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Discrete choice experiment

Benjamin M Craig, Kim Rand
BACKGROUND: The 5-level version of the EQ-5D (EQ-5D-5L) was introduced as an improvement on the original 3-level version (EQ-5D-3L). To date, 6 country-specific value sets have been published for EQ-5D-5L and 9 US value sets have been published for other instruments. Our aims were to (1) produce EQ-5D-5L values on a quality-adjusted life year (QALY) scale from the perspective of US adults and (2) compare them with US EQ-5D-3L values and the other country-specific EQ-5D-5L values. METHODS: In 2016, 8222 US respondents from all 50 states and Washington, DC completed an online survey including a discrete choice experiment with 20 paired comparisons...
April 17, 2018: Medical Care
Frauke Becker, Nana Anokye, Esther W de Bekker-Grob, Ailish Higgins, Clare Relton, Mark Strong, Julia Fox-Rushby
BACKGROUND: Increasing breastfeeding rates have been associated with reductions in disease in babies and mothers as well as in related costs. 'Nourishing Start for Health (NoSH)', a financial incentive scheme has been proposed as a potentially effective way to increase both the number of mothers breastfeeding and duration of breastfeeding. AIMS: To establish women's relative preferences for different aspects of a financial incentive scheme for breastfeeding and to identify importance of scheme characteristics on probability on participation in an incentive scheme...
2018: PloS One
Bram Roudijk, A Rogier T Donders, Peep F M Stalmeier
INTRODUCTION: Scaling severe states can be a difficult task. First, the method of measurement affects whether a health state is considered better or worse than dead. Second, in discrete choice experiments, different models to anchor health states on 0 (dead) and 1 (perfect health) produce varying amounts of health states worse than dead. RESEARCH QUESTION: Within the context of the quality-adjusted life-year (QALY) model, this article provides insight into the value assigned to dead and its consequences for decision making...
April 1, 2018: Medical Decision Making: An International Journal of the Society for Medical Decision Making
Alec Miners, Carrie Llewellyn, Carina King, Alex Pollard, Anupama Roy, Richard Gilson, Alison Rodger, Fiona Burns, Maryam Shahmanesh
To understand whether people attending sexual health (SH) clinics are willing to participate in a brief behavioural change intervention (BBCI) to reduce the likelihood of future sexually transmitted infections (STIs) and to understand their preferences for different service designs, we conducted a discrete choice experiment (DCE) with young heterosexual adults (aged 16-25 years), and men who have sex with men (MSM) aged 16 or above, attending SH clinics in England. Data from 368 participants showed that people particularly valued BBCIs that involved talking (OR 1...
January 1, 2018: International Journal of STD & AIDS
Miranda R Blake, Emily Lancsar, Anna Peeters, Kathryn Backholer
There is a paucity of evidence regarding the impact of sugar sweetened beverage (SSB) price increases on beverage consumption, using individual-level data, for the population overall and for different socioeconomic groups. This study aimed to predict the impact of altered beverage prices and educational messages on consumer purchasing behavior. 2020 adults representative of the Australian population by age, gender and income completed a discrete choice experiment online in 2016. Each subject completed 20 choice scenarios in a hypothetical convenience store setting where subjects chose between seven SSB and non-SSB beverage options or a no beverage option...
April 5, 2018: Appetite
Chelsea A Harris, Melissa J Shauver, Frank Yuan, Jacob Nasser, Kevin C Chung
PURPOSE: We sought to compare preferences for arthroplasty versus arthrodesis among patients with proximal interphalangeal (PIP) joint osteoarthritis (OA) by quantifying the patient-assigned utility of each operation's attributes. METHODS: We undertook a multistep process to identify relevant surgical attributes, including a literature review, surgeon survey, and pretest patient pilot test to build a set of discrete choice experiments. Patients with PIP joint osteoarthritis were identified using a single university electronic medical record and were recruited via electronic message or postcard...
April 5, 2018: Journal of Hand Surgery
T Lehnert, O H Günther, A Hajek, S G Riedel-Heller, H H König
BACKGROUND: Most people prefer to "age in place" and to remain in their homes for as long as possible even in case they require long-term care. While informal care is projected to decrease in Germany, the use of home- and community-based services (HCBS) can be expected to increase in the future. Preference-based data on aspects of HCBS is needed to optimize person-centered care. OBJECTIVE: To investigate preferences for home- and community-based long-term care services packages...
