Unbiased assessment of disease surveillance utilities: A prospect theory application

Arthur Attema, Lisheng He, Alasdair J C Cook and Victor J Del Rio Vilas

PLOS Neglected Tropical Diseases, 2019, vol. 13, issue 5, 1-17

Abstract: Objectives: We contribute a new methodological approach to the ongoing efforts towards evaluating public health surveillance. Specifically, we apply a descriptive framework, grounded in prospect theory (PT), for the evaluation of decisions on disease surveillance deployment. We focus on two attributes of any surveillance system: timeliness, and false positive rate (FPR). Methods: In a sample of 69 health professionals from a number of health related networks polled online, we elicited PT preferences, specifically respondents’ attitudes towards gains, losses and probabilities (i.e., if they overweight or underweight extreme probabilities) by means of a series of lotteries for either timeliness or FPR. Moreover, we estimated willingness to pay (WTP) for improvements in the two surveillance attributes. For contextualization, we apply our framework to rabies surveillance. Results: Our data reveal considerable probability weighting, both for gains and losses. In other words, respondents underestimate their chances of getting a good outcome in uncertain situations, and they overestimate their chances of bad outcomes. Moreover, there is convex utility for losses and loss aversion, that is, losses loom larger than gains of the same absolute magnitude to the respondents. We find no differences between the estimated parameters for timeliness and FPR. The median WTP is $7,250 per day gained in detection time and $30 per 1/10,000 reduction in FPR. Conclusion: Our results indicate that the biases described by PT are present among public health professionals, which highlights the need to incorporate a PT framework when eliciting their preferences for surveillance systems. Author summary: In this paper we contribute a new methodological approach to the ongoing efforts towards evaluating public health surveillance. Specifically, we apply a descriptive framework for the evaluation of decisions on disease surveillance deployment. We focus on two attributes of any surveillance system: timeliness and false positive rates. In a sample of 69 health professionals from a number of health related networks polled online, we elicited preferences, specifically respondents’ attitudes towards gains, losses and probabilities (i.e., if they overweight or underweight extreme probabilities) by means of a series of lotteries. For contextualization, we apply our framework to rabies surveillance. Our data reveal that respondents underestimate their chances of getting a good outcome in uncertain situations, and they overestimate their chances of bad outcomes. Moreover, losses loom larger than gains of the same absolute magnitude to the respondents. We find no differences between the estimated parameters for timeliness and false positive rates. Our results indicate that the biases described are present among public health professionals, and highlight the need to adjust for them when eliciting their preferences for surveillance systems.

Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0007364 (text/html)
https://journals.plos.org/plosntds/article/file?id ... 07364&type=printable (application/pdf)

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:plo:pntd00:0007364

DOI: 10.1371/journal.pntd.0007364

Access Statistics for this article

More articles in PLOS Neglected Tropical Diseases from Public Library of Science
Bibliographic data for series maintained by plosntds ().