Valuing EQ-5D-5L health states ‘in context’ using a discrete choice experiment

Cole, A; Shah, K; Mulhern, B; Feng, Y; Devlin, N

Valuing EQ-5D-5L health states ‘in context’ using a discrete choice experiment

Cole, A Shah, K Mulhern, B

Feng, Y Devlin, N

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Publication Type:: Journal Article
Citation:: European Journal of Health Economics, 2018, 19 (4), pp. 595 - 605
Issue Date:: 2018-05-01

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Field	Value	Language
dc.contributor.author	Cole, A	en_US
dc.contributor.author	Shah, K	en_US
dc.contributor.author	Mulhern, B https://orcid.org/0000-0003-3656-8063	en_US
dc.contributor.author	Feng, Y	en_US
dc.contributor.author	Devlin, N	en_US
dc.date.available	2017-05-23	en_US
dc.date.issued	2018-05-01	en_US
dc.identifier.citation	European Journal of Health Economics, 2018, 19 (4), pp. 595 - 605	en_US
dc.identifier.issn	1618-7598	en_US
dc.identifier.uri	http://hdl.handle.net/10453/124277
dc.description.abstract	© 2017, Springer-Verlag Berlin Heidelberg. Background: In health state valuation studies, health states are typically presented as a series of sentences, each describing a health dimension and severity ‘level’. Differences in the severity levels can be subtle, and confusion about which is ‘worse’ can lead to logically inconsistent valuation data. A solution could be to mimic the way patients self-report health, where the ordinal structure of levels is clear. We develop and test the feasibility of presenting EQ-5D-5L health states in the ‘context’ of the entire EQ-5D-5L descriptive system. Methods: An online two-arm discrete choice experiment was conducted in the UK (n = 993). Respondents were randomly allocated to a control (standard presentation) or ‘context’ arm. Each respondent completed 16 paired comparison tasks and feedback questions about the tasks. Differences across arms were assessed using regression analyses. Results: Presenting health states ‘in context’ can significantly reduce the selection of logically dominated health states, particularly for labels ‘severe’ and ‘extreme’ (χ2 = 46.02, p < 0.001). Preferences differ significantly between arms (likelihood ratio statistic = 42.00, p < 0.05). Comparing conditional logit modeling results, coefficients are ordered as expected for both arms, but the magnitude of decrements between levels is larger for the context arm. Conclusions: Health state presentation is a key consideration in the design of valuation studies. Presenting health states ‘in context’ affects valuation data and reduces logical inconsistencies. Our results could have implications for other valuation tasks such as time trade-off, and for the valuation of other preference-based measures.	en_US
dc.relation.ispartof	European Journal of Health Economics	en_US
dc.relation.isbasedon	10.1007/s10198-017-0905-7	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Choice Behavior	en_US
dc.subject.mesh	Health Status	en_US
dc.subject.mesh	Quality of Life	en_US
dc.subject.mesh	Adolescent	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Young Adult	en_US
dc.subject.mesh	Self Report	en_US
dc.subject.mesh	Surveys and Questionnaires	en_US
dc.title	Valuing EQ-5D-5L health states ‘in context’ using a discrete choice experiment	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	19	en_US
utslib.for	1402 Applied Economics	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	19	en_US

Abstract:

© 2017, Springer-Verlag Berlin Heidelberg. Background: In health state valuation studies, health states are typically presented as a series of sentences, each describing a health dimension and severity ‘level’. Differences in the severity levels can be subtle, and confusion about which is ‘worse’ can lead to logically inconsistent valuation data. A solution could be to mimic the way patients self-report health, where the ordinal structure of levels is clear. We develop and test the feasibility of presenting EQ-5D-5L health states in the ‘context’ of the entire EQ-5D-5L descriptive system. Methods: An online two-arm discrete choice experiment was conducted in the UK (n = 993). Respondents were randomly allocated to a control (standard presentation) or ‘context’ arm. Each respondent completed 16 paired comparison tasks and feedback questions about the tasks. Differences across arms were assessed using regression analyses. Results: Presenting health states ‘in context’ can significantly reduce the selection of logically dominated health states, particularly for labels ‘severe’ and ‘extreme’ (χ2 = 46.02, p < 0.001). Preferences differ significantly between arms (likelihood ratio statistic = 42.00, p < 0.05). Comparing conditional logit modeling results, coefficients are ordered as expected for both arms, but the magnitude of decrements between levels is larger for the context arm. Conclusions: Health state presentation is a key consideration in the design of valuation studies. Presenting health states ‘in context’ affects valuation data and reduces logical inconsistencies. Our results could have implications for other valuation tasks such as time trade-off, and for the valuation of other preference-based measures.

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http://hdl.handle.net/10453/124277