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How Should Discrete Choice Experiments with Duration Choice Sets Be Presented for the Valuation of Health States?


  • Brendan Mulhern

    (Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia)

  • Richard Norman

    (Curtin University, Perth, Australia)

  • Koonal Shah

    (Office of Health Economics, London, England)

  • Nick Bansback

    (University of British Columbia, Vancouver, Canada)

  • Louise Longworth

    (PHMR, London, England)

  • Rosalie Viney

    (Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia)


Background. Discrete Choice Experiments including duration (DCE TTO ) can be used to generate utility values for health states from measures such as EQ-5D-5L. However, methodological issues concerning the optimum way to present choice sets remain. The aim of the present study was to test a range of task presentation approaches designed to support the DCE TTO completion process. Methods. Four separate presentation approaches were developed to examine different task features including dimension level highlighting, and health state severity and duration level presentation. Choice sets included 2 EQ-5D-5L states paired with 1 of 4 duration levels, and a third “immediate death†option. The same design, including 120 choice sets (developed using optimal methods), was employed across all approaches. The online survey was administered to a sample of the Australian population who completed 20 choice sets across 2 approaches. Conditional logit regression was used to assess model consistency, and scale parameter testing investigated poolability. Results. Overall 1,565 respondents completed the survey. Three approaches, using different dimension level highlighting techniques, produced mainly monotonic coefficients that resulted in a larger disutility as the severity level increased (excepting usual activities levels 2/3). The fourth approach, using a level indicator to present the severity levels, has slightly more non-monotonicity and produced larger ordered differences for the more severe dimension levels. Scale parameter testing suggested that the data cannot be pooled. Conclusions. The results provide information regarding how to present DCE tasks for health state valuation. The findings improve our understanding of the impact of different presentation approaches on valuation, and how DCE questions could be presented to be amenable to completion. However, it is unclear if the task presentation impacts online respondent engagement.

Suggested Citation

  • Brendan Mulhern & Richard Norman & Koonal Shah & Nick Bansback & Louise Longworth & Rosalie Viney, 2018. "How Should Discrete Choice Experiments with Duration Choice Sets Be Presented for the Valuation of Health States?," Medical Decision Making, , vol. 38(3), pages 306-318, April.
  • Handle: RePEc:sae:medema:v:38:y:2018:i:3:p:306-318
    DOI: 10.1177/0272989X17738754

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    References listed on IDEAS

    1. LUYTEN, Jeroen & KESSELS, Roselinde & GOOS, Peter & BEUTELS, Philippe, 2013. "Public preferences for prioritizing preventive and curative health care interventions: A discrete choice experiment," Working Papers 2013032, University of Antwerp, Faculty of Business and Economics.
    2. Richard Norman & Brendan Mulhern & Rosalie Viney, 2016. "The Impact of Different DCE-Based Approaches When Anchoring Utility Scores," PharmacoEconomics, Springer, vol. 34(8), pages 805-814, August.
    3. Amanda Cole & Koonal Shah & Brendan Mulhern & Yan Feng & Nancy Devlin, 2018. "Valuing EQ-5D-5L health states ‘in context’ using a discrete choice experiment," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(4), pages 595-605, May.
    4. Uggeldahl, Kennet & Jacobsen, Catrine & Lundhede, Thomas Hedemark & Olsen, Søren Bøye, 2016. "Choice certainty in Discrete Choice Experiments: Will eye tracking provide useful measures?," Journal of choice modelling, Elsevier, vol. 20(C), pages 35-48.
    5. Richard Norman & Paula Cronin & Rosalie Viney, 2013. "A Pilot Discrete Choice Experiment to Explore Preferences for EQ-5D-5L Health States," Applied Health Economics and Health Policy, Springer, vol. 11(3), pages 287-298, June.
    6. Rosalie Viney & Richard Norman & John Brazier & Paula Cronin & Madeleine T. King & Julie Ratcliffe & Deborah Street, 2014. "An Australian Discrete Choice Experiment To Value Eq‐5d Health States," Health Economics, John Wiley & Sons, Ltd., vol. 23(6), pages 729-742, June.
    7. Rosalie Viney & Elizabeth Savage & Jordan Louviere, 2005. "Empirical investigation of experimental design properties of discrete choice experiments in health care," Health Economics, John Wiley & Sons, Ltd., vol. 14(4), pages 349-362, April.
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