April 6, 2018: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
Paul R Brocklehurst, Gerald McKenna, Martin Schimmel, Anastassia Kossioni, Katarina Jerković-Ćosić, Martina Hayes, Cristiane da Mata, Frauke Müller
BACKGROUND: Across the European Union costs for the treatment of oral disease is expected to rise to €93 Billion by 2020 and be higher than those for stroke and dementia combined. A significant proportion of these costs will relate to the provision of care for older people. Dental caries severity and experience is now a major public health issue in older people and periodontal disease disproportionately affects older adults. Poor oral health impacts on older people's quality of life, their self-esteem, general health and diet...
April 6, 2018: BMC Oral Health
Glen S Hazlewood
There is increasing recognition of the importance of patient preferences and methodologies to measure them. In this article, methods to quantify patient preferences are reviewed, with a focus on discrete choice experiments. In a discrete choice experiment, patients are asked to choose between 2 or more treatments. The results can be used to quantify the relative importance of treatment outcomes and/or other considerations relevant to medical decision making. Conducting and interpreting a discrete choice experiment requires multiple steps and an understanding of the potential biases that can arise, which we review in this article with examples in rheumatic diseases...
May 2018: Rheumatic Diseases Clinics of North America
Nancy K Beam, Gezehegn Bekele Dadi, Sally H Rankin, Sandra Weiss, Bruce Cooper, Lisa M Thompson
OBJECTIVES: Despite global efforts to increase facility-based delivery (FBD), 90% of women in rural Ethiopia deliver at home without a skilled birth attendant. Men have an important role in increasing FBD due to their decision-making power, but this is largely unexplored. This study aimed to determine the FBD care attributes preferred by women and men, and whether poverty or household decision-making are associated with choice to deliver in a facility. SETTING AND PARTICIPANTS: We conducted a cross-sectional discrete choice experiment in 109 randomly selected households in rural Ethiopia in September-October 2015...
April 3, 2018: BMJ Open
Marco Boeri, Alan J McMichael, Joseph P M Kane, Francis A O'Neill, Frank Kee
BACKGROUND: In discrete-choice experiments (DCEs), respondents are presented with a series of scenarios and asked to select their preferred choice. In clinical decision making, DCEs allow one to calculate the maximum acceptable risk (MAR) that a respondent is willing to accept for a one-unit increase in treatment efficacy. Most published studies report the average MAR for the whole sample, without conveying any information about heterogeneity. For a sample of psychiatrists prescribing drugs for a series of hypothetical patients with schizophrenia, this article demonstrates how heterogeneity accounted for in the DCE modeling can be incorporated in the derivation of the MAR...
April 1, 2018: Medical Decision Making: An International Journal of the Society for Medical Decision Making
Siobhan Hugh-Jones, Sally Rose, Gina Z Koutsopoulou, Ruth Simms-Ellis
Mindfulness-based interventions are effective as curative and preventative approaches to psychological health. However, the mechanisms by which outcomes are secured from such interventions when delivered in the workplace, and to a stressed workforce, are not well understood. The aim of the present study was to elicit and analyse accounts from past participants of a workplace mindfulness intervention in order to generate a preliminary model of how positive benefits appear to be secured. In-depth, semi-structured interviews were completed with 21 employees of a higher education institution who had completed an eight-week intervention based on Mindfulness-Based Stress Reduction, adapted for the workplace...
2018: Mindfulness
Michela Tinelli, Panagiotis Petrou, George Samoutis, George Olympios, Alistair McGuire
Objective: To measure patient preferences for their diabetic care in community setting. Design: Discrete-choice survey. Setting: Community setting (primary physician and hospital sites) in Cyprus. Participants: Diabetic patients attending community sites. Main Outcome Measure(s): Patient preferences, to estimate which components of quality healthcare service people value, their relative importance but also the potential shift to shared decision-making (SDM)...
