scholarly journals The Value of Preventative Dental Care: A Discrete-Choice Experiment

2021 ◽  
pp. 002203452198994
Author(s):  
D. Boyers ◽  
M. van der Pol ◽  
V. Watson ◽  
T. Lamont ◽  
B. Goulao ◽  
...  
Keyword(s):  
General Population ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Dental Care ◽  
Choice Experiment ◽  
Service Providers ◽  
Care Service ◽  
User Preferences ◽  
Care Services ◽  
Choice Tasks

Scale and polish (SP) and oral hygiene advice (OHA) are commonly provided in primary care dental practice to help prevent periodontal disease. These services are widely consumed by service users, incurring substantial cost, without any clear evidence of clinical benefit. This article aims to elicit general population preferences and willingness to pay (WTP) for preventative dental care services and outcomes. An online discrete-choice experiment (DCE) was completed by a nationally representative sample of the UK general population. Respondents each answered 10 choice tasks that varied in terms of service attributes (SP, OHA, and provider of care), outcomes (bleeding gums and aesthetics), and cost. Choice tasks were selected using a pivoted segmented experimental design to improve task realism. An error components panel logit model was used to analyze the data. Marginal WTP (mWTP) for each attribute and level was calculated. In total, 667 respondents completed the DCE. Respondents valued more frequent SP, care provided by a dentist, and personalized OHA. Respondents were willing to pay for dental packages that generated less frequent (“never” or “hardly ever”) bleeding on brushing and teeth that look and feel at least “moderately clean.” Respondents were willing to pay more (+£145/y) for improvements in an aesthetic outcome from “very unclean” (−£85/y) to “very clean” (+£60/y) than they were for reduced bleeding frequency (+£100/y) from “very often” (−£54/y) to “never” (+£36/y). The general population value routinely provided SP, even in the absence of reductions in bleeding on brushing. Dental care service providers must consider service user preferences, including preferences for both health and nonhealth outcomes, as a key factor in any service redesign. Furthermore, the results provide mWTP estimates that can be used in cost-benefit analysis of these dental care services.

scholarly journals Young people’s preferences for the use of emerging technologies for asymptomatic regular chlamydia testing and management: a discrete choice experiment in England

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023663 ◽  
Author(s):  
Sue Eaton ◽  
Deborah Biggerstaff ◽  
Stavros Petrou ◽  
Leeza Osipenko ◽  
Jo Gibbs ◽  
...  
Keyword(s):  
Young People ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Emerging Technologies ◽  
Service Providers ◽  
Cognitive Testing ◽  
Test Accuracy ◽  
Chlamydia Testing ◽  
Online Panel

ObjectiveTo undertake a comprehensive assessment of the strength of preferences among young people for attributes of emerging technologies for testing and treatment of asymptomatic chlamydia.DesignDiscrete choice experiment (DCE) with sequential mixed methods design. A staged approach to selection of attributes/levels included two literature reviews, focus groups with young people aged 16–24 years (n=21), experts’ review (n=13) and narrative synthesis. Cognitive testing was undertaken to pilot and adapt the initial questionnaire. Online national panel was used for final DCE survey to maximise generalisability. Analysis of questionnaire responses used multinomial logit models and included validity checks.SettingEngland.Participants1230 young people aged 16–24 from a national online panel (completion rate 73%).Outcome measuresORs for service attributes in relation to reference levels.ResultsThe strongest attribute influencing preferences was chlamydia test accuracy (OR 3.24, 95% CI 3.13 to 3.36), followed by time to result (OR 1.81, 95% CI 1.71 to 1.91). Respondents showed a preference for remote chlamydia testing options (self-testing, self-sampling and postal testing) over attendance at a testing location. For accessing treatment following a positive test result, there was a general preference for online (OR 1.21, 95% CI 1.15 to 1.28) versus traditional general practitioner (OR 1.18, 95% CI 1.12 to 1.24) or pharmacy (OR 1.15, 95% CI 1.10 to 1.22) over clinic services. For accessing a healthcare professional and receipt of antibiotics, there was little difference in preferences between options.ConclusionsBoth test accuracy and very short intervals between testing and results were important factors for young people when deciding whether to undergo a routine test for asymptomatic chlamydia, with test accuracy being more important. These findings should assist technology developers, policymakers, commissioners and service providers to optimise technology adoption in service redesign, although use of an online panel may limit generalisability of findings to other populations.

