How do people with dementia and family carers value dementia-specific quality of life states? An explorative "Think Aloud" study

OBJECTIVE:To investigate the decision-making processes applied by people with dementia and family carers participating in using health economic approaches to value dementia-specific quality of life states. METHODS:People with dementia (n = 13) and family carers (n = 14) participated in valuing quality of life states using two health economic approaches: Discrete Choice Experiment (DCE) and Best Worst Scaling (BWS). Participants were encouraged to explain their reasoning using a "Think Aloud" approach. RESULTS:People with dementia and family carers adopted a range of decision-making strategies including "anchoring" the presented states against current quality of life, or simplifying the decision-making by focusing on the sub-set of attributes deemed most important. Overall, there was strong evidence of task engagement for BWS and DCE. CONCLUSIONS:Health economic valuation approaches can be successfully applied with people with dementia and family carers. These data can inform the assessment of benefits from their perspectives for incorporation within economic evaluation.Julie Ratcliffe, Claire Hutchinson, Rachel Milte, Kim‐Huong Nguyen, Alyssa Welch, Tessa Caporale, Megan Corlis, Tracy Coman

One Method, Many Methodological Choices: A Structured Review of Discrete-Choice Experiments for Health State Valuation

© 2018, Springer Nature Switzerland AG. Background: Discrete-choice experiments (DCEs) are used in the development of preference-based measure (PBM) value sets. There is considerable variation in the methodological approaches used to elicit preferences. Objective: Our objective was to carry out a structured review of DCE methods used for health state valuation. Methods: PubMed was searched until 31 May 2018 for published literature using DCEs for health state valuation. Search terms to describe DCEs, the process of valuation and preference-based instruments were developed. English language papers with any study population were included if they used DCEs to develop or directly inform the production of value sets for generic or condition-specific PBMs. Assessment of paper quality was guided by the recently developed Checklist for Reporting Valuation Studies. Data were extracted under six categories: general study information, choice task and study design, type of designed experiment, modelling and analysis methods, results and discussion. Results: The literature search identified 1132 published papers, and 63 papers were included in the review. Paper quality was generally high. The study design and choice task formats varied considerably, and a wide range of modelling methods were employed to estimate value sets. Conclusions: This review of DCE methods used for developing value sets suggests some recurring limitations, areas of consensus and areas where further research is required. Methodological diversity means that the values should be seen as experimental, and users should understand the features of the value sets produced before applying them in decision making