Abstract
BackgroundMeasuring adolescents’ preferences for health states can play an important role in evaluating the delivery of pediatric healthcare. However, formal evaluation of the common direct preference elicitation methods for health states has not been done with adolescents. Therefore, the purpose of this study is to test how these methods perform in terms of their feasibility, reliability, and validity for measuring health state preferences in adolescents.MethodsThis study used a web-based survey of adolescents, 18 years of age or younger, living in the United States. The survey included four health states, each comprised of six attributes. Preferences for these health states were elicited using the visual analogue scale, time trade-off, and standard gamble. The feasibility, test-retest reliability, and construct validity of each of these preference elicitation methods were tested and compared.ResultsA total of 144 participants were included in this study. Using a web-based survey format to elicit preferences for health states from adolescents was feasible. A majority of participants completed all three elicitation methods, ranked those methods as being easy, with very few requiring assistance from someone else. However, all three elicitation methods demonstrated weak test-retest reliability, with Kendall’s tau-a values ranging from 0.204 to 0.402. Similarly, all three methods demonstrated poor construct validity, with 9–50% of all rankings aligning with our expectations. There were no significant differences across age groups.ConclusionsUsing a web-based survey format to elicit preferences for health states from adolescents is feasible. However, the reliability and construct validity of the methods used to elicit these preferences when using this survey format are poor. Further research into the effects of a web-based survey approach to eliciting preferences for health states from adolescents is needed before health services researchers or pediatric clinicians widely employ these methods.
Highlights
Measuring adolescents’ preferences for health states can play an important role in evaluating the delivery of pediatric healthcare
Health states describe a scenario that an individual may experience at a particular point in time [1]
Discrete choice experiments are commonly used to elicit preferences for health and health states [6]
Summary
Measuring adolescents’ preferences for health states can play an important role in evaluating the delivery of pediatric healthcare. Formal evaluation of the common direct preference elicitation methods for health states has not been done with adolescents. The scenario is comprised of attributes that define physical and mental functional abilities, and the severity of symptoms. These attributes may be real – that is, Crump et al BMC Pediatrics (2018) 18:199 pain”, “moderate pain”, “severe pain”). The extent to which an individual desires one health state over another – referred to as a preference in this study – can be measured. It is common practice to measure preferences for health states in adults [3]. A systematic review identified 344 studies eliciting health and health care preferences from adults using direct methods [4]. Discrete choice experiments are commonly used to elicit preferences for health and health states [6]
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