Discrete choice experiments in health economics

Title: Discrete choice experiments in health economics
Authors: Bryan, Stirlin and Dolan, Paul
PublisherEuropean journal of health economics, 5 (3). pp. 199-202
ISSN: 618-7598
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Abstract: One method that is increasingly being used in health economics to elicit stated preferences concerning health matters is the discrete choice experiment (DCE). This editorial explores four sets of issues facing researchers who wish to employ DCE techniques: (a) normative issues about how data from DCE studies might be used to inform policy, (b) psychological issues concerning the meaningfulness of the data generated, (d) technical issues relating to how the data are generated and (d) issues relating to the generalisability of the data from DCE studies. Given current uncertainties surrounding these issues, it is our view that more caution and greater circumspection towards DCE is appropriate at this stage.

Explaining attitudes towards ambiguity: an experimental test of the comparative ignorance hypothesis

Title: Explaining attitudes towards ambiguity: an experimental test of the comparative ignorance hypothesis
Authors: Dolan, Paul and Jones, Martin
PublisherScottish journal of political economy, 51 (3). pp. 281-301
ISSN: 0036-9292
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Abstract: Many theories have been put forward to explain attitudes towards ambiguity. This paper reports on an experiment designed to test for the existence of Comparative Ignorance when it is tested over events with a range of different likelihoods. A total of 93 subjects valued a series of gambles, one of which was played out for real. The results do not lend support to the theory, although the relationship between risk and ambiguity does appear to correspond with other theories and previous empirical work.

A note on a discussion group study of public preferences regarding priorities in the allocation of donor kidneys

Title: A note on a discussion group study of public preferences regarding priorities in the allocation of donor kidneys
Authors: Dolan, Paul and Shaw, Rebecca
PublisherHealth policy, 68 (1). pp. 31-36
ISSN: 0168-8510
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Abstract: Objective: To explore whether and how people wish to give differential priority based on certain characteristics of the potential recipient of a donor kidney. Design: A random sample of people resident in York was invited to attend two focus group meetings each, a fortnight apart. Setting: The City of York. Participants: Twenty-three randomly chosen people meeting in four groups of five or six. Main outcome measures: Those factors that people think should be taken into account when allocating donor kidneys, in addition to the expected benefits from transplantation. Results: People are willing and able to distinguish between potential recipients of a kidney transplantation according to a range of characteristics beyond the expected benefits from treatment. There is a clear consensus across the four groups that one of the most important considerations is what will happen to the patient without treatment, and so priority is given to those with a poor prognosis. There is also a strong view that priority should be given to younger patients and to those with dependants. The time spent waiting for a transplant is also important, but less so. Conclusions: A sample of the general public, after discussion and debate, wish to take account of a number of patient characteristics when allocating donor kidneys. There is some degree of consensus about what these factors should be and this suggests that it might be possible to develop a set of guidelines for the allocation of donor kidneys.

To what extent do people prefer health states with higher values? A note on evidence from the EQ-5D valuation set

Title: To what extent do people prefer health states with higher values? A note on evidence from the EQ-5D valuation set
Authors: Roberts, Jennifer and Dolan, Paul
Publisher: Health economics, 13 (7). pp. 733-737
ISSN: 1057-9230
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Abstract: The EQ-5D general population valuation set (or ‘tariff’) is increasingly being used in the evaluation of health care interventions and has been recommended by the National Institute for Clinical Excellence (NICE) for use in cost-utility analyses of health technologies. To be of use to decision-makers, the health gain implied by changes in health state values must reflect individual preferences. At the simplest level, if State A has a higher mean value than State B, then the majority of people should consider a move from B to A to be a good thing. In this paper, we examine the extent to which this is true by re-analysing data from the general population study used to derive the EQ-5D tariff. We show that, on average, the difference in value between two states has to be as large as 0.20 (on a scale where one represents full and zero represents death) for 70% of respondents to agree with the sign of that difference (never mind its size). Results such as these have important implications for the use of the EQ-5D tariff that has been generated from these data.