Discrete choice experiments to generate utility values for multi-attribute utility instruments: a systematic review...

Area of Science:

• Health Economics
• Preference Measurement
• Systematic Review Methodology

Background:

• Discrete Choice Experiments (DCEs) are increasingly utilized for generating utility values in health economics.
• A wide variety of methodological approaches exist for designing and analyzing DCEs.
• Standardized utility values are crucial for preference-based health measures, both generic and condition-specific.

Purpose of the Study:

• To systematically review and summarize the methods employed in the design and analysis of DCEs for utility value estimation.
• To identify common practices and variations in DCE methodology for preference-based health instruments.
• To assess the quality of reporting for DCE methods in published literature.

Main Methods:

• A systematic literature search was conducted across MEDLINE, Embase, Cochrane Library, and CINAHL, adhering to PRISMA guidelines.
• Standardized data extraction focused on DCE design (choice sets, pairs, randomization), analysis techniques, and quality assessment using the CREATE checklist.
• Thirty-eight studies involving general populations, students, and patients were included in the review.

Main Results:

• Generic multi-attribute instruments (MAUIs), particularly the EQ-5D, were most frequently evaluated using DCEs.
• Significant diversity was observed in DCE methodologies, including the number of alternatives, attributes, sample sizes, and analysis techniques.
• Despite methodological variations, the quality of reporting for DCE methods in the included studies was generally high.

Conclusions:

• Discrete Choice Experiments (DCEs) represent a significant methodology for measuring utility values in health preference instruments.
• The current landscape of DCEs reveals considerable heterogeneity in design and analysis approaches.
• A definitive 'gold standard' method for DCEs in this context cannot yet be established.