March 24, 2018: International Journal for Quality in Health Care
Farimah Rahimi, Hamid Reza Rasekh, Ezatollah Abbasian, Farzad Peiravian, Masoud Etemadifar, Fereshteh Ashtari, Ali Mohammad Sabzghabaee, Mohammad Reza Amirsadri
Multiple sclerosis is a chronic, progressive, and common disease affecting the central nervous system in young adults. Interferon-beta is one of the most widely used medicines to reduce the disease progression. Given the variety of drugs in this category, we aimed to identify the preferences of patients for IFN-β that play an important role in policymaking in this area. Discrete choice experiment method was used in the present study to identify and prioritize those attributes that are of interest to MS patients and increases the utility of the use of IFN-β in their treatment...
2018: PloS One
Mandy Gutknecht, Marthe-Lisa Schaarschmidt, Marion Danner, Christine Blome, Matthias Augustin
Background: Psoriasis affects different aspects of health-related quality of life (eg, physical, psychological, and social impairments); these health domains can be of different importance for patients. The importance of domains can be measured with the Patient Benefit Index (PBI). This questionnaire weights the achievement of treatment goals by Likert scales (0, "not important at all" to 4, "very important") using the Patient Needs Questionnaire (PNQ). Treatment goals assessed with the PBI have been assigned to five health domains; the importance of each domain can be calculated as the average importance of the respective treatment goals...
2018: Patient Preference and Adherence
Shiva Farashahi, Chih-Chung Ting, Chang-Hao Kao, Shih-Wei Wu, Alireza Soltani
When making choices, collecting more information is beneficial but comes at the cost of sacrificing time that could be allocated to making other potentially rewarding decisions. To investigate how the brain balances these costs and benefits, we conducted a series of novel experiments in humans and simulated various computational models. Under six levels of time pressure, subjects made decisions either by integrating sensory information over time or by dynamically combining sensory and reward information over time...
March 27, 2018: PLoS Computational Biology
Jaein Seo, B Douglas Smith, Elihu Estey, Ernest Voyard, Bernadette O' Donoghue, John F P Bridges
OBJECTIVE: Acute myeloid leukemia (AML) is a progressive blood cancer with few effective treatment options. As part of a patient-focused drug development (PFDD) initiative led by the Leukemia and Lymphoma Society (LLS), we sought to use a community-centered approach to develop and pilot an instrument to measure patient preferences for the benefits and risks of treating AML. METHODS: Instrument development was informed by a literature review, engagement with expert stakeholders (n = 12), engagement with community stakeholders, and pretesting...
March 22, 2018: Current Medical Research and Opinion
Maria Elena Miletto Petrazzini, Cristiano Bertolucci, Augusto Foà
Quantitative abilities have been reported in many animal species. Two main methods have been extensively used: spontaneous choice tests and training procedures. A recent study showed that ruin lizards are capable of spontaneously discriminating between the surface area of two food items of different size, but failed when food was presented in sets of discrete items differing in number. In the present study, we used a training procedure to further investigate quantitative abilities in ruin lizards. Subjects were presented with two sets of yellow disks differing either in number (Experiment 1) or in area (Experiment 2) and were trained on different discriminations of increasing difficulty (1 vs...
2018: Frontiers in Psychology
Matthew Quaife, Fern Terris-Prestholt, Robyn Eakle, Maria A Cabrera Escobar, Maggie Kilbourne-Brook, Mercy Mvundura, Gesine Meyer-Rath, Sinead Delany-Moretlwe, Peter Vickerman
INTRODUCTION: A number of antiretroviral HIV prevention products are efficacious in preventing HIV infection. However, the sexual and reproductive health needs of many women extend beyond HIV prevention, and research is ongoing to develop multi-purpose prevention technologies (MPTs) that offer dual HIV and pregnancy protection. We do not yet know if these products will be an efficient use of constrained health resources. In this paper, we estimate the cost-effectiveness of combinations of candidate multi-purpose prevention technologies (MPTs), in South Africa among general population women and female sex workers (FSWs)...
March 2018: Journal of the International AIDS Society
Gillian Marion Scanlan, Jennifer Cleland, Peter Johnston, Kim Walker, Nicolas Krucien, Diane Skåtun
OBJECTIVES: Multiple personal and work-related factors influence medical trainees' career decision-making. The relative value of these diverse factors is under-researched, yet this intelligence is crucially important for informing medical workforce planning and retention and recruitment policies. Our aim was to investigate the relative value of UK doctors' preferences for different training post characteristics during the time period when they either apply for specialty or core training or take time out...
March 12, 2018: BMJ Open
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