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Discrete choice experiments in health economics

For better or for worse?

  • Editorial
  • Published:
The European Journal of Health Economics, formerly: HEPAC Aims and scope Submit manuscript

Abstract

One method that is increasingly being used in health economics to elicit stated preferences concerning health matters is the discrete choice experiment (DCE). This editorial explores four sets of issues facing researchers who wish to employ DCE techniques: (a) normative issues about how data from DCE studies might be used to inform policy, (b) psychological issues concerning the meaningfulness of the data generated, (d) technical issues relating to how the data are generated and (d) issues relating to the generalisability of the data from DCE studies. Given current uncertainties surrounding these issues, it is our view that more caution and greater circumspection towards DCE is appropriate at this stage.

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References

  1. Kroes EP, Sheldon R (1988) Stated preference methods: an introduction. J Transport Econ Policy 22:11–26

    Google Scholar 

  2. Hensher DA, Barnard PO, Truong TP (1988) The role of stated preference methods in studies of travel choice. J Transport Econ Policy 22:45–58

    Google Scholar 

  3. Magat WA, Viscusi WK, Huber J (1988) Paired comparison and contingent valuation approaches to morbidity risk valuation. J Environ Econ Manage 15:395–411

    Google Scholar 

  4. Hensher DA (1994) Stated preference analysis of travel choices: the state of practice. Transportation 21:107–133

    Google Scholar 

  5. Ryan M, Hughes J (1997) Using conjoint analysis to assess women’s preferences for miscarriage management. Health Econ 6:261–273

    Article  CAS  PubMed  Google Scholar 

  6. Bryan S, Buxton M, Sheldon R, Grant A (1998) Magnetic resonance imaging for the investigation of knee injuries: an investigation of preferences. Health Econ 7:595–603

    Article  CAS  PubMed  Google Scholar 

  7. Vick S, Scott A (1998) Agency in health care: examining patients’ preferences for attributes of the doctor-patient relationship. J Health Econ 17:587–605

    Article  CAS  PubMed  Google Scholar 

  8. Ratcliffe J, Buxton M (1999) Patients’ preferences regarding the process and outcomes of life-saving technology. An application of conjoint analysis to liver transplantation. Int J Technol Assess Health Care 15:340–351

    CAS  PubMed  Google Scholar 

  9. Ubach C, Scott A, French F, Awramenko M, Needham G (2003) What do hospital consultants value about their jobs? A discrete choice experiment. BMJ 326:1432

    Article  PubMed  Google Scholar 

  10. Sculpher MJ, Bryan S, Fry P, de Winter P, Payne H, Emberton M (2004) Patients’ preferences for the management of non-metastatic prostate cancer: a discrete choice experiment. BMJ 328:382–385

    Article  PubMed  Google Scholar 

  11. Ryan M (1999) Using conjoint analysis to take account of patient preferences and go beyond health outcomes: an application to in vitro fertilisation. Soc Sci Med 48:535–546

    Article  CAS  PubMed  Google Scholar 

  12. Ryan M (1999) A role for conjoint analysis in technology assessment in health care? Int J Technol Assess Health Care 15:443–457

    CAS  PubMed  Google Scholar 

  13. Ryan M, Farrar S (2000) Using conjoint analysis to elicit preferences for health care. BMJ 320 1530–1533

    Google Scholar 

  14. Ryan M (2004) Discrete choice experiments in health care. BMJ 328:360–361

    Article  PubMed  Google Scholar 

  15. Bryan S, Gold L, Sheldon R, Buxton M (2000) Preference measurement using conjoint methods: an empirical investigation of reliability. Health Econ 9:385–395

    Article  CAS  PubMed  Google Scholar 

  16. Bryan S, Parry D (2001) Structural reliability of conjoint measurement in health care: an empirical investigation. Appl Econ 34:561–567

    Article  Google Scholar 

  17. Van der Pol M, Cairns J (1998) Establishing patient preferences for blood transfusion support: an application of conjoint analysis. J Health Serv Res Policy 3:70–76

    PubMed  Google Scholar 

  18. Ryan M, Wordsworth S (2000) Sensitivity of willingness to pay estimates to the level of attributes in discrete choice experiments. Scott J Polit Econ 47:504–524

    Article  Google Scholar 

  19. Salkeld G, Ryan M, Short L (2000) The veil of experience: do consumers prefer what they know best? Health Econ 9:267–270

