Ernest H Law1, Annika L Pickard2, Anika Kaczynski3, A Simon Pickard1,2,4. 1. Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA (EHL, SP). 2. Second City Outcomes Research LLC, Chicago, IL, USA (ALP, SP). 3. Institute of Health Economics and Health Care Management, Hochschule Neubrandenburg, Neubrandenburg, Germany (AK). 4. Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan (SP).
Abstract
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 < 0.01). The adjusted odds of choice blindness in adolescents was 6.6 (95% CI = 1.8 to 23.8; P = 0.004). Conscientiousness was significantly associated with health-state choice in 3 of the 6 models predicting health-state choice (using P < 0.1 as a threshold). CONCLUSIONS: The results of this exploratory study suggest it is feasible to conduct choice experiments in adolescents; however, adolescents are significantly more likely to demonstrate choice blindness. Psychological traits may be noteworthy predictors of health-state choices, with conscientiousness independently associated with several health-state choices.
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 < 0.01). The adjusted odds of choice blindness in adolescents was 6.6 (95% CI = 1.8 to 23.8; P = 0.004). Conscientiousness was significantly associated with health-state choice in 3 of the 6 models predicting health-state choice (using P < 0.1 as a threshold). CONCLUSIONS: The results of this exploratory study suggest it is feasible to conduct choice experiments in adolescents; however, adolescents are significantly more likely to demonstrate choice blindness. Psychological traits may be noteworthy predictors of health-state choices, with conscientiousness independently associated with several health-state choices.
Authors: Barry Dewitt; Baruch Fischhoff; Alexander L Davis; Stephen B Broomell; Mark S Roberts; Janel Hanmer Journal: Med Decis Making Date: 2019-08-28 Impact factor: 2.583