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Validity and feasibility of best worst scaling using multiple treatment outcomes of Parkinson's disease

Leung, Tina Tin Wan (2013) Validity and feasibility of best worst scaling using multiple treatment outcomes of Parkinson's disease.

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Abstract:BACKGROUND Best Worst Scaling (BWS) has been shown to be more superior to traditional valuation methods, including Time Trade Off (TTO) and Visual Analogue Scale (VAS). Additional information with higher discriminative power can be collected by asking respondents to choose the best and the worst option. However, BWS can only provide cardinal utility estimates and cannot be anchored on scale with definite range for cost-utility analysis. OBJECTIVE To investigate the convergent validity, theoretical validity and feasibility of profile-based (Case 2 ) BWS and multi-profile-based (Case3) BWS. To visualize and test a BWS choice experiment for measuring treatment preferences of the public towards Parkinson's Disease (PD). METHOD An online survey was conducted in June 2013 to measure treatment preferences of the public (N=592) using VAS, TTO, Case 2 and Case 3 BWS in the Netherlands and the United Kingdom. PD treatment consists of seven attributes: Treatment methods, extent of tremor, posture and balance problems, slowness in motion, dizziness, drowsiness and rapid uncontrolled movement. To assess the convergent validity, individual treatment preferences of participants were used to model the utility of six treatments using mixed logit regression based on choice data obtained through Case 2 and Case 3 BWS. The utilities these treatments measured through BWS were correlated to those obtained through VAS and TTO. To assess the theoretical validity, conditional logit regression was conducted to model the choice data. The feasibility of BWS was examined based on the quality of response, time required to perform the BWS tasks and the preference of participants to examine the practical issues of using BWS. Result: The convergent validity of Case 2 and Case 3 BWS were satisfactory (TTO: Case 2 BWS=0.447; TTO: Case 3 BWS=0.438; VAS: Case 2 BWS: 0.593; VAS: Case 3 BWS=0.563; Case 2 BWS: Case 3 BWS= 0.830, p-value <0.00). Treatment methods, posture and balance problem, as well as rapid uncontrolled movement are relatively more important, whereas slowness in motion weighed relatively less. Completion rate is 71.7%. Mean time needed for Case 2 and Case 3 BWS are 5.0 minutes and 5.9 minutes respectively. They are equally preferred by participants (50%: 50%). CONCLUSION Given the significant correlation with traditional valuation methods and the superiorities of BWS, it can be promisingly a standardized tool in evaluating treatments for chronic diseases in reimbursement decision making. Through demonstrating the use of BWS, this study provides insight about the differences between Case 2 and Case 3 BWS. Future research is needed to standardize the method for converting latent values of BWS onto the full Quality Adjusted Life Years (QALY) scale.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Health Sciences MSc (66851)
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