Discrete Choice Experiment Method Research Articles

Patient preferences for models of care for fibromyalgia: A discrete choice experiment.

Fibromyalgia is a common reason for referral to a rheumatologist and is a centralised pain state with symptoms beginning in adolescence/early adulthood and manifests as pain throughout the body, fatigue and cognitive dysfunction. Whilst there is considerable evidence on effective treatments, diagnosis and management are complex. There is almost no evidence on how to organise health services to deliver recommended therapies. The aim of the current study was to understand patient preferences for different features of healthcare services for fibromyalgia. We use the Discrete Choice Experiment Method (DCE), a choice-based survey that quantifies preferences for attributes of goods, services or policy interventions, to elicit preferences in relation to alternative models of care for people with fibromyalgia. In this study, attributes describe different models of care for fibromyalgia. We based attributes and levels on earlier phases of the PACFiND project and a literature review on fibromyalgia models of care. The final analysis sample consisted of 518 respondents who completed the survey in full. The final analysis sample consisted of 518 respondents ((patients living in the UK, over 18 years old, with a diagnosis of fibromyalgia), who completed the survey in full. The model of care most preferred is one characterised by earlier diagnosis and ongoing management by a Rheumatologist, via Face-to-face or Phone/video call appointments, with a stronger preference for the latter mode of support. The most preferred treatment was Medication, followed by Physical Therapy, with the least preferred being Talking Therapy. Relative to a Waiting Time for treatment of 6 months, respondents would prefer a lower Waiting Time of 3 months and dislike waiting 12 months for treatment. Respondents showed willingness to receive Ongoing Help and Advice by a Nurse Practitioner or a GP, instead of a Specialist Rheumatologist, provided they were compensated by other changes in the model of care. This study has found that, although respondents express a preference for specialist care, provided by a Rheumatologist, they may be willing to trade-off this preference against other features within a model of care. This willingness to accept a different skill-mix (e.g., appointments with a GP or a Nurse Practitioner) has important implications for practice and policy, as this is a more feasible option in settings where the availability of specialist care is highly constrained.

Priorities for contraceptive method and service delivery attributes among adolescent girls and young women in Kenya: a qualitative study.

Despite increasing global commitment to meeting the family planning needs of adolescent girls and young women (AGYW), there is limited research on how they prioritize contraceptive method and service delivery characteristics. In this qualitative study, we examine the specific elements that drive the contraceptive choices of Kenyan AGYW, and apply our findings to the development of attributes and levels for a discrete choice experiment (DCE). Our four-stage approach included data collection, data reduction, removing inappropriate attributes, and optimizing wording. Between June-October 2021, we conducted in-depth interviews with 30 sexually-active 15-24 year-old AGYW in Kisumu county, Kenya who were non-pregnant and desired to delay pregnancy. Interviews focused on priorities for contraceptive attributes, how AGYW make trade-offs between among these attributes, and the influences of preferences on contraceptive choice. Translated transcripts were qualitatively coded and analyzed with a constant comparative approach to identify key concepts. We developed and iteratively revised a list of attributes and levels, and pre-tested draft DCE choice tasks using cognitive interviews with an additional 15 AGYW to optimize comprehension and relevance. In-depth interview participants' median age was 18, 70% were current students, and 93% had a primary sexual partner. AGYW named a variety of priorities and preferences related to choosing and accessing contraceptive methods, which we distilled into six key themes: side effects; effectiveness; user control; privacy; source of services; and cost. Bleeding pattern was top of mind for participants; amenorrhea was generally considered an intolerable side effect. Many participants felt more strongly about privacy than effectiveness, though some prioritized duration of use and minimizing chance of pregnancy above other contraceptive characteristics. Most AGYW preferred a clinic setting for access, as they desired contraceptive counseling from a provider, but pharmacies were considered preferable for reasons of privacy. We selected, refined, and pre-tested 7 DCE attributes, each with 2-4 levels. Identifying AGYW preferences for contraceptive method and service delivery characteristics is essential to developing innovative strategies to meet their unique SRH needs. DCE methods may provide valuable quantitative perspectives to guide and tailor contraceptive counseling and service delivery interventions for AGYW who want to use contraception.

