Document Detail

Feasibility, reliability, and validity of three health-state valuation methods using multiple-outcome vignettes on moderate-risk pregnancy at term.
MedLine Citation:
PMID:  19508667     Owner:  NLM     Status:  In-Process    
OBJECTIVES: Preference-based health-state valuation methods such as discrete choice experiment (DCE) are claimed to be superior than attitude-based valuation methods like visual analogue scale (VAS) and time trade-off (TTO). We compared VAS, TTO, and DCE in terms of feasibility, reliability, and validity using vignettes depicting moderate-risk pregnancy at term.
METHODS: People from the community (n = 97) participated in both a panel session and an individual home assignment. Each participant valuated 46 vignettes with VAS, TTO, and DCE. Each vignette consisted of five attributes: maternal health antepartum, time between diagnosis and delivery, process of delivery, maternal outcome, and neonatal outcome. The questionnaire included Feasibility, which we evaluated by questionnaire. Test–retest reliability and interobserver consistency were assessed by intraclass correlation (ICC), and variance consistency by generalization theory. Convergent validity was determined with ICC and Cohen's kappa; construct validity was determined with linear regression, multinomial logit modeling, and Kendall's Tau-b correlation (τ).
RESULTS: The DCE was reported as most feasible (DCE: 87% vs. VAS: 69% vs. TTO: 42%). Test–retest reliability was high overall and equal (VAS: ICC = 0.77; TTO: ICC = 0.79; DCE: κ = 0.78). The VAS had the highest interobserver reliability (ICC = 0.73). Convergent validity between VAS and DCE was high (κ = 0.79) and there was sufficient construct validity between VAS and DCE (τ = 0.68). The TTO yielded less optimal results. Generally, neonatal and maternal outcomes weighed most, whereas process outcomes weighed least in moderate-risk pregnancy at term.
CONCLUSIONS: In our context of multidimensional health states with complex trade-offs, DCE was superior to TTO and performed equal to VAS, with DCE displaying slightly higher user feasibility.
Denise Bijlenga; Erwin Birnie; Gouke J Bonsel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research     Volume:  12     ISSN:  1524-4733     ISO Abbreviation:  Value Health     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2011-04-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883818     Medline TA:  Value Health     Country:  United States    
Other Details:
Languages:  eng     Pagination:  821-7     Citation Subset:  IM    
Academic Medical Centre—University of Amsterdam, Amsterdam,The Netherlands.
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