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A Framework for Instrument Development of a Choice Experiment: An Application to Type 2 Diabetes

Author

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  • Ellen M. Janssen

    (Johns Hopkins Bloomberg School of Public Health
    Johns Hopkins Bloomberg School of Public Health)

  • Jodi B. Segal

    (Johns Hopkins Bloomberg School of Public Health
    Johns Hopkins Bloomberg School of Public Health
    Johns Hopkins School of Medicine)

  • John F. P. Bridges

    (Johns Hopkins Bloomberg School of Public Health
    Johns Hopkins Bloomberg School of Public Health
    Johns Hopkins Bloomberg School of Public Health)

Abstract

Objective Choice experiments are increasingly used to obtain patient preference information for regulatory benefit–risk assessments. Despite the importance of instrument design, there remains a paucity of literature applying good research principles. We applied a novel framework for instrument development of a choice experiment to measure type 2 diabetes mellitus treatment preferences. Methods Applying the framework, we used evidence synthesis, expert consultation, stakeholder engagement, pretest interviews, and pilot testing to develop a best–worst scaling (BWS) and discrete choice experiment (DCE). We synthesized attributes from published DCEs for type 2 diabetes, consulted clinical experts, engaged a national advisory board, conducted local cognitive interviews, and pilot tested a national survey. Results From published DCEs (n = 17), ten attribute categories were extracted with cost (n = 11) having the highest relative attribute importance (RAI) (range 6–10). Clinical consultation and stakeholder engagement identified six attributes for inclusion. Cognitive pretesting with local diabetes patients (n = 25) ensured comprehension of the choice experiment. Pilot testing with patients from a national sample (n = 50) identified nausea as most important (RAI for DCE: 10 [95 % CI 8.5–11.5]; RAI for BWS: 10 [95 % CI 8.9–11.1]). The developed choice experiment contained five attributes (A1c decrease, blood glucose stability, low blood glucose, nausea, additional medicine, and cost). Conclusion The framework for instrument development of a choice experiment included five stages of development and incorporated multiple stakeholder perspectives. Further comparisons of instrument development approaches are needed to identify best practices. To facilitate comparisons, researchers need to be encouraged to publish or discuss their instrument development strategies and findings.

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  • Ellen M. Janssen & Jodi B. Segal & John F. P. Bridges, 2016. "A Framework for Instrument Development of a Choice Experiment: An Application to Type 2 Diabetes," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 9(5), pages 465-479, October.
    • Handle: RePEc:spr:patien:v:9:y:2016:i:5:d:10.1007_s40271-016-0170-3
    DOI: 10.1007/s40271-016-0170-3
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    References listed on IDEAS

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    1. Jennifer Whitty & Emily Lancsar & Kylie Rixon & Xanthe Golenko & Julie Ratcliffe, 2014. "A Systematic Review of Stated Preference Studies Reporting Public Preferences for Healthcare Priority Setting," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 7(4), pages 365-386, December.
    2. Eve Wittenberg & Monica Bharel & Adrianna Saada & Emely Santiago & John Bridges & Linda Weinreb, 2015. "Measuring the Preferences of Homeless Women for Cervical Cancer Screening Interventions: Development of a Best–Worst Scaling Survey," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(5), pages 455-467, October.
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    6. Susan Joy & Emily Little & Nisa Maruthur & Tanjala Purnell & John Bridges, 2013. "Patient Preferences for the Treatment of Type 2 Diabetes: A Scoping Review," PharmacoEconomics, Springer, vol. 31(10), pages 877-892, October.
    7. Tracey-Lea Laba & Beverley Essue & Merel Kimman & Stephen Jan, 2015. "Understanding Patient Preferences in Medication Nonadherence: A Review of Stated Preference Data," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(5), pages 385-395, October.
    8. Michael Clark & Domino Determann & Stavros Petrou & Domenico Moro & Esther Bekker-Grob, 2014. "Discrete Choice Experiments in Health Economics: A Review of the Literature," PharmacoEconomics, Springer, vol. 32(9), pages 883-902, September.
    9. Marion Danner & Vera Vennedey & Mickaël Hiligsmann & Sascha Fauser & Stephanie Stock, 2016. "Focus Groups in Elderly Ophthalmologic Patients: Setting the Stage for Quantitative Preference Elicitation," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 9(1), pages 47-57, February.
    10. 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.
    11. Lill-Brith Arx & Trine Kjær, 2014. "The Patient Perspective of Diabetes Care: A Systematic Review of Stated Preference Research," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 7(3), pages 283-300, September.
    12. Tanjala S. Purnell & Thomas J. Lynch & Lee Bone & Jodi B. Segal & Crystal Evans & Daniel R. Longo & John F. P. Bridges, 2016. "Perceived Barriers and Potential Strategies to Improve Self-Management Among Adults with Type 2 Diabetes: A Community-Engaged Research Approach," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 9(4), pages 349-358, August.
    13. Aisha Harun & Carol Li & John F. P. Bridges & Yuri Agrawal, 2016. "Understanding the Experience of Age-Related Vestibular Loss in Older Individuals: A Qualitative Study," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 9(4), pages 303-309, August.
    14. S. Wortley & G. Wong & A. Kieu & K. Howard, 2014. "Assessing Stated Preferences for Colorectal Cancer Screening: A Critical Systematic Review of Discrete Choice Experiments," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 7(3), pages 271-282, September.
    15. Susan dosReis & Xinyi Ng & Emily Frosch & Gloria Reeves & Charles Cunningham & John Bridges, 2015. "Using Best–Worst Scaling to Measure Caregiver Preferences for Managing their Child’s ADHD: A Pilot Study," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(5), pages 423-431, October.
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    Cited by:

    1. Anna Nicolet & Clémence Perraudin & Joël Wagner & Ingrid Gilles & Nicolas Krucien & Isabelle Peytremann-Bridevaux & Joachim Marti, 2022. "Patient and Public Preferences for Coordinated Care in Switzerland: Development of a Discrete Choice Experiment," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 15(4), pages 485-496, July.
    2. Zhou, Mo & Bridges, John F.P., 2019. "Explore preference heterogeneity for treatment among people with Type 2 diabetes: A comparison of random-parameters and latent-class estimation techniques," Journal of choice modelling, Elsevier, vol. 30(C), pages 38-49.
    3. Eve Wittenberg, 2016. "Instrument Development in Choice Experiments. Commentary on: “Applying a Framework for Instrument Development of a Choice Experiment to Measure Treatment Preferences in Type 2 Diabetes”," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 9(5), pages 379-381, October.
    4. Dudinskaya, Emilia Cubero & Naspetti, Simona & Zanoli, Raffaele, 2020. "Using eye-tracking as an aid to design on-screen choice experiments," Journal of choice modelling, Elsevier, vol. 36(C).
    5. Aizaki, Hideo & Fogarty, James, 2019. "An R package and tutorial for case 2 best–worst scaling," Journal of choice modelling, Elsevier, vol. 32(C), pages 1-1.
    6. Brouwers, Jonas & Cox, Bianca & Van Wilder, Astrid & Claessens, Fien & Bruyneel, Luk & De Ridder, Dirk & Eeckloo, Kristof & Vanhaecht, Kris, 2021. "The future of hospital quality of care policy: A multi-stakeholder discrete choice experiment in Flanders, Belgium," Health Policy, Elsevier, vol. 125(12), pages 1565-1573.

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