An empirical comparison of methods for analyzing correlated data from a discrete choice survey to elicit patient preference for colorectal cancer screening

BMC Medical Research Methodology

Lehana Thabane⁴  John K Marshall³  Deborah A Marshall²  Eleanor Pullenayegum¹  Ji Cheng¹ 

[1] Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada;Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada;Department of Medicine, Division of Gastroenterology, McMaster University, Hamilton, ON, Canada;Biostatistics Unit/FSORC, 3rd Floor Martha, Room H325, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON L8N 4A6, Canada

关键词: Patient preference;    Statistical model;    Intra-class correlation;    Discrete choice experiment;   

Others  :  1136830
DOI  :  10.1186/1471-2288-12-15

 received in 2011-05-28, accepted in 2012-02-20,  发布年份 2012

【 摘 要 】

Background

A discrete choice experiment (DCE) is a preference survey which asks participants to make a choice among product portfolios comparing the key product characteristics by performing several choice tasks. Analyzing DCE data needs to account for within-participant correlation because choices from the same participant are likely to be similar. In this study, we empirically compared some commonly-used statistical methods for analyzing DCE data while accounting for within-participant correlation based on a survey of patient preference for colorectal cancer (CRC) screening tests conducted in Hamilton, Ontario, Canada in 2002.

Methods

A two-stage DCE design was used to investigate the impact of six attributes on participants' preferences for CRC screening test and willingness to undertake the test. We compared six models for clustered binary outcomes (logistic and probit regressions using cluster-robust standard error (SE), random-effects and generalized estimating equation approaches) and three models for clustered nominal outcomes (multinomial logistic and probit regressions with cluster-robust SE and random-effects multinomial logistic model). We also fitted a bivariate probit model with cluster-robust SE treating the choices from two stages as two correlated binary outcomes. The rank of relative importance between attributes and the estimates of β coefficient within attributes were used to assess the model robustness.

Results

In total 468 participants with each completing 10 choices were analyzed. Similar results were reported for the rank of relative importance and β coefficients across models for stage-one data on evaluating participants' preferences for the test. The six attributes ranked from high to low as follows: cost, specificity, process, sensitivity, preparation and pain. However, the results differed across models for stage-two data on evaluating participants' willingness to undertake the tests. Little within-patient correlation (ICC ≈ 0) was found in stage-one data, but substantial within-patient correlation existed (ICC = 0.659) in stage-two data.

Conclusions

When small clustering effect presented in DCE data, results remained robust across statistical models. However, results varied when larger clustering effect presented. Therefore, it is important to assess the robustness of the estimates via sensitivity analysis using different models for analyzing clustered data from DCE studies.

【 授权许可】

   
2012 Cheng et al; licensee BioMed Central Ltd.

【 图 表 】

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