scholarly journals Manipulating the 5 Dimensions of the EuroQol Instrument: The Effects on Self-Reporting Actual Health and Valuing Hypothetical Health States

2019 ◽  
Vol 39 (4) ◽  
pp. 380-392 ◽  
Author(s):  
Aki Tsuchiya ◽  
Nick Bansback ◽  
Arne Risa Hole ◽  
Brendan Mulhern
Keyword(s):  
Discrete Choice ◽  
Online Survey ◽  
Self Report ◽  
Discrete Choice Experiments ◽  
Health State ◽  
Health States ◽  
Different Types ◽  
Health State Valuations ◽  
The Uk ◽  
Actual Health

Background. The EQ-5D instrument has 5 dimensions. This article reports on the effects of manipulating a) the order in which the 5 dimensions are presented (appearing first v. last), b) splitting of the composite dimensions (“pain or discomfort” and “anxiety or depression”), and c) removing or “bolting off” 1 of the 5 EQ-5D dimensions at a time. The effects were examined in 2 contexts: 1) self-reporting health and 2) health state valuations. Methods. Three different types of discrete choice experiments (DCE) including a duration attribute were designed. An online survey with 12 subtypes, each with 10 DCE tasks, was designed and completed by 2494 members of the UK general public. Results. Of the 3 manipulations in the self-reporting context, only b) splitting anxiety or depression had a significant effect. In the health state valuation context, b) splitting level 5 pain or discomfort (relative to pain) and splitting level 5 anxiety or depression (relative to anxiety) had significant effects as did c) bolting off dimensions. Conclusions. We find that the values given to certain health dimensions are sensitive to the way in which it is described and the other health dimensions presented. Of particular interest is the effect of splitting composite dimensions: a given EQ-5D(-5L) profile may mean different things depending on whether the profile is used to self-report one’s health or to value hypothetical states, so that the health state values of EQ-5D(-5L) in population tariffs may not correspond to the states that patients self-report themselves in.

scholarly journals Using Discrete Choice Experiments with Duration to Model EQ-5D-5L Health State Preferences

2016 ◽  
Vol 37 (3) ◽  
pp. 285-297 ◽  
Author(s):  
Brendan Mulhern ◽  
Nick Bansback ◽  
Arne Risa Hole ◽  
Aki Tsuchiya
Keyword(s):  
Discrete Choice ◽  
Choice Experiments ◽  
Discrete Choice Experiments ◽  
Health State ◽  
Two Stage ◽  
Health States ◽  
Stage Design ◽  
Choice Sets ◽  
Two Stage Design ◽  
The Uk

Background: Discrete choice experiments incorporating duration can be used to derive health state values for EQ-5D-5L. Yet, methodological issues relating to the duration attribute and the optimal way to select health states remain. The aims of this study were to: test increasing the number of duration levels and choice sets where duration varies (aim 1); compare designs with zero and non-zero prior values (aim 2); and investigate a novel, two-stage design to incorporate prior values (aim 3). Methods: Informed by zero and non-zero prior values, two efficient designs were developed, each consisting of 120 EQ-5D-5L health profile pairs with one of six duration levels (aims 1 and 2). Another 120 health state pairs were selected, with one of six duration levels allocated in a second stage based on existing estimated utility of the states (aim 3). An online sample of 2,002 members of the UK general population completed 10 choice sets each. Differences across the regression coefficients from the three designs were assessed. Results: The zero prior value design produced a model with coefficients that were generally logically ordered, but the non-zero prior value design resulted in a set of less ordered coefficients where some differed significantly. The two-stage design resulted in ordered and significant coefficients. The non-zero prior value design may include more “difficult” choice sets, based on the proportions choosing each profile. Conclusions: There is some indication of compromised “respondent efficiency”, suggesting that the use of non-zero prior values will not necessarily result in better overall precision. It is feasible to design discrete choice experiments in two stages by allocating duration values to EQ-5D-5L health state pairs based on estimates from prior studies.

