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January 2002 - present
Publications
Publications (96)
This study investigates whether a popular stated preference method, the choice experiment (CE), reliably measures individuals’ values for a good. We address this question using an induced value experiment. Our results indicate that CEs fail to elicit payoff maximizing choices. We find little evidence that increasing the salience of the choices or a...
Health utility indices (HUIs) are widely used in economic evaluation. The best–worst scaling (BWS) method is being used to value dimensions of HUIs. However, little is known about the properties of this method. This paper investigates the validity of the BWS method to develop HUI, comparing it to another ordinal valuation method, the discrete choic...
This paper uses meta-regression analysis to test how aspects of discrete choice experiment (DCE) study design influence survey response rates. DCEs are a survey-based method used to elicit preferences for health and health care and are prone to survey errors of coverage, sampling, non-response and measurement. However, research on DCE response rate...
This paper investigates if respondents' choice to not consider all characteristics of a multi-attribute health service may represent preferences. Over the last decade, an increasing number of studies account for attribute non-attendance (ANA) when using discrete choice experiments to elicit individual's preferences. Most studies assume such behavio...
Background/aims
To elicit the preferences and calculate the willingness to pay (WTP) of patients with ocular hypertension (OHT) for eye monitoring services in the UK.
Methods
Patients with OHT aged at least 18 years recruited from four NHS ophthalmology departments were included in the study. Patients’ preferences and WTP for an OHT monitoring ser...
Background/Aims
To assess the cost-effectiveness of making treatment decisions for patients with ocular hypertension (OHT) based on a risk prediction (RP) tool in the United Kingdom.
Methods
A discrete event simulation model was constructed to compare the cost-effectiveness of an alternative care pathway in which the treatment decision was guided...
Pregnant women living in rural areas considering their preferred place of birth may have to ‘trade-off’ travel time/distance and other attributes of care (e.g. the full choice of birthplace options is rarely available locally). This study assesses the preferences and trade-offs of recent mothers who live in remote and rural areas of Great Britain....
Introduction
Climate change poses a major threat to our health, livelihoods and the planet. In 2020, the UK National Health Service (NHS) committed to reducing its Scope 1, 2 and 3 emissions to reach net zero by 2045. Although a net zero NHS would help to limit the consequences of climate change, little is known about the UK general public’s values...
The Discrete Choice Experiment (DCE) remains by far the most popular mechanism used to elicit preferences for non-market goods and services. Yet, the actual reliability of DCE still is questionable. Using an induced value experimental design, we show that standard benchmarks achieve no better than 56 to 60% of payoff-maximizing choices. In this pap...
Introduction
Covid‐19 expanded the use of remote working to engage with public contributors in health and social care research. These changes have the potential to limit the ability to participate in patient and public involvement and engagement (PPIE) for some public contributors. It is therefore important to understand public contributors' prefer...
Objective: To understand how individuals trade off between features of non-pharmaceutical interventions (eg, lockdowns) to control a pandemic across the four nations of the UK.
Design: A survey that included a discrete choice experiment. The survey design was informed using policy documents, social media analysis and input from remote think-aloud i...
Context
Advances in systemic agents have increased overall survival for men diagnosed with metastatic prostate cancer. Additional cytoreductive prostate treatments and metastasis-directed therapies are under evaluation. These confer toxicity but may offer incremental survival benefits. Thus, an understanding of patients’ values and treatment prefer...
It can be assumed that higher SARS-CoV-2 infection risk is associated with higher COVID-19 vaccination intentions, although evidence is scarce. In this large and representative survey of 6007 adults aged 18–64 years and residing in France, 8.1% (95% CI, 7.5–8.8) reported a prior SARS-CoV-2 infection in December 2020, with regional variations accord...
Introduction Systemic therapy with androgen deprivation therapy (ADT) and intensification with agents such as docetaxel, abiraterone acetate and enzalutamide has resulted in improved overall survival in men with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC). Novel local cytoreductive treatments and metastasis-directed the...
Objective
To understand how individuals make trade-offs between features of lockdown interventions to control a pandemic across the four nations of the United Kingdom.
