Abstract
Quality-Adjusted Life-Years (QALYs) are typically derived from individual preferences over health episodes. This paper reports the first experimental investigation into the effects of collective decision making on health valuations, using both time trade-off (TTO) and standard gamble (SG) tasks. We investigated collective decision making in dyads, by means of a mixed-subjects design where we control for learning effects. Our data suggest that collective decision making has little effect on decision quality, as no effects were observed on decision consistency and monotonicity for both methods. Furthermore, QALY weights remained similar between individual and collective decisions, and the typical difference in elicited weights between TTO and SG was not affected. These findings suggest that consulting with others has little effect on health state valuation, although learning may have. Additionally, our findings add to the literature of the effect of collective decision making, suggesting that no such effect occurs for TTO and SG.
Highlights
Many decisions about health are made in deliberation with others, e.g. children, spouses or medical professionals
These studies suggest that risk preferences, which are relevant for standard gamble (SG), and time preferences, which are relevant for time trade-off (TTO), might be affected by collective decision making
Discounting of future life years leads to downwards bias in TTO [22,23,24], and if such discounting is lower in when individuals decide in a group [11] this could lead to higher TTO weights
Summary
Many decisions about health are made in deliberation with others, e.g. children, spouses or medical professionals. Just a single study explored collective valuation for both SG and TTO and found only small effects [27]; this study used an anonymous voting system to obtain collective SG and TTO responses, i.e. deliberation between respondents was not allowed Those few studies on the effects of deliberation or collective decisions on QALY weights differ in several respects from the economic literature, in which typically smaller groups decide together (i.e. bargaining is included). We obtained a baseline measurement for SG and TTO for each subject, after which we distinguished between groups and individuals for repeated decisions By using such a control condition (similar to that of [17]), we are able to isolate the effect of deciding collectively on multiple facets of SG and TTO decisions (only related to deliberation, bargaining and information exchange). A comparison of individual and collective decision making for standard gamble and time trade‐off
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