Public preferences for home care services for people with dementia: A discrete choice experiment on personhood

2020 ◽  
Vol 245 ◽  
pp. 112675 ◽  
Author(s):  
Sharon Walsh ◽  
Eamon O'Shea ◽  
Tom Pierse ◽  
Brendan Kennelly ◽  
Fiona Keogh ◽  
...  
Keyword(s):  
Home Care ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Home Care Services ◽  
Public Preferences ◽  
Care Services ◽  
People With Dementia

scholarly journals Product attributes important to US adult consumers’ use of electronic nicotine delivery systems: a discrete choice experiment

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e027247 ◽  
Author(s):  
Christine E Kistler ◽  
Leah M Ranney ◽  
Erin L Sutfin ◽  
Keith Chrzan ◽  
Christopher J Wretman ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Delivery Systems ◽  
Product Attributes ◽  
Worst Case ◽  
Electronic Nicotine Delivery Systems ◽  
Nicotine Delivery ◽  
The Usa ◽  
Choice Tasks

ObjectiveTo understand the importance of electronic nicotine delivery systems (ENDS) product attributes to adult consumers in the USA by age and gender.DesignCross-sectional survey with a discrete choice experiment (best–worst, case 2, scaling) of 19 choice tasks in which participants answered what would make them most want to use and least want to use an ENDS product.Setting and participantsA national sample of adults (aged 18+ years) in the USA who had tried an ENDS product at least once.MeasuresWe included 9 ENDS attributes with levels that varied across 19 choice tasks. We performed a multinomial logistic regression to obtain overall importance scores, attribute-level part-worth utilities and most important attribute.ResultsOf 660 participants, 81% were white, 51% women and 37% had at least a 4-year college degree with an average age of 42.0 years (SD ±19.4). The attributes had the following importance: harms of use 17.6%; general effects 14.1%; cessation aid 12.6%; purchase price 12.1%; monthly cost 12.0%; nicotine content 11.4%; flavour availability 8.4%; device design 7.2%; modifiability 4.6%. Harms of use was the most important attribute for all ages and genders (p<0.05); variation in other important attributes existed by age though not by gender.ConclusionThis study identified the importance of nine ENDS attributes. Perceived harms of use of ENDS use appeared most important, and modifiability was least important. Variation by consumer group existed, which may allow for targeted interventions to modify ENDS use.

General Population vs. Patient Preferences in Anticoagulant Therapy: A Discrete Choice Experiment

2018 ◽  
Vol 12 (2) ◽  
pp. 235-246 ◽  
Author(s):  
Mehdi Najafzadeh ◽  
Sebastian Schneeweiss ◽  
Niteesh K. Choudhry ◽  
Jerry Avorn ◽  
Joshua J. Gagne
Keyword(s):  
General Population ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Anticoagulant Therapy ◽  
Patient Preferences ◽  
Choice Experiment

scholarly journals Numeracy and Understanding of Quantitative Aspects of Predictive Models: A Pilot Study

2018 ◽  
Vol 09 (03) ◽  
pp. 683-692
Author(s):  
Gary Weissman ◽  
Kuldeep Yadav ◽  
Vanessa Madden ◽  
Katherine Courtright ◽  
Joanna Hart ◽  
...  
Keyword(s):  
Pilot Study ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Predictive Models ◽  
Choice Experiment ◽  
Prediction Models ◽  
User Preferences ◽  
Amazon Mechanical Turk ◽  
Clinical Prediction ◽  
Clinical Prediction Models

Background The assessment of user preferences for performance characteristics of patient-oriented clinical prediction models is lacking. It is unknown if complex statistical aspects of prediction models are readily understandable by a general audience. Objective A pilot study was conducted among nonclinical audiences to determine the feasibility of interpreting statistical concepts that describe the performance of prediction models. Methods We conducted a cross-sectional electronic survey using the Amazon Mechanical Turk platform. The survey instrument included educational modules about predictive models, sensitivity, specificity, and confidence intervals (CIs). Follow-up questions tested participants' abilities to interpret these characteristics with both verbatim and gist knowledge. Objective and subjective numeracy were assessed using previously validated instruments. We also tested understanding of these concepts when embedded in a sample discrete choice experiment task to establish feasibility for future elicitation of preferences using a discrete choice experiment design. Multivariable linear regression was used to identify factors associated with correct interpretation of statistical concepts. Results Among 534 respondents who answered all nine questions, the mean correct responses was 95.9% (95% CI, 93.8–97.4) for sensitivity, 93.1% (95% CI, 90.5–95.0) for specificity, and 86.6% (95% CI, 83.3–89.3) for CIs. Verbatim interpretation was high for all concepts, but significantly higher than gist only for CIs (p < 0.001). Scores on each discrete choice experiment tasks were slightly lower in each category. Both objective and subjective numeracy were positively associated with an increased proportion of correct responses (p < 0.001). Conclusion These results suggest that a nonclinical audience can interpret quantitative performance measures of predictive models with very high accuracy. Future development of patient-facing clinical prediction models can feasibly incorporate patient preferences for model features into their development.

scholarly journals Exploring how individuals complete the choice tasks in a discrete choice experiment: an interview study

