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Getting it right with discrete choice experiments: Are we hot or cold?
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DOI：10.1016/j.socscimed.2024.116850.png)
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Abstract
En 中文
Discrete Choice Experiments (DCEs) are widely employed survey -based methods to assess preferences for healthcare services and products. While they offer an experimental way to represent health -related decisions, the stylized representation of scenarios in DCEs may overlook contextual factors that could influence decisionmaking. The aim of this paper was to evaluate the predictive validity of preferences elicited through a DCE in decisions likely influenced by a hot -cold empathy gap, and compare it to another commonly used method, a direct -elicitation question. We focused on preferences for pain -relief modalities, especially for an epidural during childbirth - a context where direct -elicitation questions have shown a preference for or intention to have a natural birth (representing the cold state), yet individuals often opt for an epidural during labor (representing the hot state). Leveraging a unique dataset collected from 248 individuals, we incorporated both the stated preferences collected through a survey administered upon hospital admission for childbirth and the actual painrelief modality usage data documented in medical records. The DCE allowed for the evaluation of scenarios outside of those expected by respondents to simulate decision -making during childbirth. When we compared the predicted epidural use with the actual epidural use during labor, we observed a choice concordance of 71-60%, depending on the model specification. The concordance rate between the predicted and actual choices increased to 77-76% when accounting for the initial use of other ineffective modalities. In contrast, the direct -elicitation choices, relying solely on respondents' baseline expectations, yielded a lower concordance rate of 58% with actual epidural use. These findings highlight the flexibility of the DCE method in simulating complex decision contexts, including those involving hot -cold empathy gaps. The DCE proves valuable in assessing nuanced preferences, providing a more accurate representation of the decision -making processes in healthcare scenarios.
Keywords:
EPIDURAL ANALGESIA
LABOR PAIN
PREFERENCES
EXPERIENCES
VALIDITY
HEALTH
WOMEN
EXPECTATIONS
METAANALYSIS
WILLINGNESS
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