Design
Survey that included a Discrete Choice Experiment (DCE). The survey design was informed using policy documents, social media analysis and with input from remote think aloud in...
In summary, offering “radical treatment” without "cure" in oligometastatic prostate cancer creates a unique patient-clinician environment that calls for a deeper appraisal of patients’ decision-making, trade-offs, and preferences. Understanding how decisions are made in this environment will help us invest in emerging interventional treatments that...
Background
Opinion polls on vaccination intentions suggest that COVID-19 vaccine hesitancy is increasing worldwide; however, the usefulness of opinion polls to prepare mass vaccination campaigns for specific new vaccines and to estimate acceptance in a country's population is limited. We therefore aimed to assess the effects of vaccine characterist...
Introduction
Social distancing and lockdown measures are among the main government responses to the COVID-19 pandemic. These measures aim to limit the COVID-19 infection rate and reduce the mortality rate of COVID-19. Given we are likely to see local lockdowns until a treatment or vaccine for COVID-19 is available, and their effectiveness depends o...
Consumers’ food choices often deviate from rationality. This paper explores whether deviations from rationality impact home-grown values elicited using either bid- or choice-based value elicitation techniques. The paper focuses on second-price Vickrey auctions and discrete choice experiments, which are widely used to value
innovative private goods...
Purpose:
The COMPARE (COMparing treatment options for ProstAte cancer) study aimed to evaluate and quantify the trade-offs patients make between different aspects of active surveillance and definitive therapy.
Materials and methods:
A discrete choice experiment tool was used to elicit patients' preferences for different treatment characteristics...
Background. Choice experiments (CE) are applied in health economics to elicit public preferences and willingness to pay (WTP). CEs are frequently administered as Internet-based surveys. Internet surveys have recognized advantages, but concerns exist about the representativeness of Internet samples, data quality, and the impact on elicited values. A...
The Index of Multiple Deprivation (IMD), used widely in England, is an important tool for social need and inequality identification. It summarises deprivation across seven dimensions (income, employment, health, education, housing and services, environment, and crime) to measure an area’s multidimensional deprivation. The IMD aggregates the dimensi...
Resource allocation decisions require information about individuals' preferences for goods and services. Survey based stated preference methods, such as discrete choice experiments (DCEs), are used to elicit preferences for non-market goods. A critique of stated preference research is that respondents to hypothetical surveys may not provide careful...
This paper tests if Second Price Vickrey Auction (SPVA) and Discrete Choice Experiment
(DCE) are isomorphic and whether lack of isomorphism is due to value-elicitation, value-formation or both. We conduct an artefactual field experiment that combines induced-value (IV) and home-grown (HG) procedures using SPVA and DCE. IV preferences are elicited f...
Background:
Discrete choice experiments (DCEs) are widely used to quantify individuals’ preferences for healthcare. Guidelines recommend the design of DCEs should be informed by qualitative research. However, only few studies go beyond guidelines by fully presenting qualitative and quantitative research jointly together in a mixed methods approach...
We run an artefactual field experiment that combines induced-value (IV) and home-grown (HG) procedures using Second Price Vickrey Auction (SPVA) and Discrete Choice Experiment (DCE). We test if lack of isomorphism is due to value-elicitation, value-formation or both. We use two experimental treatments, one per elicitation method. In each treatment,...
Objective
To assess the influence of disease activity of patients with rheumatoid arthritis on treatment choices of rheumatologists in countries with restricted access to expensive, innovative drugs.
Methods
Rheumatologists from Hungary, Romania and UK were invited to complete two consecutive discrete choice experiments with hypothetical drug trea...
Objectives.:
To estimate the preferences of osteoporotic patients for medication attributes, and analyse data from seven European countries.
Methods.:
A discrete choice experiment was conducted in Belgium, France, Ireland, the Netherlands, Spain, Switzerland and the UK. Patients were asked to choose repeatedly between two hypothetical unlabelled...
