Designing Unforced Choice Experiments to Inform Health Care Decision Making

Implications of Using Opt-Out, Neither, or Status Quo Alternatives in Discrete Choice Experiments

Domino Determann, Dorte Gyrd-Hansen, G Ardine de Wit, Esther W de Bekker-Grob, Ewout W Steyerberg, Mattijs S Lambooij, Line Bjørnskov Pedersen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Background. Discrete choice experiments (DCEs) are increasingly used in the health care context to inform on patient preferences for health care services. In order for such experiments to provide useful and policy-relevant information, it is vital that the design includes those options that the respondent faces in the real-life situation. Whether to include opt-out, neither, or status quo alternatives has, however, received little attention in the DCE literature. We aim to investigate whether the use of different unforced choice formats affects DCE results in different settings: 1) opt-out versus neither in a health care market where there is no status quo and 2) including status quo in addition to opt-out in a health care market with a status quo. Design. A DCE on Dutch citizens' preferences for personal health records served as our case, and 3189 respondents were allocated to the different unforced choice formats. We used mixed logit error component models to estimate preferences. Results. We found that the use of different unforced choice formats affects marginal utilities and welfare estimates and hence the conclusions that will be drawn from the DCE to inform health care decision making. Conclusions. To avoid biased estimates, we recommend that researchers are hesitant to use the neither option and consider including a status quo in addition to opt-out in settings where a status quo exists.

OriginalsprogEngelsk
TidsskriftMedical Decision Making
Vol/bind39
Udgave nummer6
Sider (fra-til)681-692
ISSN0272-989X
DOI
StatusUdgivet - aug. 2019

Fingeraftryk

Health Care Sector
Delivery of Health Care
Personal Health Records
Patient Preference
Health Services
Research Personnel
Surveys and Questionnaires

Citer dette

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title = "Designing Unforced Choice Experiments to Inform Health Care Decision Making: Implications of Using Opt-Out, Neither, or Status Quo Alternatives in Discrete Choice Experiments",
abstract = "Background. Discrete choice experiments (DCEs) are increasingly used in the health care context to inform on patient preferences for health care services. In order for such experiments to provide useful and policy-relevant information, it is vital that the design includes those options that the respondent faces in the real-life situation. Whether to include opt-out, neither, or status quo alternatives has, however, received little attention in the DCE literature. We aim to investigate whether the use of different unforced choice formats affects DCE results in different settings: 1) opt-out versus neither in a health care market where there is no status quo and 2) including status quo in addition to opt-out in a health care market with a status quo. Design. A DCE on Dutch citizens' preferences for personal health records served as our case, and 3189 respondents were allocated to the different unforced choice formats. We used mixed logit error component models to estimate preferences. Results. We found that the use of different unforced choice formats affects marginal utilities and welfare estimates and hence the conclusions that will be drawn from the DCE to inform health care decision making. Conclusions. To avoid biased estimates, we recommend that researchers are hesitant to use the neither option and consider including a status quo in addition to opt-out in settings where a status quo exists.",
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Designing Unforced Choice Experiments to Inform Health Care Decision Making : Implications of Using Opt-Out, Neither, or Status Quo Alternatives in Discrete Choice Experiments. / Determann, Domino; Gyrd-Hansen, Dorte; de Wit, G Ardine; de Bekker-Grob, Esther W; Steyerberg, Ewout W; Lambooij, Mattijs S; Bjørnskov Pedersen, Line.

I: Medical Decision Making, Bind 39, Nr. 6, 08.2019, s. 681-692.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Designing Unforced Choice Experiments to Inform Health Care Decision Making

T2 - Implications of Using Opt-Out, Neither, or Status Quo Alternatives in Discrete Choice Experiments

AU - Determann, Domino

AU - Gyrd-Hansen, Dorte

AU - de Wit, G Ardine

AU - de Bekker-Grob, Esther W

AU - Steyerberg, Ewout W

AU - Lambooij, Mattijs S

AU - Bjørnskov Pedersen, Line

PY - 2019/8

Y1 - 2019/8

N2 - Background. Discrete choice experiments (DCEs) are increasingly used in the health care context to inform on patient preferences for health care services. In order for such experiments to provide useful and policy-relevant information, it is vital that the design includes those options that the respondent faces in the real-life situation. Whether to include opt-out, neither, or status quo alternatives has, however, received little attention in the DCE literature. We aim to investigate whether the use of different unforced choice formats affects DCE results in different settings: 1) opt-out versus neither in a health care market where there is no status quo and 2) including status quo in addition to opt-out in a health care market with a status quo. Design. A DCE on Dutch citizens' preferences for personal health records served as our case, and 3189 respondents were allocated to the different unforced choice formats. We used mixed logit error component models to estimate preferences. Results. We found that the use of different unforced choice formats affects marginal utilities and welfare estimates and hence the conclusions that will be drawn from the DCE to inform health care decision making. Conclusions. To avoid biased estimates, we recommend that researchers are hesitant to use the neither option and consider including a status quo in addition to opt-out in settings where a status quo exists.

AB - Background. Discrete choice experiments (DCEs) are increasingly used in the health care context to inform on patient preferences for health care services. In order for such experiments to provide useful and policy-relevant information, it is vital that the design includes those options that the respondent faces in the real-life situation. Whether to include opt-out, neither, or status quo alternatives has, however, received little attention in the DCE literature. We aim to investigate whether the use of different unforced choice formats affects DCE results in different settings: 1) opt-out versus neither in a health care market where there is no status quo and 2) including status quo in addition to opt-out in a health care market with a status quo. Design. A DCE on Dutch citizens' preferences for personal health records served as our case, and 3189 respondents were allocated to the different unforced choice formats. We used mixed logit error component models to estimate preferences. Results. We found that the use of different unforced choice formats affects marginal utilities and welfare estimates and hence the conclusions that will be drawn from the DCE to inform health care decision making. Conclusions. To avoid biased estimates, we recommend that researchers are hesitant to use the neither option and consider including a status quo in addition to opt-out in settings where a status quo exists.

KW - discrete choice experiment

KW - neither

KW - opt-out

KW - status quo

KW - unforced choice

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M3 - Journal article

VL - 39

SP - 681

EP - 692

JO - Medical Decision Making

JF - Medical Decision Making

SN - 0272-989X

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ER -