Getting it right with discrete choice experiments: Are we hot or cold?

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 decision-making. 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 pain-relief 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.

Comparison of four value sets derived using different TTO and DCE approaches: application to the new region-specific PBM, AP-7D

BackgroundAP-7D is a newly developed preference-based measure (PBM) in East and Southeast Asia. However, no value set has been established yet. Comparison of the characteristics of value sets obtained by different methods is necessary to consider the most appropriate methodology for valuation survey of AP-7D.MethodWe surveyed the general population’s preference of AP-7D health states by four valuation methods (a) composite time trade-off (cTTO); (b) simple discrete choice experiment (DCE); (c) DCE with duration; and (d) ternary DCE. In Japan, we collected approximately 1,000 samples for cTTO tasks through a face-to-face survey and 2,500 samples for each of the three DCE tasks. Respondents were selected through quota sampling based on the sex and age. The cTTO data were analyzed using a linear mixed and tobit model; the DCE data were analyzed using a simple and panel conditional logit model. Where the results of the analysis showed inconsistencies, a constrained model was used.ResultsSince all the unconstrained models, except simple DCE, showed one or more inconsistencies, the constrained model was used for the analyses. The minimum values for the models were as follows: TTO model, -0.101; simple DCE model, -0.106; DCE with duration model, -0.706; ternary DCE model, -0.306. The score for the DCE with the duration model was much lower than that for the other models. Although the value sets for AP-7D differed among the four valuation methods, the ternary DCE model showed intermediate characteristics between those of the cTTO and DCE with duration models. As compared with to EQ-5D-5L, the distributions of all the scores on the Japanese AP-7D moved to the left. Although “Energy” was one of the domains with the least influence on the AP-7D score in all four models, “Burden to others” had the largest impact on the preferences.ConclusionWe constructed four value sets using different TTO and DCE methods. Our findings are expected not only to contribute to the development of AP-7D, but also other preference-based measures.

Willingness to pay for solar off-grid lighting in rural India

This paper attempts to quantitatively determine the factors that affect the adoption of solar off-grid lighting products from the experience of using solar study lamps. The discrete choice experiment method is applied where the rural household in the primary survey is asked to reveal their willingness to pay for solar off-grid lighting products like Solar Pocket lamp, Solar Hurricane lamp, and Solar Home Lighting System (SHLS) in the pre-intervention and post-intervention stages. The baseline (pre-intervention) and impact (post-intervention) data helps to check whether exposure to the use of solar off-grid product technology will improve familiarity and boosts confidence, which in turn results in a higher willingness to pay for the products. The data analysis using Tobit regression reveals that the willingness to pay significantly rises in the post-intervention phase in the case of all three products. This study examines the factors influencing ‘base of pyramid’ households' willingness to pay for solar off-grid lighting systems in India. Using data collected from 663 households, it is identified that the money spent on kerosene lighting, electricity reliability, household type, total assets, and knowledge of the health effects of kerosene, the specification of the solar panel, the number of solar lamps, and the functioning status of the study lamp are major determinants of the willingness to pay for solar off-grid technologies.

Can environmentally themed music increase consumers' willingness to pay for low-carbon food? A discrete choice experiment method

Transitioning to low-carbon food consumption is indispensable for adapting to and mitigating climate change. Nevertheless, altering dietary habits presents a host of formidable challenges. To explore the role of environmentally themed music in promoting low-carbon food consumption, we conducted a discrete choice experiment, incorporating Michael Jackson's renowned “Earth Song” in the background information. The results revealed the following key insights: Firstly, consumers show concerns about food safety, nutrients, and unnaturalness of the cell-cultured beef, demonstrating the existence of food neophobia or distrust of novelties in cell-cultured beef. Secondly, while the inclusion of environmentally themed music did not completely eliminate consumers' food neophobia, it undeniably played a pivotal role in significantly improving their willingness to pay (WTP) for cell-cultured meat. This effect was achieved by effectively conveying environmental information, stimulating guilt and responsibility, and igniting consumers' enthusiasm for environmental protection. Thirdly, the introduction of “Earth Song” caused a crowding-out effect on eco-friendly packaging and carbon labeling, and reshaped trust in distribution channels. These impacts are all related to the high price of low-carbon food. All these conclusions underscore the substantial role that environmentally themed music can play in promoting low-carbon foods and valuable insights for policymakers and low-carbon food producers.

