Adaptive choice-based conjoint analysis: a new patient-centered approach to the assessment of health service preferences

Abstract

Conjoint analysis (CA) has emerged as an important approach to the assessment of health service preferences. This article examines Adaptive Choice-Based Conjoint Analysis (ACBC) and reviews available evidence comparing ACBC with conventional approaches to CA. ACBC surveys more closely approximate the decision-making processes that influence real-world choices. Informants begin ACBC surveys by completing a build-your-own (BYO) task identifying the level of each attribute that they prefer. The ACBC software composes a series of attribute combinations clustering around each participant's BYO choices. During the Screener section, informants decide whether each of these concepts is a possibility or not. Probe questions determine whether attribute levels consistently included in or excluded from each informant's Screener section choices reflect 'Unacceptable' or 'Must Have' simplifying heuristics. Finally, concepts identified as possibilities during the Screener section are carried forward to a Choice Tournament. The winning concept in each Choice Tournament set advances to the next choice set until a winner is determined.A review of randomized trials and cross-over studies suggests that, although ACBC surveys require more time than conventional approaches to CA, informants find ACBC surveys more engaging. In most studies, ACBC surveys yield lower standard errors, improved prediction of hold-out task choices, and better estimates of real-world product decisions than conventional choice-based CA surveys.

Fig. 1

Sample build-your-own (BYO) exercise. Note that attributes with an established preference order (e.g. preference for less frequent side effects) could be excluded from the BYO task. These attributes are, in any case, carried into the Screener section of the survey (reproduced with permission from Sawtooth Software, Inc.).

Fig. 2

Sample page from the Screener section of an Adaptive Choice-Based Conjoint analysis (ACBC) survey (reproduced with permission from Sawtooth Software, Inc.).

Fig. 3

Screening for ‘unacceptable’ attribute levels (reproduced with permission from Sawtooth Software, Inc.).

Fig. 4

Sample page from a Choice Task Tournament (reproduced with permission from Sawtooth Software, Inc.).