovery domain based on patient characteristics and factors that remained constant over the study (such as sex or preinjury work status) and patient characteristics and factors that varied over the study (including current work status or patient-reported health status). We previously published the 6-week results. This paper expands upon the prior publication to evaluate longitudinal changes in patient recovery priorities. Results Physical recovery was the respondents’ main priority at all three timepoints, representing 60% ± 9% of their overall concern. Work-related recovery and access to disability benefits were of secondary importance and were associated with 27% ± 6% and 13% ± 7% of the patients’ concern, respectively. The patients’ concern for physical recovery was 6% (95% CrI 4% to 7%) higher at 12 months after fracture that at 6 weeks postfracture. The mean concern for work-related recovery increased by 7% (95% CrI 6% to 8%) from 6 weeks to 6 months after injury. The mean importance of disability benefits increased by 2% (95% CrI 1% to 4%) from 6 weeks to 6 months and remained 2% higher (95% CrI 0% to 3%) at 12 months after the injury. Differences in priorities were greater within a given patient over time than between patients as measured using the coefficient of variation (physical recovery [245% versus 7%; p < 0.001], work-related recovery [678% versus 12%; p < 0.001], and disability benefits [620% versus 33%; p < 0.001]. There was limited evidence that biopsychosocial factors were associated with variation in recovery priorities. Patients’ concern for physical recovery was 2% higher for every 10-point increase in their Patient-reported Outcome Measure Information System (PROMIS) physical health status score (95% CrI 1% to 3%). A 10-point increase in the patient’s PROMIS mental health status score was associated with a 1% increase in concern for work-related recovery (95% CrI 0% to 2%). Conclusion Work-related recovery and accessing disability benefits were a secondary concern compared with physical recovery in the 12 months after injury for patients with fractures. However, the importance of work-related recovery was elevated after the subacute phase. Priorities were highly variable within a given patient in the year after injury compared with between-patient differences. Given this variation, orthopaedic surgeons should consider assessing and reassessing the socioeconomic well-being of their patients throughout their continuum of care. Level of Evidence Level II, therapeutic study.

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The Illusion of Stable Preferences over Major Life Decisions

Abstract: NBER working papers are circulated for discussion and comment purposes. They have not been peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications.

Cited by 7 publications

References 30 publications

The Enduring Case for Fertility Desires

The Enduring Case for Fertility Desires

You Know What I Know: Interviewer Knowledge Effects in Subjective Expectation Elicitation

Patients Place More of an Emphasis on Physical Recovery Than Return to Work or Financial Recovery

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