Economic valuation of industrial heritage: A choice experiment on Shanghai Baosteel industrial site

Industrial heritage has in recent years become an important component in land use and urban development policies. Yet, assessing the economic value associated with the preservation and reuse of industrial complexes remains an open question. In this paper, we apply a discrete choice experiment (DCE) method to assess the economic valuation of the Baosteel steel factory, an industrial brownfield in Shanghai planned to be transformed into an arts and entertainment hub. By eliciting the preferences of locals for the preservation and reuse of distinct attributes of the site, our findings suggest that the preservation of significant landmarks and the intangible component of the industrial site are the two most relevant attributes worth protection. Moreover, we add evidence on the relationship between respondents' economic preferences and their attitude toward the cultural value conveyed by industrial heritage by showing how distinct groups of respondents express different preferences for single attributes of the industrial heritage. The paper contributes to the heritage valuation literature by illustrating the implications and challenges of assessing the demand for industrial heritage rehabilitation projects.

PCR130 Factors Associated With Adjuvant Treatment Options in Resected Stage III Melanoma, From a Patient and Physician Perspective: Preference Assessment Using the Discrete Choice Experiment Method (Pamela Study)

PCR130 Factors Associated With Adjuvant Treatment Options in Resected Stage III Melanoma, From a Patient and Physician Perspective: Preference Assessment Using the Discrete Choice Experiment Method (Pamela Study)

Public preferences and willingness to pay for low impact development: a comparative case study of pilot sponge cities in China

Abstract Increased urbanization and climate change globally have increased the frequency of extreme weather, especially rainstorms and flooding. Low impact development (LID) has been adopted for several decades to reduce urban pluvial flooding and cope with urban climate change. However, LID hasn't been widely used due to the lack of sustainable funding. In this article, a discrete choice experiment method was used to understand public preferences and willingness to pay (WTP) for the functions of LID facilities. Four attributes were selected, and after that, 958 and 646 valid questionnaires were collected in the pilot sponge cities of Zhengzhou and Hebi, respectively. The results showed that respondents showed a significant WTP for LID facilities, with a desire to support rainwater drainage, recreation and entertainment, and the landscape environment. Experience of flooding had a significant effect on Zhengzhou respondents, but not on Hebi respondents. We have concluded that rainwater drainage should still be considered the most important function of LID facilities. At the same time, educational level and flood experiences may not affect the public's WTP. This article can provide a reference for cities that would like to implement LID and create a stormwater fee system to adapt to global change.

Chinese and Thai consumers’ willingness to pay for quality rice attributes: a discrete choice experiment method

Food safety scandals have heightened the general public concern about food quality, safety, and environmental friendliness in food markets globally. Several studies have ascertained that consumers are willing to pay a premium price for food products with quality and safety information labels. However, most of these studies are country-specific, while few studies have investigated consumer preferences in a comparative context. In this study, we employed the Discrete Choice Experiment (DCE) to examine 1,900 Chinese and 2,986 Thai consumers’ willingness-to-pay (WTP) for brand, traceability, and green and organic certification labels on rice. A mixed logit model (MXL) was used to compute consumers’ WTP. The results demonstrate that consumers from both countries preferred green and organic certified labels. However, Chinese consumers’ preference for green and organic certified rice outweighs that of Thai consumers. For brand labels and green and organic certifications, Thai consumers are willing to pay more than the Chinese due to awareness and trust. However, Chinese consumers are willing to pay more for information with traceability labels than Thai consumers because of the increase in household income and health consciousness. The MXL also shows that trust, income, and age are factors associated with consumers’ preferences for certified rice in both countries. To boost consumers’ preferences for certified rice, relevant stakeholders need to implement the use of brand labels, traceability, and certification labels in the rice value chain.