Context:
Many individual- and job-related factors are known to influence medical careers decision making. Previous research has extensively studied medical trainees' (residents') and students' views of the factors that are important. However, how trainees and students trade off these factors at times of important careers-related decision making is...
Monetary valuation quantifies exchange values, but broader approaches are needed to understand the meaning of those monetary values and the shared, plural and cultural values that underpin them. In this study, we integrated deliberative monetary valuation, storytelling, subjective well-being and psychometric approaches to comprehensively elicit cul...
Objective
To explore and quantify men’s preferences and willingness to pay (WTP) for attributes of medications for lower urinary tract symptoms associated with benign prostatic hyperplasia using a discrete choice experiment.
Subjects and methods
Men in the UK aged ≥45 years with moderate-to-severe lower urinary tract symptoms/benign prostatic hype...
Valuation that focuses only on individual values evades the substantial collective and intersubjective meanings, significance and value from ecosystems. Shared, plural and cultural values of ecosystems constitute a diffuse and interdisciplinary field of research, covering an area that links questions around value ontology, elicitation and aggregati...
Objective
To evaluate to what extent rheumatologists consider economic aspects and patients’ preferences when choosing drug treatments in patients with active RA.
Methods
In a discrete choice experiment, rheumatologists were asked to choose between two unlabelled drug treatment options for a hypothetical RA patient with moderate disease activity w...
Background
Economic considerations and patient preferences are increasingly important when choosing treatments. It is not known to what extent rheumatologists across Europe account for these factors when changing drug therapies in patients with active rheumatoid arthritis (RA).
Objectives
To compare the value that rheumatologists across Europe att...
Objective To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis.
Methods In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with moderate disease activity. Treatme...
The 2003 Health Economics paper by Dolan, Olsen, Menzel and Richardson on “An inquiry into the different perspectives that can be used when eliciting preferences in health” presents a conceptual framework of six perspectives along two dimensions: preferences (personal, social, and socially inclusive personal) and context (ex ante and ex post). The...
Background:
Demand for health services continues to rise. Greater use of community pharmacy services instead of medical services for minor ailments could help relieve pressure on healthcare providers in high-cost settings. Community pharmacies are recognised sources of treatment and advice for people wishing to manage these ailments. However, incr...
Context:
Many individual and job-related factors are known to influence medical careers decision making. Medical trainees' (residents) views of which characteristics of a training post are important to them have been extensively studied but how they trade-off these characteristics is under-researched. Such information is crucial for the developmen...
Preventive health care is promoted by many organisations from the World Health Organisation (WHO) to regional and national governments. The degree of cost-sharing between individuals and the health care service affects preventive service use. For instance, out-of-pocket fees that are paid by individuals for curative services reduce preventive care...
Symptoms are important drivers for the use of primary care services. Strategies aimed at shifting the focus away from the GP have broadened the range of primary healthcare available.
To explore preferences for managing symptoms and investigate trade-offs that the public are willing to make when deciding between different primary care services.
UK-w...
Background Economic considerations and patient preferences are increasingly important when choosing treatments. It is not known to what extent rheumatologists across Europe account for these factors when changing drug therapies in patients with active rheumatoid arthritis (RA).
Objectives To evaluate the extent to which rheumatologists across Europ...
Social valuation of ecosystem services and public policy alternatives is one of the greatest challenges facing ecological economists today. Frameworks for valuing nature increasingly include shared/social values as a distinct category of values. However, the nature of shared/social values, as well as their relationship to other values, has not yet...
Recreational users appreciate the UK marine environment for its cultural ecosystem services (CES) and their use and non-use values. UK Governments are currently establishing a network of marine protected areas (MPAs) informed by ecological data and socio-economic evidence. Evidence on CES values is needed, but only limited data have been available....
Justificativa: Em Portugal o consumo de medicamentos é parcialmente financiado pelo estado, através de um complexo de sistema de comparticipação. O contínuo aumento das despesas de saúde aliado às recentes políticas de contenção da despesa pública têm fomentado a discussão sobre priorização na saúde, nomeadamente sobre quais os critérios apropriado...