scholarly journals Exploring Differences between TTO and DCE in the Valuation of Health States

2016 ◽  
Vol 37 (3) ◽  
pp. 273-284 ◽  
Author(s):  
Angela Robinson ◽  
Anne E. Spencer ◽  
José Luís Pinto-Prades ◽  
Judith A. Covey
Keyword(s):  
Discrete Choice ◽  
Discrete Choice Experiments ◽  
Matching Task ◽  
Health State ◽  
Choice Data ◽  
Health States ◽  
The United Kingdom ◽  
Recent Interest ◽  
Matching Procedure ◽  
Health State Utility Values

There is recent interest in using discrete choice experiments (DCEs) to derive health state utility values, and results can differ from time tradeoff (TTO). Clearly, DCE is “choice based,” whereas TTO is generally considered a “matching” task. We explore whether procedural adaptations to the TTO, which make the method more closely resemble a DCE, make TTO and choice converge. In particular, we test whether making the matching procedure in TTO less “transparent” to the respondent reduces disparities between TTO and DCE. We designed an interactive survey that was hosted on the Internet, and 2022 interviews were achieved in the United Kingdom in a representative sample of the population. We found a marked divergence between TTO and DCE, but this was not related to the “transparency” of the TTO procedure. We conclude that a difference in the error structure between TTO and choice and that factors other than differences in utility are affecting choices is driving the divergence. The latter has fundamental implications for the way choice data are analyzed and interpreted.

scholarly journals NCOG-36. FIRST HEALTH UTILITIES OF GLIOBLASTOMA PATIENTS USING TTFIELDS TREATMENT

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii137-ii137
Author(s):  
Gordon Chavez ◽  
Christina Proescholdt
Keyword(s):  
Population Sample ◽  
National Health System ◽  
Medical Decision ◽  
Economic Evaluations ◽  
Health State ◽  
High Quality ◽  
Health States ◽  
Tumor Treating Fields ◽  
Health State Utilities ◽  
The Uk

Abstract BACKGROUND Despite the importance of Health State Utilities for health policy and medical decision making, there are no publications that provide high quality utility values estimated from glioblastoma multiforme (GBM) patients. Published health economic evaluations for GBM treatments rely on utilities determined by Garside et al. (2007), which used the standard gamble method in healthy panel members of the UK National Health System. There are no published utilities for GBM estimated from a general population sample, and there are no utility estimates whatsoever for Tumor Treating Fields (TTFields) users. METHODS We designed a study to remedy this major deficit by eliciting utilities directly from GBM patients using the EuroQol 5-Dimension (EQ-5D) survey. The EQ-5D is a widely used and NICE-recommended tool for the estimation of health state utilities. The survey is composed of a questionnaire that asks patients to specify their health state along 5 dimensions: Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression. Statistical models provided by EuroQol’s network of researchers convert this data into health state utility estimates. RESULTS The EQ-5D questionnaire is administered to active patients using TTFields treatment during the study duration, allowing the elicitation of health preference measures for different glioblastoma health states based on: progression status (progressed vs. non-progressed), current treatments (TTFields only vs. TTFields + others) and time-from-diagnosis (0-12 months vs. > 12 months) CONCLUSION These results are important for understanding the patient preferences using TTFields treatment and communicating these preferences to decision makers. This study is the first to provide direct, high quality utility measures in glioblastoma patients using TTFields treatment.

scholarly journals Understanding public preferences and trade-offs for government responses during a pandemic: a protocol for a discrete choice experiment in the UK

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e043477
Author(s):  
Mesfin G Genie ◽  
Luis Enrique Loría-Rebolledo ◽  
Shantini Paranjothy ◽  
Daniel Powell ◽  
Mandy Ryan ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Online Survey ◽  
Research Unit ◽  
Media Analysis ◽  
Moral Foundation ◽  
Trade Offs ◽  
Ethics Research ◽  
The Uk

