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Exploring the Reference Point in Prospect Theory: Gambles for Length of Life

Author

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  • Sylvie M. C. van Osch

    (Leiden University Medical Center, Department of Medical Decision Making, J10-S, PO Box 9600, 2300 RC Leiden, Netherlands; phone: +31 (0)71-5264570; fax: +31 (0)71-5266838; s.m.c.van_osch@lumc.nl)

  • Wilbert B. van den Hout
  • Anne M. Stiggelbout

    (Department of Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands)

Abstract

Attitude toward risk is an important factor determining patient preferences. Risk behavior has been shown to be strongly dependent on the perception of the outcome as either a gain or a loss. According to prospect theory, the reference point determines how an outcome is perceived. However, no theory on the location of the reference point exists, and for the health domain, there is no direct evidence for the location of the reference point. This article combines qualitative with quantitative data to provide evidence of the reference point in life-year certainty equivalent (CE) gambles and to explore the psychology behind the reference point. The authors argue that goals (aspirations) in life influence the reference point. While thinking aloud, 45 healthy respondents gave certainty equivalents for life-year CE gambles with long and short durations of survival. Contrary to suggestions from the literature, qualitative data argued that the offered certainty equivalent most frequently served as the reference point. Thus, respondents perceived life-year CE gambles as mixed. Framing of the question and goals set in life appeared to be important factors behind the psychology of the reference point. On the basis of the authors' quantitative and qualitative data, they argue that goals alter the perception of outcomes as described by prospect theory by influencing the reference point. This relationship is more apparent for the near future as opposed to the remote future, as goals are mostly set for the near future.

Suggested Citation

  • Sylvie M. C. van Osch & Wilbert B. van den Hout & Anne M. Stiggelbout, 2006. "Exploring the Reference Point in Prospect Theory: Gambles for Length of Life," Medical Decision Making, , vol. 26(4), pages 338-346, July.
    • Handle: RePEc:sae:medema:v:26:y:2006:i:4:p:338-346
    DOI: 10.1177/0272989X06290484
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    References listed on IDEAS

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    1. Miyamoto, John M. & Eraker, Stephen A., 1989. "Parametric models of the utility of survival duration: Tests of axioms in a generic utility framework," Organizational Behavior and Human Decision Processes, Elsevier, vol. 44(2), pages 166-202, October.
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    Cited by:

    1. Attema, Arthur E. & Brouwer, Werner B.F. & l’Haridon, Olivier, 2013. "Prospect theory in the health domain: A quantitative assessment," Journal of Health Economics, Elsevier, vol. 32(6), pages 1057-1065.
    2. Aurélien Baillon & Han Bleichrodt & Alessandra Cillo, 2015. "A Tailor-Made Test of Intransitive Choice," Operations Research, INFORMS, vol. 63(1), pages 198-211, February.
    3. repec:cup:judgdm:v:8:y:2013:i:1:p:16-24 is not listed on IDEAS
    4. Han Bleichrodt & Yu Gao & Kirsten I. M. Rohde, 2016. "A measurement of decreasing impatience for health and money," Journal of Risk and Uncertainty, Springer, vol. 52(3), pages 213-231, June.
    5. Foster, Gigi & Frijters, Paul & Johnston, David W., 2012. "The triumph of hope over disappointment: A note on the utility value of good health expectations," Journal of Economic Psychology, Elsevier, vol. 33(1), pages 206-214.
    6. Stephane Hess & Amanda Stathopoulos & Andrew Daly, 2012. "Allowing for heterogeneous decision rules in discrete choice models: an approach and four case studies," Transportation, Springer, vol. 39(3), pages 565-591, May.
    7. Aurélien Baillon & Han Bleichrodt & Vitalie Spinu, 2020. "Searching for the Reference Point," Management Science, INFORMS, vol. 66(1), pages 93-112, January.
    8. Stefan A. Lipman & Werner B.F. Brouwer & Arthur E. Attema, 2019. "QALYs without bias? Nonparametric correction of time trade‐off and standard gamble weights based on prospect theory," Health Economics, John Wiley & Sons, Ltd., vol. 28(7), pages 843-854, July.
    9. Attema, Arthur E. & Brouwer, Werner B.F., 2012. "A test of independence of discounting from quality of life," Journal of Health Economics, Elsevier, vol. 31(1), pages 22-34.
    10. Erik Nord & Anja Undrum Enge & Veronica Gundersen, 2010. "QALYs: is the value of treatment proportional to the size of the health gain?," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 596-607, May.
    11. Adam Oliver, 2018. "Your money and your life: Risk attitudes over gains and losses," Journal of Risk and Uncertainty, Springer, vol. 57(1), pages 29-50, August.
    12. repec:cup:judgdm:v:3:y:2008:i::p:162-173 is not listed on IDEAS
    13. Amanda M. Wilson & Irene Mussio & Susan Chilton & Lynn B. Gerald & Rachael M. Jones & Frank A. Drews & Judy S. LaKind & Paloma I. Beamer, 2022. "A Novel Application of Risk–Risk Tradeoffs in Occupational Health: Nurses’ Occupational Asthma and Infection Risk Perceptions Related to Cleaning and Disinfection during COVID-19," IJERPH, MDPI, vol. 19(23), pages 1-14, December.
    14. Ulrich Schmidt & Horst Zank, 2012. "A genuine foundation for prospect theory," Journal of Risk and Uncertainty, Springer, vol. 45(2), pages 97-113, October.
    15. Stefan A. Lipman & Arthur E. Attema & Matthijs M. Versteegh, 2022. "Correcting for discounting and loss aversion in composite time trade‐off," Health Economics, John Wiley & Sons, Ltd., vol. 31(8), pages 1633-1648, August.
    16. Lipman, Stefan A. & Brouwer, Werner B.F. & Attema, Arthur E., 2020. "Living up to expectations: Experimental tests of subjective life expectancy as reference point in time trade-off and standard gamble," Journal of Health Economics, Elsevier, vol. 71(C).
    17. Oliver, Adam, 2018. "Your money and your life: risk attitudes over gains and losses," LSE Research Online Documents on Economics 88583, London School of Economics and Political Science, LSE Library.
    18. Jose-Luis Pinto-Prades & Jose-Maria Abellan-Perpiñan, 2012. "When normative and descriptive diverge: how to bridge the difference," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 38(4), pages 569-584, April.
    19. Bhavani Shanker Uppari & Sameer Hasija, 2019. "Modeling Newsvendor Behavior: A Prospect Theory Approach," Manufacturing & Service Operations Management, INFORMS, vol. 21(3), pages 481-500, July.
    20. Attema, Arthur E. & Brouwer, Werner B.F. & l’Haridon, Olivier & Pinto, Jose Luis, 2015. "Estimating sign-dependent societal preferences for quality of life," Journal of Health Economics, Elsevier, vol. 43(C), pages 229-243.
    21. Einat Neuman & Shoshona Neuman, 2008. "Reference-dependent preferences and loss aversion: A discrete choice experiment in the health-care sector," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 3, pages 162-173, February.
    22. Abellan-Perpiñan, Jose Maria & Bleichrodt, Han & Pinto-Prades, Jose Luis, 2009. "The predictive validity of prospect theory versus expected utility in health utility measurement," Journal of Health Economics, Elsevier, vol. 28(6), pages 1039-1047, December.
    23. Helen Colby & Gretchen B. Chapman, 2013. "Savings, subgoals, and reference points," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 8(1), pages 16-24, January.

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