Background The patient's perspective is becoming increasingly important in clinical and policy decisions. Information about what patients prefer, and how they value various aspects of a health intervention can be useful when designing and evaluating health care programs and could help health professionals to improve disease management.
Objectives T...
Responding to a stated preference discrete choice experiment (DCE) is a complex task for respondents to undertake. Task complexity can induce response error, thereby decreasing the statistical precision of the econometric model. This study explores the link between task complexity and statistical precision as moderated by the level of thoughtful de...
The patient's perspective is becoming increasingly important in clinical and policy decisions. In this study, we aimed to evaluate the preferences of patients with, or at risk of, osteoporosis for medication attributes, and to establish how patients trade between these attributes.
A discrete choice experiment survey was designed and patients were a...
Childlessness is a major public health concern in the United States, particularly among educated adults. Among women who turned 45 in 2006, one fifth had no children. We examine the likelihood that a childless woman wants a baby sometime in the future and its determinants.
From 2006 to 2010, 5,410 in-person interview surveys were conducted with chi...
There are increasing concerns that monetary valuation of ecosystem services using survey-based methods does not fully capture the value that people attach to the natural environment. For example, people have values in relation to nature that are not instrumental, but relate to rights, duties and virtues, which are difficult to translate into prefer...
Many stated preference studies report framing effects in responses to valuation questions. Framing in stated preference studies occurs when respondents use irrelevant information contained in the question to help them value the good. This may occur because respondents are uncertain or do not hold well-formed preferences for the good in question. We...
A568 VALUE IN HEALTH 16 (2013) A323–A636 mated, where EQ-5D was regressed on 1) eight SF-36 scores; 2) as per 1) plus squared and pair-wise interaction terms, 3) as per 1) plus clinical characteristics; and 4) as per 3) plus squared and pair-wise interaction terms, respectively. Model 2 and 4 were developed by using stepwise regression analyses. Mo...
Background: In Portugal, the pharmaceutical consumption is subsidized by public funds, through a reimbursement system. The rising expenditure with health care and the recent need of cost containment policies made priority setting compulsory for deciding which pharmaceuticals should be included on the reimbursement lists. Clinical evidence of the be...
Purpose:
To examine how the introduction of free eye examinations in Scotland affected people's use of eye care services. Particularly, to assess if more people are now having their eyes examined regularly, and whether there are differences in the way people responded to the policy across socio-economic groups.
Methods:
Using the British Househo...
To determine the willingness to pay (WTP) of senior managers in the UK National Health Service (NHS) for services to help manage performance concerns with doctors, dentists and pharmacists.
A discrete choice experiment (DCE) was used to elicit senior managers' preferences for a support service to help manage clinical performance concerns. The DCE w...
Health-care organizations need to prioritize their resource use and should incorporate the public's preferences into their priority setting process.
We apply a discrete choice experiment (DCE) to obtain weights, from the public, for use in a priority setting exercise. Ten attributes were chosen: location of care, public consultation, use of technol...
The North Sea oil and gas industry currently faces recruitment and retention difficulties because of a shortage of skilled workers. One means of retaining existing employees is to improve workers’ job satisfaction. In this paper, we investigate the determinants of job satisfaction and intentions to quit within this industry sector. We find that ind...
Genital herpes (GH) is widespread, and detrimental to patients' quality of life. It is not always adequately treated, however, with potential consequences for patients' well-being and healthcare costs. Involving patients in treatment decisions can increase their satisfaction and adherence. We investigated patients' preferences for different GH trea...
Objective: To value services that help organisations to manage performance concerns with doctors, dentists or pharmacists. Methods: Qualitative and quantitative methods. Qualitative analysis consists of: a literature review; interviews with support service providers and clinical professional bodies; and discussion groups with managers who deal with...
Multiple-job holding is an important labour market phenomenon. In this article, we examine individuals' motives for multiple-job holding. Specifically, we estimate an empirical model of the motivation for moonlighting assuming that individuals hold a second job for either financial or for nonpecuniary motives. Our results contribute to a better und...