IntroductionSocial distancing and lockdown measures are among the main government responses to the COVID-19 pandemic. These measures aim to limit the COVID-19 infection rate and reduce the mortality rate of COVID-19. Given we are likely to see local lockdowns until a treatment or vaccine for COVID-19 is available, and their effectiveness depends on public acceptability, it is important to understand public preference for government responses.Methods and analysisUsing a discrete choice experiment (DCE), this study will investigate the public’s preferences for pandemic responses in the UK. Attributes (and levels) are based on: (1) lockdown measures described in policy documents; (2) literature on preferences for lockdown measures and (3) a social media analysis. Attributes include: lockdown type; lockdown length; postponement of usual non-urgent medical care; number of excess deaths; number of infections; impact on household spending and job losses. We will prepilot the DCE using virtual think aloud interviews with respondents recruited via Facebook. We will collect preference data using an online survey of 4000 individuals from across the four UK countries (1000 per country). We will estimate the relative importance of the attributes, and the trade-offs individuals are willing to make between attributes. We will test if respondents’ preferences differ based on moral attitudes (using the Moral Foundation Questionnaire), socioeconomic circumstances (age, education, economic insecurity, health status), country of residence and experience of COVID-19.Ethics and disseminationThe University of Aberdeen’s College Ethics Research Board (CERB) has approved the study (reference: CERB/2020/6/1974). We will seek CERB approval for major changes from the developmental and pilot work. Peer-reviewed papers will be submitted, and results will be presented at public health and health economic conferences nationally and internationally. A lay summary will be published on the Health Economics Research Unit blog.

scholarly journals How Should Discrete Choice Experiments with Duration Choice Sets Be Presented for the Valuation of Health States?

2017 ◽  
Vol 38 (3) ◽  
pp. 306-318 ◽  
Author(s):  
Brendan Mulhern ◽  
Richard Norman ◽  
Koonal Shah ◽  
Nick Bansback ◽  
Louise Longworth ◽  
...  
Keyword(s):  
Discrete Choice ◽  
Choice Experiments ◽  
Discrete Choice Experiments ◽  
Health States ◽  
Choice Sets

scholarly journals Understanding psychiatrists' knowledge, attitudes and experiences in identifying and supporting their patients on the autism spectrum: online survey

BJPsych Open ◽  
2019 ◽  
Vol 5 (3) ◽  
Author(s):  
Laura Crane ◽  
Ian Davidson ◽  
Rachel Prosser ◽  
Elizabeth Pellicano
Keyword(s):  
Online Survey ◽  
Critical Role ◽  
Autism Spectrum ◽  
Self Report ◽  
Personal Connection ◽  
Effective Care ◽  
Care And Support ◽  
Diagnostic Management ◽  
Specific Factors ◽  
The Uk

BackgroundPsychiatrists play a critical role in identifying and supporting their patients on the autism spectrum in the UK, yet little is known about their knowledge, attitudes and experiences in this regard.AimsTo understand psychiatrists' experiences of working with autistic individuals, their confidence in making diagnostic/management decisions and the factors that affect such decisions.MethodA total of 172 psychiatrists took part in an online self-report survey.ResultsMost psychiatrists reported receiving useful training on autism and were knowledgeable about the condition, particularly those with a personal connection to autism. Higher confidence in working with autistic patients was linked to greater levels of autism knowledge, experience and training. Several systemic and autism-specific factors were highlighted by psychiatrists, which were felt to challenge their ability to provide effective care and support for their patients on the autism spectrum.ConclusionsPsychiatrists' views corroborated previous research with the autism community, highlighting the need to co-design services that are accessible, respectful and person-centred.Declaration of interestI.D. is the Royal College of Psychiatrists' Autism Champion.

