ICEPOP (Investigating Choice Experiments for the Preferences of Older People)
Background
This programme aims to inform decision making for older people through the application and development of Stated Preference Discrete Choice Modelling (SPDCM), specifically the development of the method of Best-Worst Scaling. The two aspects of the programme - informing decision making for older people and the methodology of SPDCM – are moving forward in tandem, with individual studies informing SPDCM methodology for future studies, and the particular SPDCM experiments providing useful information for decision making for older people.
In informing decision making for older people, the aim is to move beyond the current narrow theoretical focus on health maximisation for the patient that pervades cost-effectiveness analysis, towards a more genuine decision-maker approach that considers the wider factors that are important in informing decision making for older people. To this end, individual projects in the areas of quality of life and capability, informal care, death and dying, financing old age, and priority setting are ongoing or envisaged.
A large number of methodological issues still have to be resolved for SPDCM and, specifically, Best-Worst Scaling. Many of these issues are particularly pertinent to the use of these methods for the complex area of health care and for the estimation of utilities. This programme will tackle issues relating to the best methods for use in developing attributes and levels, designing statistically efficient and practical experiments, determining sample sizes and conducting experiments. In tackling these issues, the programme will draw on a variety of research methods including simulation, qualitative methods and randomised controlled trials.
Main Aims
- To develop an index of quality of life for older people;
- To investigate various methodological issues in the use of stated preference discrete choice modelling in health care.
Progress To Date
A literature review has been conducted which has looked at attributes of quality of life in older people and has extended the literature base to include literature that contributed to the definition and conceptual development of quality of life.
Work has been conducted with the National Centre for Social Research who were contracted to conduct and analyse semi-structured interviews with older people to identify core attributes of quality of life. A paper describing this work is currently in press.
The main discrete choice modelling exercise is currently being conducted utilising a representative sample of older people from the UK using the attributes and levels identified in the qualitative interviews.
Alongside the project to construct the main quality of life index, work has begun to address methodological issues in the use of discrete choice modelling and to investigate other issues in eliciting preferences for health and social care among older people. The methodological work includes simulation studies to investigate the statistical properties of Best-Worst Scaling, whilst the preferences of carers and attitudes toward any trade-offs between quality and length of life are the subjects of empirical work among older people.
Work has been planned to estimate the preferences of individual patients with depression using Best-Worst Scaling. This work will be conducted alongside the TREAD Study.
Peer-Reviewed Publications
Lancsar E, Louviere JJ, Flynn TN. Several methods to investigate relative attribute impact in stated preference experiments. Social Science and Medicine. 2007; 64: 1738-1753.
Flynn TN, Louviere JJ, Peters TJ, Coast J. Best-Worst Scaling: What it can do for health care research and how to do it. Journal of Health Economics. 2007; 26: 171-189.
Coast J, Horrocks S. Developing attributes and levels for discrete choice experiments using qualitative methods. Journal of Health Services Research & Policy. 2007; 12(1): 25-30.
Coast J, Salisbury C, de Berker D, Noble A, Horrocks S, Peters TJ, Flynn TN. Preferences for aspects of a dermatology consultation. British Journal of Dermatology 2006; 155:387-392.
Coast J, Flynn TN, Salisbury C, Louviere J, Peters TJ. Maximising responses to discrete choice experiments: a randomised trial. Applied Health Economics and Health Policy. 2006; 5(4): 249-260.
Grewal I, Lewis J, Flynn TN, Brown J, Bond J, Coast J. Developing attributes for a generic quality of life measure for older people: preferences or capabilities? Social Science & Medicine. 2006, 62; 1891-1901.
Brown J, Bowling A and Flynn TN. (2004). Models of quality of life. A taxonomy and systematic review of the literature. Report commissioned by European Forum on Population Ageing Research/Quality of Life, University of Sheffield (Prof. Alan Walker).
Coast J. (2004). Is economic evaluation in touch with society's health values? British Medical Journal 32; 1233-1236.
Seminar/Conference Presentations
Flynn TN. I'll tell you which patient is most bothered about waiting time: estimating individual-level preferences from a discrete choice experiment in health care. Centre for the Study of Choice, University of Technology, Sydney, Australia, December 2006.
Coast J, Flynn T, Grewal I, Lewis J, Natarajan L, Sproston K. Developing an index of capability for health and social policy evaluation for older people: theoretical and methodological challenges. Health Economists’ Study Group, City University, London, January 2006.
Al-Janabi HJ, Flynn TN, Coast J. Meta-ethnography: Determining the attributes for a discrete choice experiment. Health Economists’ Study Group, City University, London, January 2006.
Flynn TN, Louviere JL, Peters TJ, Coast J. Estimating preferences for a dermatology consultation using Best-Worst Scaling: Comparison of three methods of analysis. Health Economists’ Study Group, City University, London, January 2006.
Coast J. Developing attributes for a generic quality of life measure for older people: is it preferences or capabilities that are important? Society for Social Medicine Conference, Glasgow, September 2005.
Coast J. "Nuggets of information" or "an appropriate normative framework"? Values in economic evaluation. Health Economics Research Centre, Oxford, April 2005.
Flynn TN. The use of best-worst scaling in estimating patient preferences. School of Health and Related Research, University of Sheffield. April 2005.
Flynn TN, Louviere JJ, Peters TJ, Coast J. Best-Worst Scaling: What it can do for health care and how to do it. UK Health Economists’ Study Group conference, Oxford, January 2005.
Flynn TN. The use of discrete choice modelling in estimating patient preferences. Patient-practitioner workshop. Department of Social Medicine, Bristol, November 2004.
Flynn TN. Best-Worst Scaling. A new type of discrete choice modelling. Royal Statistical Society Primary Health Care Study Group, London, October 2004.
Flynn TN. Constructing a new quality of life questionnaire. The use of SPDCM in utility elicitation. UK Department of Health, London, June 2004.
Flynn TN. Constructing a new quality of life questionnaire. The use of SPDCM in utility elicitation. Centre for Health Economics Research and Evaluation, University of Technology, Sydney, Australia, March 2004.
Flynn TN, Brown J, Peters TJ, Coast J. Issues in conceptualising and eliciting quality of life preferences from a discrete choice experiment. 2nd international conference on health economics and health management, Kalamata, Greece, May 2003.
Other Dissemination
Flynn TN. Radio interview about the project on the 'Life Matters' show on ABC National radio in Australia, broadcast on 17 March 2004.
Further Information
The ICEPOP Programme
Department of Social Medicine
Canynge Hall
University of Bristol
Whiteladies Road
Bristol
BS8 2PR
UK
Principal Investigator
Research Fellow
Research Associate
PhD Students
Main Collaborators to Date
Professor Jordan Louviere, School of Marketing, University of Technology, Sydney, PO Box 123, Broadway NSW 2007, Australia.
Professor John Bond, Centre for Health Services Research, University of Newcastle upon Tyne.
Professor Ann Bowling, Department of Primary Care and Population Studies, University College, University of London.
Jane Lewis, Qualitative Research Unit, National Centre for Social Research, London.
Professor Tim Peters, Academic Unit of Primary Health Care, University of Bristol.