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Empirical Testing of the External Validity of a Discrete Choice Experiment to Determine Preferred Treatment Option: The Case of Sleep Apnea

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  • Nicolas Krucien
  • Amiram Gafni
  • Nathalie Pelletier‐Fleury

Abstract

There is an increasing use of the discrete choice experiment (DCE) method in health care to estimate preferences of individuals and the public for different services. Despite this increasing use, there are few studies that investigate the validity of the DCE in health. This study investigates the external validity of DCE by comparing the predicted treatment choices from the DCE to the actual treatment choices made by the same respondents using a decision board (DB) approach. The sample includes 140 patients who came for a sleep apnea routine visit in a hospital setting. Each respondent answered 10 DCE tasks and 1 DB task. The preferences were estimated with a generalized multinomial logit model and the predicted and actual treatment choices were compared both at the sample and individual levels. The results raise questions about the external validity of DCE in health. At the sample level, the comparison showed large but not significant differences between the two methods. This can be explained in part by the aggregation process that obscures variability in the individuals’ preferences. At the individual level, the comparison showed that the two methods led to significantly different patterns of choices. Copyright © 2014 John Wiley & Sons, Ltd.

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  • Nicolas Krucien & Amiram Gafni & Nathalie Pelletier‐Fleury, 2015. "Empirical Testing of the External Validity of a Discrete Choice Experiment to Determine Preferred Treatment Option: The Case of Sleep Apnea," Health Economics, John Wiley & Sons, Ltd., vol. 24(8), pages 951-965, August.
    • Handle: RePEc:wly:hlthec:v:24:y:2015:i:8:p:951-965
    DOI: 10.1002/hec.3076
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    2. John C. Whitehead & Daniel K. Lew, 2020. "Estimating recreation benefits through joint estimation of revealed and stated preference discrete choice data," Empirical Economics, Springer, vol. 58(4), pages 2009-2029, April.
    3. Pedersen, Line Bjørnskov & Hess, Stephane & Kjær, Trine, 2016. "Asymmetric information and user orientation in general practice: Exploring the agency relationship in a best–worst scaling study," Journal of Health Economics, Elsevier, vol. 50(C), pages 115-130.
    4. Werbeck, Anna, 2024. "Stated preferences and actual choices in german health insurance," Ruhr Economic Papers 1091, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    5. Sydenham, Rikke Vognbjerg & Jarbøl, Dorte Ejg & Hansen, Malene Plejdrup & Justesen, Ulrik Stenz & Watson, Verity & Pedersen, Line Bjørnskov, 2022. "Prescribing antibiotics: Factors driving decision-making in general practice. A discrete choice experiment," Social Science & Medicine, Elsevier, vol. 305(C).
    6. Matthew Quaife & Fern Terris-Prestholt & Gian Luca Di Tanna & Peter Vickerman, 2018. "How well do discrete choice experiments predict health choices? A systematic review and meta-analysis of external validity," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(8), pages 1053-1066, November.
    7. Marcel F. Jonker & Bas Donkers & Esther de Bekker‐Grob & Elly A. Stolk, 2019. "Attribute level overlap (and color coding) can reduce task complexity, improve choice consistency, and decrease the dropout rate in discrete choice experiments," Health Economics, John Wiley & Sons, Ltd., vol. 28(3), pages 350-363, March.
    8. Vikas Soekhai & Esther W. Bekker-Grob & Alan R. Ellis & Caroline M. Vass, 2019. "Discrete Choice Experiments in Health Economics: Past, Present and Future," PharmacoEconomics, Springer, vol. 37(2), pages 201-226, February.

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