Prevalence of Missing Values and Protest Zeros in Contingent Valuation in Dental Medicine

Pedram Sendi, Arta Ramadani and Michael M. Bornstein
Additional contact information
Pedram Sendi: Department of Oral Health and Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland
Arta Ramadani: Department of Oral Health and Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland
Michael M. Bornstein: Department of Oral Health and Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058 Basel, Switzerland

IJERPH, 2021, vol. 18, issue 14, 1-11

Abstract: Background: The number of contingent valuation (CV) studies in dental medicine using willingness-to-pay (WTP) methodology has substantially increased in recent years. Missing values due to absent information (i.e., missingness) or false information (i.e., protest zeros) are a common problem in WTP studies. The objective of this study is to evaluate the prevalence of missing values in CV studies in dental medicine, to assess how these have been dealt with, and to suggest recommendations for future research. Methods: We systematically searched electronic databases (MEDLINE, Web of Science, Cochrane Library, PROSPERO) on 8 June 2021, and hand-searched references of selected reviews. CV studies in clinical dentistry using WTP for valuing a good or service were included. Results: We included 49 WTP studies in our review. Out of these, 19 (38.8%) reported missing values due to absent information, and 28 (57.1%) reported zero values (i.e., WTP valued at zero). Zero values were further classified into true zeros (i.e., representing the underlying preference of the respondent) or protest zeros (i.e., false information as a protest behavior) in only 9 studies. Most studies used a complete case analysis to address missingness while only one study used multiple imputation. Conclusions: There is uncertainty in the dental literature on how to address missing values and zero values in CV studies. Zero values need to be classified as true zeros versus protest zeros with follow-up questions after the WTP elicitation procedure, and then need to be handled differently. Advanced statistical methods are available to address both missing values due to missingness and due to protest zeros but these are currently underused in dental medicine. Failing to appropriately address missing values in CV studies may lead to biased WTP estimates of dental interventions.

Keywords: dental medicine; contingent valuation; willingness-to-pay; health services research; oral public health; missing values; protest zeros; economic evaluation; health state utility (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
https://www.mdpi.com/1660-4601/18/14/7219/pdf (application/pdf)
https://www.mdpi.com/1660-4601/18/14/7219/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:14:p:7219-:d:589205

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().