Improving the quality of discrete-choice experiments in health: how can we assess validity and reliability?

ABSTRACT

Introduction: The recent endorsement of discrete-choice experiments (DCEs) and other stated-preference methods by regulatory and health technology assessment (HTA) agencies has placed a greater focus on demonstrating the validity and reliability of preference results.

Areas covered: We present a practical overview of tests of validity and reliability that have been applied in the health DCE literature and explore other study qualities of DCEs. From the published literature, we identify a variety of methods to assess the validity and reliability of DCEs. We conceptualize these methods to create a conceptual model with four domains: measurement validity, measurement reliability, choice validity, and choice reliability. Each domain consists of three categories that can be assessed using one to four procedures (for a total of 24 tests). We present how these tests have been applied in the literature and direct readers to applications of these tests in the health DCE literature. Based on a stakeholder engagement exercise, we consider the importance of study characteristics beyond traditional concepts of validity and reliability.

Expert commentary: We discuss study design considerations to assess the validity and reliability of a DCE, consider limitations to the current application of tests, and discuss future work to consider the quality of DCEs in healthcare.

KEYWORDS:

• Benefit-risk assessment
• discrete-choice experiment
• patient preferences
• reliability
• stated-preference methods
• validity

Acknowledgments

The authors sincerely thank the Johns Hopkins Institute for Clinical and Translational Research (ICTR) Community Research Advisory Council (C-RAC) and members of the Diabetes Action Board (DAB) for their valuable contributions and engagement in the research study.

Declaration of interest

DA Marshall is funded through a Canada Research Chair, Health Systems and Services Research and the Arthur J.E. Child Chair Rheumatology Outcomes Research. AB Hauber is an employee of RTI Health Solutions. The funders had no role in the design and conduct of the study, interpretation of the data, or preparation of the manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported by a Patient-Centered Outcomes Research Institute (PCORI) Methods Award (ME-1303-5946) and by the Center for Excellence in Regulatory Science and Innovation (CERSI) (1U01FD004977-01).