Who pays attention in stated‐choice surveys?

Özdemir, Semra; Mohamed, Ateesha F.; Hauber, A. Brett

doi:10.1002/hec.1452

Cited by 34 publications

(28 citation statements)

References 24 publications

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“…As noted previously, DCEs are challenging for participants [44], requiring motivation, literacy, and numeracy, which may introduce selection bias [23]. We attempted to reduce this effect by using an interviewer rather than a postal questionnaire.…”

Section: Discussionmentioning

confidence: 99%

Patients' & Healthcare Professionals' Values Regarding True- & False-Positive Diagnosis when Colorectal Cancer Screening by CT Colonography: Discrete Choice Experiment

et al. 2013

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PurposeTo establish the relative weighting given by patients and healthcare professionals to gains in diagnostic sensitivity versus loss of specificity when using CT colonography (CTC) for colorectal cancer screening.Materials and MethodsFollowing ethical approval and informed consent, 75 patients and 50 healthcare professionals undertook a discrete choice experiment in which they chose between “standard” CTC and “enhanced” CTC that raised diagnostic sensitivity 10% for either cancer or polyps in exchange for varying levels of specificity. We established the relative increase in false-positive diagnoses participants traded for an increase in true-positive diagnoses.ResultsData from 122 participants were analysed. There were 30 (25%) non-traders for the cancer scenario and 20 (16%) for the polyp scenario. For cancer, the 10% gain in sensitivity was traded up to a median 45% (IQR 25 to >85) drop in specificity, equating to 2250 (IQR 1250 to >4250) additional false-positives per additional true-positive cancer, at 0.2% prevalence. For polyps, the figure was 15% (IQR 7.5 to 55), equating to 6 (IQR 3 to 22) additional false-positives per additional true-positive polyp, at 25% prevalence. Tipping points were significantly higher for patients than professionals for both cancer (85 vs 25, p<0.001) and polyps (55 vs 15, p<0.001). Patients were willing to pay significantly more for increased sensitivity for cancer (p = 0.021).ConclusionWhen screening for colorectal cancer, patients and professionals believe gains in true-positive diagnoses are worth much more than the negative consequences of a corresponding rise in false-positives. Evaluation of screening tests should account for this.

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Section: Discussionmentioning

confidence: 99%

Patients' & Healthcare Professionals' Values Regarding True- & False-Positive Diagnosis when Colorectal Cancer Screening by CT Colonography: Discrete Choice Experiment

et al. 2013

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“…Additionally, in the prostate cancer-screening cohort, a majority of the participants indicated that they did not understand one or more attributes (mostly the risk attributes). Studies state that a lack of understanding of certain attribute (levels) might be due to a lower educational level, older age and a lower health literacy [ 8 , 21 , 23 , 45 , 46 ]. The current study indeed showed that the number of attributes included in decision-making, decision strategy, interpretation of the risk attributes and understanding of the risk attributes differed between participants with different educational levels and health literacy scores.…”

Section: Discussionmentioning

confidence: 99%

Exploring how individuals complete the choice tasks in a discrete choice experiment: an interview study

Veldwijk

Determann

Lambooij

et al. 2016

BMC Med Res Methodol

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BackgroundTo be able to make valid inferences on stated preference data from a Discrete Choice Experiment (DCE) it is essential that researchers know if participants were actively involved, understood and interpreted the provided information correctly and whether they used complex decision strategies to make their choices and thereby acted in accordance with the continuity axiom.MethodsDuring structured interviews, we explored how 70 participants evaluated and completed four discrete choice tasks aloud. Hereafter, additional questions were asked to further explore if participants understood the information that was provided to them and whether they used complex decision strategies (continuity axiom) when making their choices. Two existing DCE questionnaires on rotavirus vaccination and prostate cancer-screening served as case studies.ResultsA large proportion of the participants was not able to repeat the exact definition of the risk attributes as explained to them in the introduction of the questionnaire. The majority of the participants preferred more optimal over less optimal risk attribute levels. Most participants (66 %) mentioned three or more attributes when motivating their decisions, thereby acting in accordance with the continuity axiom. However, 16 out of 70 participants continuously mentioned less than three attributes when motivating their decision. Lower educated and less literate participants tended to mention less than three attributes when motivating their decision and used trading off between attributes less often as a decision-making strategy.ConclusionThe majority of the participants seemed to have understood the provided information about the choice tasks, the attributes, and the levels. They used complex decision strategies (continuity axiom) and are therefore capable to adequately complete a DCE. However, based on the participants’ age, educational level and health literacy additional, actions should be undertaken to ensure that participants understand the choice tasks and complete the DCE as presumed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12874-016-0140-4) contains supplementary material, which is available to authorized users.

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“…The prior28 estimates of attribute coefficients used in the final efficient design were derived from a pilot survey (see below). A further three choice sets were added to each block as tests of transitivity29 30 and monotonicity29—which are tests of theoretical validity and rationality of choice sets used in the DCE. Theoretical validity and rationality checks assessed whether the parameters moved in the expected direction.…”

Section: Methodsmentioning

confidence: 99%

Preferences for centralised emergency medical services: discrete choice experiment

et al. 2019

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ObjectivesIt is desirable that public preferences are established and incorporated in emergency healthcare reforms. The aim of this study was to investigate preferences for local versus centralised provision of all emergency medical services (EMS) and explore what individuals think are important considerations for EMS delivery.DesignA discrete choice experiment was conducted. The attributes used in the choice scenarios were: travel time to the hospital, waiting time to be seen, length of stay in the hospital, risks of dying, readmission and opportunity for outpatient care after emergency treatment at a local hospital.SettingNorth East England.ParticipantsParticipants were a randomly sampled general population, aged 16 years or above recruited from Healthwatch Northumberland network database of lay members and from clinical contact with Northumbria Healthcare National Health Service Foundation Trust via Patient Experience Team.Primary and secondary outcome measuresAnalysis used logistic regression modelling techniques to determine the preference of each attribute. Marginal rates of substitution between attributes were estimated to understand the trade-offs individuals were willing to make.ResultsResponses were obtained from 148 people (62 completed a web and 86 a postal version). Respondents preferred shorter travel time to hospital, shorter waiting time, fewer number of days in hospital, low risk of death, low risk of readmission and outpatient follow-up care in their local hospital. However, individuals were willing to trade off increased travel time and waiting time for high-quality centralised care. Individuals were willing to travel 9 min more for a 1-day reduction in length of stay in the hospital, 38 min for a 1% reduction in risk of death and 112 min for having outpatient follow-up care at their local hospital.ConclusionsPeople value centralised EMS if it provides higher quality care and are willing to travel further and wait longer.

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Who pays attention in stated‐choice surveys?

Cited by 34 publications

References 24 publications

Patients' & Healthcare Professionals' Values Regarding True- & False-Positive Diagnosis when Colorectal Cancer Screening by CT Colonography: Discrete Choice Experiment

Patients' & Healthcare Professionals' Values Regarding True- & False-Positive Diagnosis when Colorectal Cancer Screening by CT Colonography: Discrete Choice Experiment

Exploring how individuals complete the choice tasks in a discrete choice experiment: an interview study

Preferences for centralised emergency medical services: discrete choice experiment

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