Estimating the monetary value of a Quality-Adjusted Life-Year in Quebec.

The value of a Quality-Adjusted Life-Year (QALY) is of great importance for the healthcare system. It helps when it comes to defining a cost-effectiveness threshold for the evaluation of health technologies. No willingness-to-pay value for a QALY exists in the province of Quebec, Canada. In this paper, we empirically investigated the monetary value of a QALY for the population of Quebec. Based on the Short-Form 6-Dimension version 2 (SF-6Dv2), we conducted an online survey with a representative adult sample living in Quebec. We used a time trade-off (TTO) combined with contingent valuation (CV), and a discrete choice experiment (DCE) to assess both the population's willingness to pay (WTP) for one QALY and the marginal WTP for health attributes. A health utility algorithm using hybrid regression was developed to determine a preference-based value set for health states. Main analysis was conducted on 993 answers for the CV and 2143 answers for the DCE. The willingness-to-pay per QALY varied from CA$ 47,048.84 (CI: 21,554.38; 72,543.30) for CV to CA$ 73,936.87 (CI: 63,105.40; 84,768.35) for DCE. Among the 6 dimensions of the SF-6Dv2, marginal WTP varied from CA$ 4499.15 (CI: 2975.06; 6023.25) for more role accomplishment in daily activities to CA$ 15,867.12 (CI: 13,825.75; 17,908.49) for less pain. Robustness check with multiple alternative samples, as well as alternative health utility algorithms, showed that the results were robust and the DCE method provided 50% larger results than the CV method, although confidence intervals overlap. This paper provides useful information for decision-makers on the monetary value of a QALY in Quebec.

Willingness to pay to avoid mining with adverse externalities

ABSTRACT This paper is one of the very few to use the discrete choice experiment method (DCEM) to estimate the nonmarket values of the impacts on the environmental and health related to mining activities in a developing country. We show that the local population that live close to the mining sites is willing to contribute relatively high levels of money or working hours to avoid mining projects using open pits as their exploitation technology and having important adverse impacts on residents’ environment and health. This study is also one the first to apply the DCEM on the mining setting, to analyse the welfare differences between two contribution modes, money and working hours, and to use the mixed-logit model in this context. We found that the willingness to pay with money, relative to the willingness to work, is not downward biased, a concern in the related literature considering developing countries. To prevent social conflicts, mining companies and governments need to consider the high value that local populations assign to avoid mining with adverse attributes. Such conflicts are costly for mining companies, local populations and countries.

Mitigating effect of providing specific information on consumers’ negative reactions to cause-related marketing

Cause-related marketing (CRM) has received attention from companies around the world in recent years. Companies in Japan use CRM, but they are struggling with it because Japanese consumers have little interest in social contribution and have negative attitudes toward CRM. This study addresses the reason why Japanese consumers display negative attitudes toward products related to CRM from the viewpoint of company motives toward CRM. An online survey was completed by 290 university students in Japan. We estimated the data using the Discrete Choice Experiment (DCE) method. We found that Japanese consumers displayed negative willingness to pay (WTP) toward a well-known brand’s product with CRM information (β = −2.485, WTP = −106.7, p < .001). Providing information on the company’s motive for long-term commitment to CRM (the company’s positive motive for CRM) mitigates the negative effect of CRM (β = −1.721, WTP = −46.3, p < .001). Given this information, the overall assessment (WTP) of CRM (whether a CRM campaign has positive effects on product choice or not) is 2.6, which value is larger than the −45.2 WTP value where a consumer is not given this information. Our results contribute to the theoretical and practical aspects of CRM. Theoretically, we investigate the negative aspects of CRM, whereas many studies focus only on the positive aspects. We concluded that, in Japan, a company is required to demonstrate the motive behind their CRM campaign for it to have an impact on product choice.

