How to do (or not to do) … Designing a discrete choice experiment for application in a low-income country

TLDR

Discrete choice experiments (DCEs) are a quantitative method for eliciting preferences that is useful for health policy and planning and is increasingly applied in low‑ and middle‑income countries, despite being widely used in high‑income settings. The paper introduces DCEs to policy‑makers and researchers with limited experience and outlines the stages of conducting a DCE, emphasizing design considerations for low‑income settings. DCEs ask respondents to choose between hypothetical scenarios defined by multiple attributes, and the resulting data are analyzed to assess attribute influence and relative importance, with the paper detailing the stages and design considerations for low‑income settings.

Abstract

Understanding the preferences of patients and health professionals is useful for health policy and planning. Discrete choice experiments (DCEs) are a quantitative technique for eliciting preferences that can be used in the absence of revealed preference data. The method involves asking individuals to state their preference over hypothetical alternative scenarios, goods or services. Each alternative is described by several attributes and the responses are used to determine whether preferences are significantly influenced by the attributes and also their relative importance. DCEs are widely used in high-income contexts and are increasingly being applied in low- and middle-income countries to consider a range of policy concerns. This paper aims to provide an introduction to DCEs for policy-makers and researchers with little knowledge of the technique. We outline the stages involved in undertaking a DCE, with an emphasis on the design considerations applicable in a low-income setting.