Deciding Between SF-6Dv2 Health States: A Think-Aloud Study of Decision-Making Strategies Used in Discrete Choice Experiments

Dec 1, 2022, 00:00
10.1016/j.jval.2022.07.018
https://www.valueinhealthjournal.com/article/S1098-3015(22)02138-6/fulltext
Title : Deciding Between SF-6Dv2 Health States: A Think-Aloud Study of Decision-Making Strategies Used in Discrete Choice Experiments
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(22)02138-6&doi=10.1016/j.jval.2022.07.018
First page : 2034
Section Title : PREFERENCE-BASED ASSESSMENTS
Open access? : Yes
Section Order : 2034

Objective

This study aimed to gain insight into decision-making strategies individuals used when evaluating pairs of SF-6Dv2 health states in discrete choice experiments (DCEs).

Methods

This qualitative, cross-sectional, noninterventional study asked participants to use a think-aloud approach to compare SF-6Dv2 health states in DCEs. Thematic analysis focused on comprehension and cognitive strategies used to compare health states and make decisions.

Results

Participants (N = 40) used 3 main strategies when completing DCEs: (1) trading, (2) reinterpretation, and (3) relying on previous experience. Trading was the most common strategy, used by everyone at least once, and involved prioritizing key attributes, such as preferring a health state with significant depression but no bodily pain. Reinterpretation was used by 17 participants and involved reconstructing health states by changing underlying assumptions (eg, rationalizing selecting a health state with significant pain because they could take pain medications). Finally, some (n = 13) relied on previous experience when making decisions on some choice tasks. Participants with experience dealing with pain, for instance, prioritized health states with the least impact in this dimension.

Conclusions

Qualitatively evaluating the decision-making strategies used in DCEs allows researchers to evaluate whether the tasks and attributes are interpreted accurately. The findings from this study add to the understanding of the generation of SF-6Dv2 health utility weights and the validity of these weights (e.g., reinterpreting health states could undermine the validity of DCEs and utility weights), and the overall usefulness of the SF-6Dv2. The methodology described in this study can and should be carried forth in valuing other health utility measures, not just the SF-6Dv2.

Categories :
  • Decision Modeling & Simulation
  • Health State Utilities
  • Instrument Development, Validation, & Translation
  • Patient-Centered Research
  • Study Approaches
  • Surveys & Expert Panels
Tags :
  • discrete choice experiment
  • health state utility
  • qualitative
  • SF-6Dv2
  • think-aloud
Regions :
  • North America
ViH Article Tags :