Economics at your fingertips  

Severity-Stratified Discrete Choice Experiment Designs for Health State Evaluations

Sesil Lim (), Marcel F. Jonker, Mark Oppe, Bas Donkers () and Elly Stolk
Additional contact information
Sesil Lim: Erasmus University Rotterdam
Marcel F. Jonker: Erasmus University Rotterdam
Mark Oppe: Erasmus University Rotterdam
Elly Stolk: Erasmus University Rotterdam

PharmacoEconomics, 2018, vol. 36, issue 11, 1377-1389

Abstract: Abstract Background Discrete choice experiments (DCEs) are increasingly used for health state valuations. However, the values derived from initial DCE studies vary widely. We hypothesize that these findings indicate the presence of unknown sources of bias that must be recognized and minimized. Against this background, we studied whether values derived from a DCE are sensitive to how well the DCE design spans the severity range. Methods We constructed an experiment involving three variants of DCE tasks for health state valuation: standard DCE, DCE-death, and DCE-duration. For each type of DCE, an experimental design was generated under two different conditions, enabling a comparison of health state values derived from current best practice Bayesian efficient DCE designs with values derived from ‘severity-stratified’ designs that control for coverage of the severity range in health state selection. About 3000 respondents participated in the study and were randomly assigned to one of the six study arms. Results Imposing the severity-stratified restriction had a large effect on health states sampled for the DCE-duration approach. The unstratified efficient design returned a skewed distribution of selected health states, and this introduced bias. The choice probability of bad health states was underestimated, and time trade-offs to avoid bad states were overestimated, resulting in too low values. Imposing the same restriction had limited effect in the DCE-death approach and standard DCE. Conclusion Variation in DCE-derived values can be partially explained by differences in how well selected health states spanned the severity range. Imposing a ‘severity stratification’ on DCE-duration designs is a validity requirement.

Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations: Track citations by RSS feed

Downloads: (external link) Abstract (text/html)
Access to the full text of the articles in this series is restricted.

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:

Ordering information: This journal article can be ordered from

Access Statistics for this article

PharmacoEconomics is currently edited by Timothy Wrightson and Christopher I. Carswell

More articles in PharmacoEconomics from Springer
Bibliographic data for series maintained by Sonal Shukla ().

Page updated 2019-09-13
Handle: RePEc:spr:pharme:v:36:y:2018:i:11:d:10.1007_s40273-018-0694-6