    Article  CAS  PubMed  Google Scholar 

  20. Longworth L, Ratcliffe J, Boulton M (2001) Investigating women’s preferences for intrapartum care: home versus hospital births. Health Soc Care Community 9:404–413

    Article  CAS  PubMed  Google Scholar 

  21. McKenzie L, Cairns J, Osman L (2001) Sympton-based outcome measures for asthma: the use of discrete choice methods to assess patient preferences. Health Policy 57:193–204

    Article  CAS  PubMed  Google Scholar 

  22. McKessock L, Smith BH, Scott A, Graham W, Terry PB, Templeton A, Fitzmaurice AE (2001) A randomized controlled trial of direct access for laparoscopic sterilization. Fam Pract 18:1–8

    Article  CAS  PubMed  Google Scholar 

  23. Osman LM, McKenzie L, Cairns J, Friend JAR, Godden DJ, Legge JS, Douglas JG (2001) Patient weighting of importance of asthma symptoms. Thorax 56:138–142

    Article  CAS  PubMed  Google Scholar 

  24. Shackley P, Slack R, Michaels J (2001) Vascular patients’ preferences for local treatment: an application of conjoint analysis. J Health Serv Res Policy 6:151–157

    Article  CAS  PubMed  Google Scholar 

  25. Jan S, Mooney G (2000) The use of conjoint analysis to elicit community preferences in public health research: a case study of hospital services in South Australia. Aust N Z J Public Health 24:64–70

    CAS  PubMed  Google Scholar 

  26. Morgan A, Shackley P, Pickin M, Brazier J (2000) Quantifying patient preferences for out-of-hours primary care. J Health Serv Res Policy 5:214–218

    CAS  PubMed  Google Scholar 

  27. Ryan M, McIntosh E, Dean T, Old P (2000) Trade-offs between location and waiting times in the provision of health care: the case of elective surgery on the Isle of Wight. J Public Health Med 22:202–210

    Article  CAS  PubMed  Google Scholar 

  28. Lloyd AJ (2003) Threats to the estimation of benefit: are preference elicitation methods accurate? Health Econ 12:393–402

    Article  PubMed  Google Scholar 

  29. Cairns J, van der Pol M, Lloyd A (2002) Decision making heuristics and the elicitation of preferences: being fast and frugal about the future. Health Econ 11:655–658

    Article  PubMed  Google Scholar 

  30. Gosden T, Bowler I, Sutton M (2000) How do general practitioners choose their practice? Preferences for practice and job characteristics. J Health Serv Res Policy 5:208–213

    CAS  PubMed  Google Scholar 

  31. Morgan A, Shackley P, Pickin M, Brazier J (2000) Quantifying patient preferences for out-of-hours primary care. J Health Serv Res Policy 5:214–218

    CAS  PubMed  Google Scholar 

  32. San Miguel F, Ryan M, McIntosh E (2000) Applying conjoint analysis in economic evaluations: an application to menorrhagia. Appl Econ 32:823–833

    Article  Google Scholar 

  33. Scott A (2001) Eliciting GPs preferences for pecuniary and non-pecuniary job characteristics. J Health Econ 20:329–347

    Article  CAS  PubMed  Google Scholar 

  34. Goodman MJ (2003) Consultants naively undervaluing themselves. BMJ Rapid Response (bmj.com, 5 July 2003)

  35. Farrar S, Ryan M, Ross D, Ludbrook A (2000) Using discrete choice modelling in priority setting: an application to clinical service developments. Soc Sci Med 50:63–75

    Article  CAS  PubMed  Google Scholar 

  36. Scott A (2002) Identifying and analysing dominant preferences in discrete choice experiments: an application in health care. J Econ Psychol 23:383–398

    Article  Google Scholar 

  37. Dolan P (1997) Modelling valuations for EuroQol health states. Med Care 35:1095–1108

    Article  CAS  PubMed  Google Scholar 

  38. Ryan M, McIntosh E, Shackley P (1998) Methodological issues in the application of conjoint analysis in health care. Health Econ 7:373–378

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Stirling Bryan.

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Bryan, S., Dolan, P. Discrete choice experiments in health economics. Eur J Health Econom 5, 199–202 (2004). https://doi.org/10.1007/s10198-004-0241-6

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  • DOI: https://doi.org/10.1007/s10198-004-0241-6

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