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Jorien Veldwijk ◽  
Domino Determann ◽  
Mattijs S. Lambooij ◽  
Janine A. van Til ◽  
Ida J. Korfage ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Interview Study ◽  
Choice Tasks

scholarly journals Service providers endorse integrated services model for youth with mental health and substance use challenges: findings from a discrete choice experiment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa D. Hawke ◽  
Lehana Thabane ◽  
Srividya N. Iyer ◽  
Alexia Jaouich ◽  
Paula Reaume-Zimmer ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Service Provider ◽  
Choice Experiment ◽  
Latent Class ◽  
Service Providers ◽  
Youth Services ◽  
Service Components

Abstract Background Given high rates of mental health and substance challenges among youth and substantial system access barriers, system innovation is required. Integrated youth services (IYS) models aim to transform youth mental health and substance use services by creating integrative, collaborative models of care in youth-friendly settings. This study examines service provider perspectives on the key service components to include in IYS models. Method A discrete choice experiment modeled service provider preferences for the service components of IYSs. The sample includes 388 service provider/agency leader participants (age 18+) from youth-serving organizations in Ontario. Importance scores and utility values were calculated for 12 attributes represented by four levels each. Latent class analysis identified subgroups of participants with different preferences. Results The majority of participants were direct service providers working in larger organizations in the mental health and/or substance use sectors in large urban centers. Participants strongly endorsed service models that provide rapid access to the widest variety of culturally sensitive service options, with supplementary e-health services, in youth-focused community settings with evening and weekend hours. They prefer caregiver involvement in youth services and treatment decisions and support youth and family engagement. Latent class analyses reveal three segments of service providers: a Youth-Focused Service Accessibility segment representing 62.1% (241/388) of participants, a Service Options segment representing 27.6% (107/388) of participants, and a Caregiver Integration segment representing 10.3% (40/388) of participants. Within these segments, the degree of prioritization of the various service components differ; however, the overall endorsement of the service components remains largely consistent across classes for most attributes. The segments did not differ based on demographic or agency characteristics. Conclusions The core characteristics of IYS settings for youth with mental health and substance use challenges, i.e., rapid access to a wide range of youth-oriented services, are strong priorities of service providers and youth-serving agency leaders. These findings confirm that youth-oriented service providers endorse the importance and relevance of IYS models as a whole; strong service provider buy-in to the model is expected to facilitate development, implementation and scaling of IYS models. Hearing stakeholder perspectives, including those of service providers, youth, and caregivers, is essential to developing, effectively implementing, and scaling effective youth services.

scholarly journals Preferences for pre-exposure prophylaxis (PrEP) among men who have sex with men and transgender women at risk of HIV infection: a multicentre protocol for a discrete choice experiment in Brazil

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e049011
Author(s):  
Claudia Cristina de Aguiar Pereira ◽  
Thiago Silva Torres ◽  
Paula Mendes Luz ◽  
Brenda Hoagland ◽  
Alessandro Farias ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Risk Behaviour ◽  
Transgender Women ◽  
Second Phase ◽  
Qualitative Approaches ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Choice Tasks

IntroductionPre-exposure prophylaxis (PrEP) is an important and well-established prevention strategy for sexual acquisition of HIV. In Brazil, transgender women (TGW) and men who have sex with men (MSM) bear the largest burden among key populations. Little is known about preferences for PrEP characteristics in these vulnerable populations in Latin America. The goal of this study is to investigate preferences of TGW and MSM with respect to PrEP characteristics, whether current user or not, and to assess any attributes and levels that may improve the decision to start using PrEP (uptake) and optimal continuity of use (adherence), which are important dimensions for PrEP success.Methods and analysisWe hereby outline the protocol of a discrete choice experiment (DCE) to be conducted among TGW and MSM in Brazil. The study will be carried out in two phases. The first phase involves literature review and qualitative approaches including in-depth interviews to inform the development of the DCE (attributes and levels). The second phase entails the DCE survey and supporting questions pertaining to sociodemographic and risk behaviour information. The survey is aimed at current PrEP users and non-users, consisting of two modes of administration: face to face in five Brazilian capitals (Rio de Janeiro, Brasília, Manaus, Porto Alegre and Salvador) and online targeting the entire country. A D-efficient zero-prior blocked experimental design will be used to select 60 paired-profile DCE choice tasks, in which participants will be randomly assigned to one of four groups and presented with a set of 15 choice tasks. The planned sample size is 1000 volunteers.Ethics, timeline and disseminationThe study was approved by Comitê de Ética em Pesquisa—Instituto Nacional de Infectologia Evandro Chagas—INI/FIOCRUZ, CEP/INI, CAAE 28416220.2.1001.5262, approval number 3.979.759 in accordance with the Comissão Nacional de Ética em Pesquisa (CONEP—Brazilian National Board of Research Ethics). The study will be conducted between 2020 and 2021. The results will be disseminated to the scientific community and to the public in general through publications in published in peer-reviewed journals and in scientific conferences.

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