Comparing Outcomes of a Discrete Choice Experiment and Case 2 Best-Worst Scaling: An Application to Neuromuscular Disease Treatment

Vikas Soekhai; Bas Donkers; Jennifer Viberg Johansson; Cecilia Jimenez-Moreno; Cathy Anne Pinto; G Ardine de Wit; Esther de Bekker-Grob

doi:10.1007/s40271-023-00615-0

Comparing Outcomes of a Discrete Choice Experiment and Case 2 Best-Worst Scaling: An Application to Neuromuscular Disease Treatment

Vikas Soekhai, Bas Donkers, Jennifer Viberg Johansson, Cecilia Jimenez-Moreno, Cathy Anne Pinto, G Ardine de Wit, Esther de Bekker-Grob

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

BACKGROUND AND OBJECTIVES: Case 2 best-worst scaling (BWS-2) is an increasingly popular method to elicit patient preferences. Because BWS-2 potentially has a lower cognitive burden compared with discrete choice experiments, the aim of this study was to compare treatment preference weights and relative importance scores.

METHODS: Patients with neuromuscular diseases completed an online survey at two different moments in time, completing one method per occasion. Patients were randomly assigned to either first a discrete choice experiment or BWS-2. Attributes included: muscle strength, energy endurance, balance, cognition, chance of blurry vision, and chance of liver damage. Multinomial logit was used to calculate overall relative importance scores and latent class logit was used to estimate heterogeneous preference weights and to calculate the relative importance scores of the attributes for each latent class.

RESULTS: A total of 140 patients were included for analyses. Overall relative importance scores showed differences in attribute importance rankings between a discrete choice experiment and BWS-2. Latent class analyses indicated three latent classes for both methods, with a specific class in both the discrete choice experiment and BWS-2 in which (avoiding) liver damage was the most important attribute. Ex-post analyses showed that classes differed in sex, age, level of education, and disease status. The discrete choice experiment was easier to understand compared with BWS-2.

CONCLUSIONS: This study showed that using a discrete choice experiment and BWS-2 leads to different outcomes, both in preference weights as well as in relative importance scores, which might have been caused by the different framing of risks in BWS-2. However, a latent class analysis revealed similar latent classes between methods. Careful consideration about method selection is required, while keeping the specific decision context in mind and pilot testing the methods.

Original language	English
Pages (from-to)	239-253
Journal	Patient-patient centered outcomes research
Volume	16
Issue number	3
Early online date	13 Feb 2023
DOIs	https://doi.org/10.1007/s40271-023-00615-0
Publication status	Published - May 2023

Bibliographical note

Funding

We thank all patient organizations supporting this study: Muscular Dystrophy UK, Myotonic Dystrophy Support Group; Cure DM CIC; the Lily Foundation for Mitochondrial Disorders; United Mitochondrial Disease Foundation, MitoCanada; Muscular Dystrophy Canada; Muscular Dystrophy Association; MDF; and Muscular Dystrophy New Zealand. We thank members of the Wellcome Research Centre for Mitochondrial Research who provided input and expertise into the design of this study. We thank the UK Myotonic Dystrophy Patient Registry at Newcastle University for facilitating participant recruitment and supporting with the pilot stages of the study. We thank the Newcastle University Ethics Committee for revising the ethical aspect of this project. Mito Foundation; Cure DM CIC; (Lily); (UMDF); Muscular Dystrophy Canada (MDC); Muscular Dystrophy Association (MDA); Myotonic org; MitoCanada; (MDNZ); and, via the UK Myotonic Dystrophy Patient Registry and the New Zealand Neuromuscular Disease Patient Registry.