Treatment of venous thromboembolism with vitamin K antagonists: patients’ health state valuations and treatment preferences

2004 ◽  
Vol 92 (12) ◽  
pp. 1336-1341 ◽  
Author(s):  
Patrick Bossuyt ◽  
Peep Stalmeier ◽  
Mirjam Sprangers ◽  
Carlo van Dongen ◽  
Saskia Middeldorp ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Patient Characteristics ◽  
Haemorrhagic Stroke ◽  
Treatment Preferences ◽  
Health State ◽  
Health States ◽  
Health State Valuations ◽  
Cessation Of Treatment

SummaryDetermining the optimal duration of vitamin K antagonist (VKA) therapy for patients with venous thromboembolism (VTE) requires a weighting of the benefits and risks of treatment. The objectives of our study were to investigate patient variability in health state valuations associated with VKA therapy and treatment preferences, and to investigate the extent to which valuations and treatment preferences are associated with prior experience with these health states and other patient characteristics. Valuations of outcomes after VTE scaled from 0 (tantamount to death) to 1 (tantamount to perfect health) were elicited from 53 patients who had experienced VTE, 23 patients who had experienced major bleeding during treatment, and 48 patients with the post-thrombotic syndrome. In addition, patients’ treatment preferences were evaluated using treatment trade-off questions. Median health state valuations ranged from 0.33 for ‘non-fatal haemorrhagic stroke’ to 0.96 for ‘no VKA treatment’. Variability between patients was substantial. Patients’ treatment preferences also varied: 25% of patients chose cessation of treatment, regardless of the probability of recurrent VTE presented, whereas 23% of patients were never willing to choose cessation of treatment. Differences in valuations and treatment preferences were not associated with type of event experienced. Due to the substantial and unpredictable variability in valuations and treatment preferences, recommendations regarding treatment duration should be tailored to patients’ specific values and concerns.

scholarly journals A protocol for a discrete choice experiment: understanding patient medicine preferences for managing chronic non-cancer pain

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e027153 ◽  
Author(s):  
Marian Shanahan ◽  
Briony Larance ◽  
Suzanne Nielsen ◽  
Milton Cohen ◽  
Maria Schaffer ◽  
...  
Keyword(s):  
Focus Group ◽  
Cancer Pain ◽  
Discrete Choice ◽  
Online Survey ◽  
Latent Class ◽  
Management Strategies ◽  
Discrete Choice Experiments ◽  
Research Centre ◽  
Treatment Preferences ◽  
Convenience Sample

IntroductionHigh rates of chronic non-cancer pain (CNCP), concerns about adverse effects including dependence among those prescribed potent pain medicines, the recent evidence supporting active rather than passive management strategies and a lack of funding for holistic programme have resulted in challenges around decision making for treatment among clinicians and their patients. Discrete choice experiments (DCEs) are one way of assessing and valuing treatment preferences. Here, we outline a protocol for a study that assesses patient preferences for CNCP treatment.Methods and analysisA final list of attributes (and their levels) for the DCE was generated using a detailed iterative process. This included a literature review, a focus group and individual interviews with those with CNCP and clinicians who treat people with CNCP. From this process a list of attributes was obtained. Following a review by study investigators including pain and addiction specialists, pharmacists and epidemiologists, the final list of attributes was selected (number of medications, risk of addiction, side effects, pain interference, activity goals, source of information on pain, provider of pain care and out-of-pocket costs). Specialised software was used to construct an experimental design for the survey. The survey will be administered to two groups of participants, those from a longitudinal cohort of patients receiving opioids for CNCP and a convenience sample of patients recruited through Australia’s leading pain advocacy body (Painaustralia) and their social media and website. The data from the two participant groups will be initially analysed separately, as their demographic and clinical characteristics may differ substantially (in terms of age, duration of pain and current treatment modality). Mixed logit and latent class analysis will be used to explore heterogeneity of responses.Ethics and disseminationEthics approval was obtained from the University of New South Wales Sydney Human Ethics committee HC16511 (for the focus group discussions, the one-on-one interviews and online survey) and HC16916 (for the cohort). A lay summary will be made available on the National Drug and Alcohol Research Centre website and Painaustralia’s website. Peer review papers will be submitted, and it is expected the results will be presented at relevant pain management conferences nationally and internationally. These results will also be used to improve understanding of treatment goals between clinicians and those with CNCP.

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