Exploring Decisional Conflict With Measures of Numeracy and Optimism in a Stated Preference Survey. Issue 2 (November 2021)

• Record Type: Journal Article
• Authors: Sutphin, Jessie; DiSantostefano, Rachael L.; Leach, Colton; Hauber, Brett; Mansfield, Carol
• Is Part Of: MDM policy & practice. Volume 6:Issue 2(2021)
• Publication Date: 2021-11
• Subjects: decisional conflict -- discrete-choice experiment -- latent class analysis -- psychological variables -- stated preferences; Medicine -- Decision making -- Periodicals; Medicine -- Decision making; Decision Making; Clinical Medicine; Health Policy; Periodicals; Periodicals; Electronic journals; 616.075
• DOI: 10.1177/23814683211058663
• Languages: English
• ISSNs: 2381-4683

Abstract

Objectives: Low optimism and low numeracy are associated with difficulty or lack of participation in making treatment-related health care decisions. We investigated whether low optimism and low self-reported numeracy scores could help uncover evidence of decisional conflict in a discrete-choice experiment (DCE). Methods: Preferences for a treatment to delay type 1 diabetes were elicited using a DCE among 1501 parents in the United States. Respondents chose between two hypothetical treatments or they could choose no treatment (opt out) in a series of choice questions. The survey included a measure of optimism and a measure of subjective numeracy. We used latent class analyses where membership probability was predicted by optimism and numeracy scores. Results: Respondents with lower optimism scores had a higher probability of membership in a class with disordered preferences ( P value for optimism coefficient = 0.032). Those with lower self-reported numeracy scores were more likely to be in a class with a strong preference for opting out and disordered preferences ( P = 0.000) or a class with a preference for opting out and avoiding serious treatment-related risks ( P = 0.015). Conclusions: If respondents with lower optimism and numeracy scores are more likely to choose to opt out or have disordered preferences in a DCE, it may indicate that they have difficulty completing choice tasks.