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Choice Blindness and Health-State Choices among Adolescents and Adults


  • Ernest H. Law
  • Annika L. Pickard
  • Anika Kaczynski
  • A. Simon Pickard


Objective. To assess the feasibility and validity of using a discrete choice experiment format to elicit health preferences in adolescents by comparing illogical choices and choice-blindness rates between adults and adolescents; and to explore the relationship between personality traits and health-state choices. Methods. A convenience sample of adults and adolescents (12 to 17 y old) were recruited from around Chicago, USA. A personality inventory was administered, followed by pairwise comparisons of 6 health-state scenarios which asked each candidate to select their preferred choice. Health-state descriptions were based on a simplified 3-dimension version of the EQ-5D (mobility, pain, depression, each with 3 levels). For 2 scenarios, the respondent’s preferred choice was switched; if the respondent did not notice the switch they were considered “choice blind†. Logistic regression evaluated the association of personality, gender, and age with choice blindness and health-state choice. Results. Ninety-nine respondents were recruited (44% adults). Comparing adolescents to adults, there was no significant difference in the rate of illogical preferences (9% v. 12%) or in preferring dead to the worst health state (56% v. 64%) ( P > 0.05). Choice-blindness rates were significantly higher in adolescents (35%) than adults (9%) ( P

Suggested Citation

  • Ernest H. Law & Annika L. Pickard & Anika Kaczynski & A. Simon Pickard, 2017. "Choice Blindness and Health-State Choices among Adolescents and Adults," Medical Decision Making, , vol. 37(6), pages 680-687, August.
  • Handle: RePEc:sae:medema:v:37:y:2017:i:6:p:680-687
    DOI: 10.1177/0272989X17700847

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    References listed on IDEAS

    1. Nancy J. Devlin & Paul Hansen & Paul Kind & Alan Williams, 2003. "Logical inconsistencies in survey respondents' health state valuations ‐ a methodological challenge for estimating social tariffs," Health Economics, John Wiley & Sons, Ltd., vol. 12(7), pages 529-544, July.
    2. Ratcliffe, Julie & Huynh, Elisabeth & Chen, Gang & Stevens, Katherine & Swait, Joffre & Brazier, John & Sawyer, Michael & Roberts, Rachel & Flynn, Terry, 2016. "Valuing the Child Health Utility 9D: Using profile case best worst scaling methods to develop a new adolescent specific scoring algorithm," Social Science & Medicine, Elsevier, vol. 157(C), pages 48-59.
    3. Kathryn E. Flynn & Maureen A. Smith, 2007. "Personality and Health Care Decision-Making Style," Journals of Gerontology: Series B, Gerontological Society of America, vol. 62(5), pages 261-267.
    4. Mandy Ryan & Verity Watson & Vikki Entwistle, 2009. "Rationalising the ‘irrational’: a think aloud study of discrete choice experiment responses," Health Economics, John Wiley & Sons, Ltd., vol. 18(3), pages 321-336, March.
    5. Julie Ratcliffe & Elisabeth Huynh & Katherine Stevens & John Brazier & Michael Sawyer & Terry Flynn, 2016. "Nothing About Us Without Us? A Comparison of Adolescent and Adult Health‐State Values for the Child Health Utility‐9D Using Profile Case Best–Worst Scaling," Health Economics, John Wiley & Sons, Ltd., vol. 25(4), pages 486-496, April.
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