Assessing the attractiveness of tourism resources in Noto using the best–worst scaling and discrete choice experiment methods: further utilization of satoyama and satoumi for tourism

Assessing the attractiveness of tourism resources in Noto using the best–worst scaling and discrete choice experiment methods: further utilization of satoyama and satoumi for tourism

Exploring Public Preference and Willingness to Pay for the Ecosystem Benefits of Urban Green Infrastructure: Evidence from a Discrete Choice Experiment of Pilot Sponge Cities in China

Global extreme weather events such as rainstorms, floods and droughts have become increasingly frequent, posing significant threats to human beings worldwide. Green infrastructure has been implemented for decades to mitigate these issues. However, its widespread adoption in cities is still limited. A lack of sustainable funds was viewed as a great challenge for its widespread implementation. Many developed countries have practiced public participation and stormwater fee systems to mitigate these challenges. To assess the value that citizens place on the ecosystem benefits provided by urban green infrastructure is of great importance for increasing public participation and their willingness to pay. Thus, this paper aims to explore public preferences and their willingness to pay for the benefits of green infrastructure to support the construction and maintenance costs. A discrete choice experiment method was employed and five attributes were selected: reduction in run-off pollutant, degrees of ponding, plant type, planting aesthetics and the amount of payment. The Ngene1.2 software was used to generate a questionnaire, and data collected from the case cities, Xianyang and Xi’xian New Area, China, were analyzed using the mixed logit model. The results revealed that in Xianyang, the willingness to pay was not significantly associated with cognition, while in Xi’xian New Area, willingness to pay was positively related to cognition. Respondents exhibited a significant willingness to pay for green infrastructure to achieve reduced degrees of ponding in both cities, as well as improving planting aesthetics in Xi’xian New Area. Based on these findings, we conclude that government decision-makers should prioritize disseminating knowledge about green infrastructure to residents before implementing such projects in communities. The findings provide valuable insights into the potential economic value of urban green infrastructure and can guide policymakers and urban planners in making decisions regarding the design, implementation, and management of green infrastructure. This study contributes to the understanding of citizen perspectives and the economic evaluation of ecosystem services provided by urban green infrastructure.

Assessment of farmers’ preferences for growing particular crops and the correlation with land suitability

The success of agricultural operations is highly dependent on the site selected, which affects sustainability, and it is important to solve problems associated with activities and efficient land use. However, many researchers have selected sites based solely on climate and soil characteristics and have ignored farmer preferences, which has resulted in the failure to meet sustainable agriculture goals, and a proper strategy is therefore required to anticipate related problems. This study was conducted to: (1) analyze plantation development priorities based on the hierarchy of farmers’ preferences, (2) identify the relationship between successful plantations, climate, and soil fertility. The attributes employed to assess farmers’ preferences included price, production, and price stability over the past five years, while annual rainfall, annual temperature, and soil fertility were used to assess land suitability. Farmers’ preferences were analyzed using the discrete choice experiment (DCE) method, and land suitability was analyzed using the fuzzy method. The farmer preference analysis showed that coffee was the priority crop of farmers in most of the research areas, and cocoa was the lowest cultivation priority. Coffee had a higher land suitability index than other plants, ranging from 0.62 to 0.92, and it was dominant within the optimal suitability class. Clove, pepper, and cocoa plants belonged to the moderate land suitability class with indexes of 0.6–0.91, 0.56–0.88, and 0.4–0.86 for pepper, clove, and cocoa, respectively. A regression analysis was conducted to determine the relationship between the priority of cultivated plants based on farmers’ preference and land suitability, and a positive relationship (moderate strength) was determined. These research results show that when selecting priority crops, 21% of farmers’ decisions are influenced by land suitability.

