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      Transforming discrete choice experiment latent scale values for EQ-5D-3L using the visual analogue scale

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          Abstract

          Background

          Discrete choice experiments (DCEs) are widely used to elicit health state preferences. However, additional information is required to transform values to a scale with dead valued at 0 and full health valued at 1. This paper presents DCE-VAS, an understandable and easy anchoring method with low participant burden based on the visual analogue scale (VAS).

          Methods

          Responses from 1450 members of the UK general public to a discrete choice experiment (DCE) were analysed using mixed logit models. Latent scale valuations were anchored to a full health = 1, dead = 0 scale using participants’ VAS ratings of three states including the dead. The robustness of results was examined. This included a filtering procedure with the influence each individual respondent had on valuation being calculated, and those whose influence was more than two standard deviations away from the mean excluded.

          Results

          Coefficients in all models were in the expected direction and statistically significant. Excluding respondents who self-reported not understanding the VAS task did not significantly influence valuation, but excluding a small number who valued 33333 extremely low did. However, after eight respondents were removed via the filtering procedure, valuations were robust to removing other participants.

          Conclusion

          DCE-VAS is a feasible way of anchoring DCE results to a 0–1 anchored scale with low additional respondent burden.

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          Most cited references33

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          Mixed Logit with Repeated Choices: Households' Choices of Appliance Efficiency Level

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            Using a discrete choice experiment to estimate health state utility values.

            In this study we explored a novel application of the discrete choice experiment (DCE) that resembles the time trade off (TTO) task to estimate values on the health utility scale for the EQ-5D. The DCE was tested in a survey alongside the TTO in a sample of English-speaking Canadians recruited by a market research company. The study found that the DCE is able to derive logical and consistent values for health states valued on the full health - dead scale. The DCE overcame some issues identified in the version of TTO currently used to value EQ-5D, notably allowing for fewer data exclusions and incorporating values considered worse than dead without introducing a separate valuation procedure. This has important implications for providing robust values that represent the preferences of all respondents. Copyright © 2011 Elsevier B.V. All rights reserved.
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              A pilot discrete choice experiment to explore preferences for EQ-5D-5L health states.

              The EQ-5D-5L has recently been developed to improve the sensitivity of the widely used three-level version. Valuation studies are required before the use of this new instrument can be adopted. The use of discrete choice experiments (DCEs) in this area is a promising area of research. To test the plausibility and acceptability of estimating an Australian algorithm for the newly developed five-level version of the EQ-5D using a DCE. A choice experiment was designed, consisting of 200 choice sets blocked such that each respondent answered 10 choice sets. Each choice set presented two health state-duration combinations, and an immediate death option. The experiment was implemented in an online Australian-representative sample. A random-effects probit model was estimated. To explore the feasibility of the approach, an indicative algorithm was developed. The algorithm is transformed to a 0 to 1 scale suitable for use to estimate quality-adjusted life-year weights for use in economic evaluation. A total of 973 respondents undertook the choice experiment. Respondents were slightly younger and better educated than the general Australian population. Of the 973 respondents, 932 (95.8 %) completed all ten choice sets, and a further 12 completed some of the choice sets. In choice sets in which one health state-duration combination dominated another, the dominant option was selected on 89.5 % of occasions. The mean and median completion times were 17.9 and 9.4 min, respectively, exhibiting a highly skewed distribution. The estimation results are broadly consistent with the monotonic nature of the EQ-5D-5L. Utility is increasing in life expectancy (i.e., respondents tend to prefer health profiles with longer life expectancy), and mainly decreases in higher levels in each dimension of the instrument. A high proportion of respondents found the task clear and relatively easy to complete. DCEs are a feasible approach to the estimation of utility weights for more complex multi-attribute utility instruments such as the EQ-5D-5L.
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                Author and article information

                Contributors
                e.j.d.webb@leeds.ac.uk
                Journal
                Eur J Health Econ
                Eur J Health Econ
                The European Journal of Health Economics
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1618-7598
                1618-7601
                16 March 2020
                16 March 2020
                2020
                : 21
                : 5
                : 787-800
                Affiliations
                [1 ]GRID grid.9909.9, ISNI 0000 0004 1936 8403, Leeds Institute of Health Sciences, , University of Leeds, ; Leeds, UK
                [2 ]GRID grid.9909.9, ISNI 0000 0004 1936 8403, Leeds Institute of Medical Research At St. James’s, , University of Leeds, ; Leeds, UK
                Author information
                https://orcid.org/0000-0001-7918-839X
                Article
                1173
                10.1007/s10198-020-01173-0
                7366608
                32180068
                645d9a9f-8503-42f7-9782-ca8e2f27a88e
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 11 September 2019
                : 25 February 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000265, Medical Research Council;
                Award ID: MR/M025179/1
                Award Recipient :
                Categories
                Original Paper
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2020

                Economics of health & social care
                eq-5d,discrete choice experiment,anchoring,visual analogue scale,valuation,i10,i30,d7

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