In this study, the authors demonstrate how mixed logit analysis of discrete choice experiment (DCE) data can provide information about unobserved preference heterogeneity. Their application investigates unobserved heterogeneity in men's preferences for benign prostatic hyperplasia (BPH) treatment. They use a DCE to elicit preferences for seven char...
This study presents the first comparison of willingness to pay estimates derived from the payment card (PC) contingent valuation and discrete choice experiment (DCE) methods. A within-sample experiment was used to elicit women's preferences for Chlamydia screening. The willingness to pay estimate derived from the DCE was larger than that derived fr...
To explore women's perceptions of "choice" of place of delivery in remote and rural areas where different models of maternity services are available. Setting and
Remote and rural areas of the North of Scotland. A qualitative study design involved focus groups with women who had recent experience of maternity services.
Women had varying experiences...
Stated preference methods assume respondents' preferences are consistent with utility theory, but many empirical studies report evidence of preferences that violate utility theory. This evidence is often derived from quantitative tests that occur naturally within, or are added to, stated preference tasks. In this study, we use qualitative methods t...
To examine women's preferences for characteristics of chlamydia screening. Chlamydia trachomatis is the most common curable sexually transmitted disease. To design effective screening programs, it is important to fully capture the benefits of screening to patients. Thus, the value of experience factors must be considered alongside health outcomes....
Many stated preference studies have reported framing effects in responses to valuation questions. This occurs when respondents use irrelevant information contained in a question to help them value the good. We investigate if respondent uncertainty can explain two commonly observed framing effects in contingent valuation studies. Specifically using...
To explore women's preferences for, and trade-offs between, key attributes of intrapartum care models.
Mixed-methods study using discrete choice experiments (DCEs) and focus groups.
The North of Scotland.
Women from the catchment areas of eight rural maternity units in the North of Scotland.
Based on current policy, 'model of care' and 'time travel...
This chapter walks the reader through the stages of a discrete choice experiment (DCE) application drawing on concepts introduced
in Chapters 1 and 2. A case study eliciting women’s preferences for prenatal screening is used to illustrate the points (Ryan
et al., 2005). It should be noted that this data was collected several years ago, and therefor...
The research agendas of psychologists and economists now have several overlaps, with behavioural economics providing theoretical and experimental study of the relationship between behaviour and choice, and hedonic psychology discussing appropriate measures of outcomes of choice in terms of overall utility or life satisfaction. Here we model the rel...
Discrete choice experiments in health economics are increasingly incorporating an opt-out or status quo alternative into the choice set presented to respondents. A frequently observed phenomenon is that a group of respondents chooses not to choose on every occasion. This is a form of serial non-participation. To date, in health economics, observati...
Double bounded dichotomous choice (DBDC) contingent valuation offers increased efficiency of willingness to pay (WTP) estimates compared with the single bounded format. However, evidence suggests DBDC generates anomalous respondent behaviour. This paper provides the first investigation and explanation of these anomalies in health. Results suggest t...
Prenatal diagnosis by karyotype analysis determines the copy number and structure of each chromosome and is considered to be the 'gold standard' in detection of chromosome abnormality. This method is, however, time consuming and women may have to wait up to 21 days for the results. With improving molecular genetic techniques, the most commonly occu...
There are 2 main medical preparations available for lower urinary tract symptoms resulting from benign prostatic hyperplasia (BPH). Choosing between an alpha-blocker and a 5alpha-reductase inhibitor requires trade-offs between their attributes or characteristics. We investigated the relative importance of and trade-offs between the attributes of th...
Economic evaluation is concerned with comparing the costs and benefits of competing healthcare interventions in order to efficiently allocate resources. Whilst valuing costs is important, the valuation of benefits represents one of the greatest challenges facing health economists. This review considers the different techniques available for the val...
This paper presents an empirical examination of individuals’ motivations for multiple-job holding or moonlighting. Theoretical models of moonlighting suggest that individuals to hold a second job for either financial reasons (they face hours-constraints in their first job) or non-pecuniary motives (heterogeneous jobs). We assess the relative import...
