New Research Provides External Validation in Choices for Influenza
Vaccination or Colorectal Cancer Screening
NJ, USA—September 23, 2019—Value in
Health, the official journal of ISPOR—the professional society for health economics
and outcomes research, announced today the publication
of research demonstrating that discrete choice experiments (DCEs) are able to
predict real-world healthcare choices. The report, “Are
Healthcare Choices Predictable? The Impact of Discrete Choice Experiment Designs
and Models,” was published in the September
2019 issue of Value in Health.
The discrete choice experiment technique, originating from
mathematical psychology, is mainstream in marketing, transport, and
environmental economics, where it is used to predict individual and collective
choices. DCEs have also been introduced in health economics, where they are
commonly used for valuing health and nonhealth outcomes, investigating
trade-offs between health and nonhealth outcomes, and developing priority setting
frameworks. Currently, among other barriers, the lack of evidence about the external
validity of DCEs inhibits their greater use in healthcare decision making.
Researchers from The Netherlands and Australia sought to determine
whether the number of alternatives in a DCE choice task should reflect the
actual decision context, and how complex the choice model needs to be to be
able to predict real-world healthcare choices. Six DCEs were used, varying with
regard to medical condition (influenza vaccination or colorectal cancer
screening) and the number of alternatives per choice task. For each medical
condition, 1200 respondents were randomized to one of the DCE formats.
At an aggregate level, the choice mimicking a real-world
decision to opt for influenza vaccination and colorectal cancer screening was
correctly predicted by a DCE-based model, if scale and preference heterogeneity
were taken into account. At an individual level, the use of 3 alternatives per
choice task and a heteroskedastic error component model seemed to be most promising,
correctly predicting in 93.6% and 97.1% of the cases for vaccination and
screening, respectively. Five respondent characteristics
consistently explained a part of the observed scale and/or preference
heterogeneity: sex, numeracy skill (the ability to understand and work with
numbers), decision-making style, general attitude toward the health intervention
of interest, and experience with the health intervention of interest.
“Our study shows that discrete choice experiments are able to predict
choices—mimicking real-world decisions—if at least scale and preference
heterogeneity are taken into account,” said author Esther W. de Bekker-Grob,
PhD, Erasmus School of Health Policy & Management, Erasmus University
Rotterdam, The Netherlands. “While further research is needed to determine
whether this result remains in other contexts, we are pleased that our work has
contributed to the evidence regarding the external validity of discrete choice
experiments in healthcare decision making.”
ISPOR, the professional society for health economics and outcomes research (HEOR), is an international, multistakeholder, nonprofit dedicated to advancing HEOR excellence to improve decision making for health globally. The Society is the leading source for scientific conferences, peer-reviewed and MEDLINE®-indexed publications, good practices guidance, education, collaboration, and tools/resources in the field.
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ABOUT VALUE IN HEALTH
Value in Health (ISSN 1098-3015) is an international, indexed journal that publishes original research and health policy articles that advance the field of health economics and outcomes research to help healthcare leaders make evidence-based decisions. The journal’s 2018 impact factor score is 5.037. Value in Health is ranked 4th among 81 journals in health policy and services, 5th among 98 journals in healthcare sciences and services, and 11th among 363 journals in economics. Value in Health is a monthly publication that circulates to more than 10,000 readers around the world.
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