How do we measure the intangible? Overcoming the measurement challenge in services

AbstractMeasuring service tangibility and intangibility aspects has been an interest to service researchers. While the Likert rating scale has been widely employed for measuring mental intangibility or its dimensions, it is not free from issues such as different anchoring, that is, the same words pointing to different attitudes and understanding for different individuals. The present study proposes the usefulness of a discrete choice experiment (DCE), where respondents are asked the same questions (i.e., items) and are presented with a scale while dichotomizing the possible responses for each scale item. We show that our proposed method is accurate and generalizable across contexts and samples through multiple studies. The DCE method gives managers a better way to measure intangibility or similar service constructs like service quality, which can help them manage their service offerings and make customers happier.

Corruption and informal sector households' participation in health insurance in Sierra Leone.

Lack of credibility and trust in fund managers has been highlighted as one of the key reasons why people do not join health insurance schemes in low- and middle-income countries, especially in Africa. This work investigates the impact of corruption on households' willingness to participate and pay for health insurance in Sierra Leone. A discrete choice experiment (DCE) method was used to elicit households' willingness to participate in a health insurance scheme with different attributes. The data were collected from 1458 representative households working in the informal sector of the Northern and Western regions. We explore the relationship between household characteristics and experienced (respectively, perceived) corruption with binary and ordered logit models. We use a Mixed Logit model to estimate the association between corruption and participation in a Health Insurance Scheme (HIS) and households' willingness to pay for a HIS. We find that corruption decreases participation in a public HIS and the willingness to pay for it. Our results highlight the perverse spillover effects of corruption. Not only does corruption hinder the effectiveness of healthcare systems and, thus, worsen health outcomes. It also undermines the willingness to pay for them, jeopardizing the sustainability of healthcare systems in the countries that need them most.

Consumers’ Preference and Future Consideration Toward Organic Instant Noodles: Evidence from Indonesia

The consumption of instant noodles in Indonesia is the second highest globally. However, people are now more aware of sustainable lifestyles and the health risks of consuming food additives, so some opt for more organic choices, including instant noodles. Research on customers’ preferences in this area remains lacking, so the current study aims to fill the gap. This study also analyses the relationship between the choices and consumers’ future considerations. Discrete Choice Experiment (DCE) method was used to reveal the perception of sustainable attributes in organic instant noodles. The future considerations were measured using the Future Consequences Consideration (FCC) scale. As many as 592 respondents participated in the study, selected using the convenience sampling method. Data were analyzed using conditional logit via package support.CEs on R software. The findings show that Indonesian consumers’ preferences are primarily based on the extrinsic attributes: organic labels and packaging materials, but they also consider the health claims. They will likely prefer instant noodles with organic characteristics for future considerations. The results of this study have implications for instant noodle product development. Young consumers take up a large portion of the market, and they are now more aware of sustainability and health. The current study can inform the product development and the approach to the targeted market. To the best of the authors’ knowledge, this is the first study on consumer perception on sustainability attributes in organic instant noodles.

A national survey of Iranian general population to estimate a value set for the EQ-5D-5L.

The main aim of this study is to estimate a national value set of the EQ-5D-5L questionnaire for Iran. The composite time trade-off (cTTO) and discrete choice experiment (DCE) methods; and the protocol for EuroQol Portable Valuation Technology (EQ-PVT) were used to estimate the Iran national value set. 1179 face-to-face computer-assisted interviews were conducted with adults that were recruited from five Iran major cities in 2021. Generalized least squares, Tobit, heteroskedastic, logit, and hybrid models were used to analyze the data and to identify the best fitting model. According to the logical consistency of the parameters, significance levels and prediction accuracy indices of the MAE; a heteroscedastic censored Tobit hybrid model combining cTTO and DCE responses was considered as the best fitting model to estimate the final value set. The predicted values ranged from -1.19 for the worst health state (55555) to 1 for full health (11111), with 53.6% of the predicted values being negative. Mobility was the most influential dimension on health state preference values. The present study estimated a national EQ-5D-5L value set for Iranian policy makers and researchers. The value set enables the EQ-5D-5L questionnaire to use to calculate QALYs to assist the priority setting and efficient allocation of limited healthcare resources.