Funders	Funder number
Cure DM CIC
MitoCanada
Muscular Dystrophy New Zealand
Myotonic Dystrophy Support Group
New Zealand Neuromuscular Disease Patient Registry
UK Myotonic Dystrophy Patient Registry
Muscular Dystrophy Association
United Mitochondrial Disease Foundation
Muscular Dystrophy UK
Muscular Dystrophy Canada
Newcastle University

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s40271-023-00615-0

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Cite this

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title = "Comparing Outcomes of a Discrete Choice Experiment and Case 2 Best-Worst Scaling: An Application to Neuromuscular Disease Treatment",

abstract = "BACKGROUND AND OBJECTIVES: Case 2 best-worst scaling (BWS-2) is an increasingly popular method to elicit patient preferences. Because BWS-2 potentially has a lower cognitive burden compared with discrete choice experiments, the aim of this study was to compare treatment preference weights and relative importance scores.METHODS: Patients with neuromuscular diseases completed an online survey at two different moments in time, completing one method per occasion. Patients were randomly assigned to either first a discrete choice experiment or BWS-2. Attributes included: muscle strength, energy endurance, balance, cognition, chance of blurry vision, and chance of liver damage. Multinomial logit was used to calculate overall relative importance scores and latent class logit was used to estimate heterogeneous preference weights and to calculate the relative importance scores of the attributes for each latent class.RESULTS: A total of 140 patients were included for analyses. Overall relative importance scores showed differences in attribute importance rankings between a discrete choice experiment and BWS-2. Latent class analyses indicated three latent classes for both methods, with a specific class in both the discrete choice experiment and BWS-2 in which (avoiding) liver damage was the most important attribute. Ex-post analyses showed that classes differed in sex, age, level of education, and disease status. The discrete choice experiment was easier to understand compared with BWS-2.CONCLUSIONS: This study showed that using a discrete choice experiment and BWS-2 leads to different outcomes, both in preference weights as well as in relative importance scores, which might have been caused by the different framing of risks in BWS-2. However, a latent class analysis revealed similar latent classes between methods. Careful consideration about method selection is required, while keeping the specific decision context in mind and pilot testing the methods.",

author = "Vikas Soekhai and Bas Donkers and Johansson, {Jennifer Viberg} and Cecilia Jimenez-Moreno and Pinto, {Cathy Anne} and {de Wit}, {G Ardine} and {de Bekker-Grob}, Esther",

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doi = "10.1007/s40271-023-00615-0",

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AU - Soekhai, Vikas

AU - Donkers, Bas

AU - Johansson, Jennifer Viberg

AU - Jimenez-Moreno, Cecilia

AU - Pinto, Cathy Anne

AU - de Wit, G Ardine

AU - de Bekker-Grob, Esther

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N2 - BACKGROUND AND OBJECTIVES: Case 2 best-worst scaling (BWS-2) is an increasingly popular method to elicit patient preferences. Because BWS-2 potentially has a lower cognitive burden compared with discrete choice experiments, the aim of this study was to compare treatment preference weights and relative importance scores.METHODS: Patients with neuromuscular diseases completed an online survey at two different moments in time, completing one method per occasion. Patients were randomly assigned to either first a discrete choice experiment or BWS-2. Attributes included: muscle strength, energy endurance, balance, cognition, chance of blurry vision, and chance of liver damage. Multinomial logit was used to calculate overall relative importance scores and latent class logit was used to estimate heterogeneous preference weights and to calculate the relative importance scores of the attributes for each latent class.RESULTS: A total of 140 patients were included for analyses. Overall relative importance scores showed differences in attribute importance rankings between a discrete choice experiment and BWS-2. Latent class analyses indicated three latent classes for both methods, with a specific class in both the discrete choice experiment and BWS-2 in which (avoiding) liver damage was the most important attribute. Ex-post analyses showed that classes differed in sex, age, level of education, and disease status. The discrete choice experiment was easier to understand compared with BWS-2.CONCLUSIONS: This study showed that using a discrete choice experiment and BWS-2 leads to different outcomes, both in preference weights as well as in relative importance scores, which might have been caused by the different framing of risks in BWS-2. However, a latent class analysis revealed similar latent classes between methods. Careful consideration about method selection is required, while keeping the specific decision context in mind and pilot testing the methods.

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