The effect of reflection and deliberation on health state values

M. Karimi, J. Brazier, S. Paisley


To measure the benefits of health interventions, health economists ask members of the general public to value health states. These values are important in informing resource allocation in health care. There is a concern that participants construct their preferences during the elicitation tasks, but that conventional methods rely on one-off interviews that do not give participants enough time to reflect and deliberate on their preferences. Existing studies show that preferences over health states can change after a reflection and deliberation exercise, but most of these studies have used methods that are not conventional. This study investigates the effect of a group meeting involving reflection and deliberation on health state preferences using the commonly used EQ-5D-5L questionnaire and Time Trade Off valuation method.

A total of 62 participants were involved in 13 group meeting exercises where they valued health states before and after reflection and deliberation. There were large number of changes in health state values at the individual level, but mean aggregate level values were not statistically significantly different before and after the group meeting. All aggregate level changes were of small effect size. Thus, the use of conventional methods with one-off interviews, for purposes that use aggregated valuations, was not invalidated by this study. However, the large number of changes at the individual level suggests that participants remained uncertain about their preferences.