Using Best–Worst Scaling to Measure Caregiver Preferences for Managing their Child’s ADHD: A Pilot Study

IntroductionBest–worst scaling (BWS) is becoming increasingly popular to elicit preferences in health care. However, little is known about current practice and trends in the use of BWS in health care. This study aimed to identify, review and critically appraise BWS in health care, and to identify trends over time in key aspects of BWS.MethodsA systematic review was conducted, using Medline (via Pubmed) and EMBASE to identify all English-language BWS studies published up until April 2016. Using a predefined extraction form, two reviewers independently selected articles and critically appraised the study quality, using the Purpose, Respondents, Explanation, Findings, Significance (PREFS) checklist. Trends over time periods (≤2010, 2011, 2012, 2013, 2014 and 2015) were assessed further.ResultsA total of 62 BWS studies were identified, of which 26 were BWS object case studies, 29 were BWS profile case studies and seven were BWS multi-profile case studies. About two thirds of the studies were performed in the last 2 years. Decreasing sample sizes and decreasing numbers of factors in BWS object case studies, as well as use of less complicated analytical methods, were observed in recent studies. The quality of the BWS studies was generally acceptable according to the PREFS checklist, except that most studies did not indicate whether the responders were similar to the non-responders.ConclusionUse of BWS object case and BWS profile case has drastically increased in health care, especially in the last 2 years. In contrast with previous discrete-choice experiment reviews, there is increasing use of less sophisticated analytical methods.Electronic supplementary materialThe online version of this article (doi:10.1007/s40273-016-0429-5) contains supplementary material, which is available to authorized users.

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“…[73]Australia20149302377101114 dosReis et al. [74]USA20153721187101114 Flynn et al. [75]UK201541320165101013 Franco et al.…”

Section: Resultsunclassified

Using Best–Worst Scaling to Investigate Preferences in Health Care

et al. 2016

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“…The wide range of attributes permitted a comprehensive evaluation of caregivers’ preferences for a multimodal ADHD management approach. Attributes and attribute levels were derived from caregivers’ input to ensure these were salient and relevant care management considerations [27]. By investigating preferences for specific modes of service delivery beyond global acceptability of an intervention, this study offers a nuanced perspective of care delivery options that are most favorable to families.…”

Section: Discussionmentioning

confidence: 99%

“…Within each profile, participants selected the one ‘best’ and the one ‘worst’ attribute based on his/her preference. This instrument was developed using extensive input from caregivers and specific details about the development process and pilot results have been published elsewhere [27]. Following feedback from the 37 individuals who participated in the BWS instrument pilot test, the attribute levels of the monthly out-of-pocket costs were revised from US$150, US$300, and US$450 to US$50, US$150, and US$450, respectively.…”

Section: Methodsmentioning

confidence: 99%

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A Latent Class Analysis to Identify Variation in Caregivers’ Preferences for their Child’s Attention-Deficit/Hyperactivity Disorder Treatment: Do Stated Preferences Match Current Treatment?

Bridges

Ross

et al. 2016

Patient

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Objectives To investigate variation in caregiver preferences for their child’s attention-deficit/hyperactivity disorder (ADHD) care and to determine if their stated preferences align with current care management. Methods Caregivers of a child aged 4–14 years and in care for ADHD were recruited from pediatric outpatient clinics and advocacy groups across the state of Maryland. Participants completed a survey collecting demographics, the child’s treatment, and caregiver preferences—elicited using a best-worst scaling experiment (case 2). Latent class analysis was used to identify distinct preference segments and bivariate analyses were used to compare the association between segment membership with what the child was currently receiving for their ADHD. Results Participants (n = 184) were predominantly White (68%) and the child’s mother (84%). Most children had ADHD for 2 or more years (79%). Caregiver preferences were distinguished by two segments: continuous medication (36%) and minimal medication (64%). The two groups had very different preferences for when medication was administered (p < 0.001), but they had similar preferences for provider oriented and non-medication interventions (p > 0.05 for the caregiver behavior training, provider communication, provider specialty, and out-of-pocket costs). One third of the sample did not receive the preferred individualized education program and 42% of the minimal medication group reported using medication 7 days a week all year round. Conclusions Although behavior management training and school accommodations aspects of an ADHD care plan are more important to caregivers than evidence-based medication, fewer families had access to educational accommodations. Further research is needed to clarify how stated preferences for care align with treatments used in actual practice settings.

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“…Pilot testing is a small-scale roll-out of the developed survey instrument. It can be used to demonstrate feasibility of a preference study in a new research area and generate hypotheses for relative preference weights [21]. Pilot testing can also reveal problems with the quantitative patterns in responses, identify dominant attributes or attributes that are insensitive to level differences, or generate priors on the preference estimates that can be used for the experimental design of the full-scale survey [13].…”

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confidence: 99%