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Medical Decision Making
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The Validity of Person Tradeoff Measurements: Randomized Trial of Computer Elicitation Versus Face-to-Face Interview

Laura J. Damschroder, MS, MPH

Veterans Affairs (VA), Health Services Research and Development Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, Program for Improving Health Care Decisions, University of Michigan, Ann Arbor

Jonathan Baron, PhD

Department of Psychology, University of Pennsylvania, Philadelphia, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia

John C. Hershey, PhD

Department of Psychology, University of Pennsylvania, Philadelphia, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Wharton School, University of Pennsylvania, Philadelphia

David A. Asch, MD

Department of Psychology, University of Pennsylvania, Philadelphia, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Division of General Internal Medicine, University of Pennsylvania, Philadelphia

Christopher Jepson, PhD

Division of General Internal Medicine, University of Pennsylvania, Philadelphia

Peter A. Ubel, MD

Veterans Affairs (VA), Health Services Research and Development Center for Practice Management and Outcomes Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, Division of General Internal Medicine, University of Michigan, Ann Arbor, Program for Improving Health Care Decisions, University of Michigan, Ann Arbor

Can person tradeoff (PTO) value judgments be elicited by a computer, or is a face-to-face interview needed? The authors randomly assigned 95 subjects to interview or computer methods for the PTO, a valuation measure that is often difficult for subjects. They measured relative values of foot numbness, leg paralysis, and quadriplegia (all 3 pairs) at 2 reference group sizes (10 or 100). Relative values did not differ between computer and interview. Overall, 21% of responses were equality responses, 13% were high extreme values, and 5% violated ordinal criteria. The groups did not differ in these measures. The authors also assessed consistency across reference group size (10 v. 100). Although relative values were significantly lower for 100 than for 10, mode did not influence the size of this effect. Subjects made, on average, equally consistent judgments for the 3 comparisons. A computerized PTO elicitation protocol produced results of similar quality to that of a face-to-face interview.

Key Words: person tradeoff • utility assessment • computer elicitation • costeffectiveness • randomized trial • Internet survey

Medical Decision Making, Vol. 24, No. 2, 170-180 (2004)
DOI: 10.1177/0272989X04263160


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