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Choice Consistency in Discrete Choice Experiments: Does Numeracy Skill Matter?

Mesfin G Genie1, Nabin Poudel2, Francesco Paolucci3

  • 1Newcastle Business School, College of Human and Social Futures, The University of Newcastle, Australia; Department of Population Health Sciences, Duke University, Durham, NC, USA; Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK.

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Summary

Higher numeracy skills (NS) improve choice consistency in discrete choice experiments (DCEs). This suggests numeracy should be considered in DCE analysis to avoid biased willingness-to-wait estimates.

Keywords:
choice consistencydiscrete choice experimentsnumeracy skillwillingness-to-wait

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Area of Science:

  • Health Economics
  • Decision Science
  • Patient Preference Research

Background:

  • Discrete Choice Experiments (DCEs) are widely used to elicit patient preferences.
  • Numeracy skills (NS) can influence decision-making processes.
  • Understanding the impact of NS on DCEs is crucial for accurate preference elicitation.

Purpose of the Study:

  • To investigate the relationship between numeracy skills (NS) and choice consistency in DCEs.
  • To assess the effect of NS on willingness-to-wait (WTW) estimates for kidney transplantation.
  • To explore the generalizability of findings across different health contexts and survey formats.

Main Methods:

  • A DCE was conducted with kidney transplant patients in Italy.
  • Patients completed the DCE and a 3-item numeracy test.
  • A heteroskedastic multinomial logit model analyzed the effect of NS on choice consistency and WTW.

Main Results:

  • Higher NS were significantly associated with greater choice consistency (up to 63% increase).
  • Numeracy levels influenced willingness-to-wait estimates for kidney transplant attributes.
  • Consistent findings were observed in supplementary DCEs on COVID-19 vaccinations and rheumatoid arthritis.

Conclusions:

  • Numeracy skills significantly impact choice consistency in DCEs.
  • Failure to account for varying NS may bias willingness-to-wait estimates.
  • Consideration of numeracy is essential for robust DCE data analysis and interpretation.