OBJECTIVES: The expansion of the EQ-5D descriptive system with bolt-on items raises the challenge of valuing more complex health states without causing cognitive overload, thus requiring the reevaluation of traditional complex valuation approaches for eliciting utility weights for multiple-attribute utility instruments. This study sought to examine the acceptability and feasibility of using a new valuation method, the single profile preference elicitation (SPP), for valuing the EQ-5D descriptive systems +1 bolt-on item and to compare it to a well-established preference elicitation method, the discrete choice experiment (DCE).

METHODS: This study used an adapted cognitive interviewing framework to evaluate and compare the (SPP) and (DCE) methods in terms of their general comprehension, cognitive burden, response and engagement, and acceptability. Data was collected through online qualitative interviews, where respondents were asked to complete blocks of SPP and DCE choice tasks (7 choice tasks each). A combination of the think-aloud method and expansive probing was used to gather respondents' reports. Interviews were transcribed and the data was coded using a hybrid deductive-inductive approach.

CONCLUSIONS: The SPP method emerged from this comparison as a simpler, less cognitively demanding and a more engaging method, which also mitigated the well-documented phenomena of preference indifference between severity labels in the EQ-5D.