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“I Was Trying to Do the Maths”: Exploring the Impact of Risk Communication in Discrete Choice Experiments

Author

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  • Caroline Vass

    (The University of Manchester)

  • Dan Rigby

    (The University of Manchester)

  • Katherine Payne

    (The University of Manchester)

Abstract

Background Risk is increasingly used as an attribute in discrete choice experiments (DCEs). However, risk and probabilities are complex concepts that can be open to misinterpretation, potentially undermining the robustness of DCEs as a valuation method. This study aimed to understand how respondents made benefit–risk trade-offs in a DCE and if these were affected by the communication of the risk attributes. Methods Female members of the public were recruited via local advertisements to participate in think-aloud interviews when completing a DCE eliciting their preferences for a hypothetical breast screening programme described by three attributes: probability of detecting a cancer; risk of unnecessary follow-up; and cost of screening. Women were randomised to receive risk information as either (1) percentages or (2) percentages and icon arrays. Interviews were digitally recorded then transcribed to generate qualitative data for thematic analysis. Results Nineteen women completed the interviews (icon arrays n = 9; percentages n = 10). Analysis revealed four key themes where women made references to (1) the nature of the task; (2) their feelings; (3) their experiences, for instance making analogies to similar risks; and (4) economic phenomena such as opportunity costs and discounting. Conclusion Most women completed the DCE in line with economic theory; however, violations were identified. Women appeared to visualise risk whether they received icon arrays or percentages only. Providing clear instructions and graphics to aid interpretation of risk and qualitative piloting to verify understanding is recommended. Further investigation is required to determine if the process of verbalising thoughts changes the behaviour of respondents.

Suggested Citation

  • Caroline Vass & Dan Rigby & Katherine Payne, 2019. "“I Was Trying to Do the Maths”: Exploring the Impact of Risk Communication in Discrete Choice Experiments," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 12(1), pages 113-123, February.
    • Handle: RePEc:spr:patien:v:12:y:2019:i:1:d:10.1007_s40271-018-0326-4
    DOI: 10.1007/s40271-018-0326-4
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    References listed on IDEAS

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    1. Fredrik Carlsson & Mitesh Kataria & Elina Lampi, 2010. "Dealing with Ignored Attributes in Choice Experiments on Valuation of Sweden’s Environmental Quality Objectives," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 47(1), pages 65-89, September.
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    3. Mark Harrison & Dan Rigby & Caroline Vass & Terry Flynn & Jordan Louviere & Katherine Payne, 2014. "Risk as an Attribute in Discrete Choice Experiments: A Systematic Review of the Literature," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 7(2), pages 151-170, June.
    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. Coast, Joanna & Flynn, Terry N. & Natarajan, Lucy & Sproston, Kerry & Lewis, Jane & Louviere, Jordan J. & Peters, Tim J., 2008. "Valuing the ICECAP capability index for older people," Social Science & Medicine, Elsevier, vol. 67(5), pages 874-882, September.
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    Cited by:

    1. Caroline M. Vass & Marco Boeri, 2021. "Mobilising the Next Generation of Stated-Preference Studies: the Association of Access Device with Choice Behaviour and Data Quality," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(1), pages 55-63, January.
    2. Vass, Caroline M. & Boeri, Marco & Poulos, Christine & Turner, Alex J., 2022. "Matching and weighting in stated preferences for health care," Journal of choice modelling, Elsevier, vol. 44(C).
    3. Alison Pearce & Mark Harrison & Verity Watson & Deborah J. Street & Kirsten Howard & Nick Bansback & Stirling Bryan, 2021. "Respondent Understanding in Discrete Choice Experiments: A Scoping Review," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(1), pages 17-53, January.
    4. Caroline M. Vass & Niall J. Davison & Geert Stichele & Katherine Payne, 2020. "A Picture is Worth a Thousand Words: The Role of Survey Training Materials in Stated-Preference Studies," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 13(2), pages 163-173, April.
    5. Hangjian Wu & Emmanouil Mentzakis & Marije Schaafsma, 2022. "Exploring Different Assumptions about Outcome-Related Risk Perceptions in Discrete Choice Experiments," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 81(3), pages 531-572, March.
    6. Dan Rigby & Caroline Vass & Katherine Payne, 2020. "Opening the ‘Black Box’: An Overview of Methods to Investigate the Decision-Making Process in Choice-Based Surveys," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 13(1), pages 31-41, February.
    7. Jorge Maurino & Javier Sotoca & Ángel P. Sempere & Luis Brieva & Carlos López de Silanes & Ana B. Caminero & María Terzaghi & Julia Gracia-Gil & Gustavo Saposnik, 2021. "High-Efficacy Disease-Modifying Therapies in People with Relapsing–Remitting Multiple Sclerosis: The Role of Risk Attitude in Treatment Decisions," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(2), pages 241-248, March.

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