OBJECTIVES

Best-worst scaling (BWS) increasingly becomes an attractive instrument in China to quantify preferences for health. However, the general state and quality of health-related BWS was not reviewed. The aim of this study was to identify all health-related BWS in China and to provide a description of current practice and future challenges.

METHODS

A systematic literature review was conducted to identify health-related BWS published before 2020. The assessment focused on five issues: identification of attributes and levels, experimental design; econometric analysis; validity of responses, and interpretation of results.

RESULTS

Of the 14 abstracts we screened, 5 studies were included for data extraction and validity assessment. The studies we identified covered health human resource and health-related quality of life measurement, with the application of qualitative methods (e.g., focus group) to identify attributes and levels. Sophisticated designs (e.g., D-efficient) and flexible econometric models (e.g., mixed logit) were used for estimation. However, no study presented sufficient methodological details. The validity of responses was not adequately considered, due to the lack of internal validity tests incorporated within BWS questionnaire.

CONCLUSIONS

The use of empirical BWS covered important health policy questions and boosted preference elicitation in China. Inadequate disclosure of methodological details impedes quality assessment and indicates an early stage of development in BWS application in China. Careful identification of attributes, efficient design, advanced models to incorporate heterogeneities, adequate assessment of external and internal validity, appropriate interpretation of results may contribute to the integration of health-related BWS into the decision-making process.