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. 2019 May 1;13(5):e0007364.
doi: 10.1371/journal.pntd.0007364. eCollection 2019 May.

Unbiased assessment of disease surveillance utilities: A prospect theory application

Arthur E Attema  1 , Lisheng He  2 , Alasdair J C Cook  3 , Victor J Del Rio Vilas  3   4
Affiliations

Unbiased assessment of disease surveillance utilities: A prospect theory application

Arthur E Attema et al. PLoS Negl Trop Dis. .

Abstract

Objectives: We contribute a new methodological approach to the ongoing efforts towards evaluating public health surveillance. Specifically, we apply a descriptive framework, grounded in prospect theory (PT), for the evaluation of decisions on disease surveillance deployment. We focus on two attributes of any surveillance system: timeliness, and false positive rate (FPR).

Methods: In a sample of 69 health professionals from a number of health related networks polled online, we elicited PT preferences, specifically respondents' attitudes towards gains, losses and probabilities (i.e., if they overweight or underweight extreme probabilities) by means of a series of lotteries for either timeliness or FPR. Moreover, we estimated willingness to pay (WTP) for improvements in the two surveillance attributes. For contextualization, we apply our framework to rabies surveillance.

Results: Our data reveal considerable probability weighting, both for gains and losses. In other words, respondents underestimate their chances of getting a good outcome in uncertain situations, and they overestimate their chances of bad outcomes. Moreover, there is convex utility for losses and loss aversion, that is, losses loom larger than gains of the same absolute magnitude to the respondents. We find no differences between the estimated parameters for timeliness and FPR. The median WTP is $7,250 per day gained in detection time and $30 per 1/10,000 reduction in FPR.

Conclusion: Our results indicate that the biases described by PT are present among public health professionals, which highlights the need to incorporate a PT framework when eliciting their preferences for surveillance systems.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Risk premiums plotted against probability of the worst outcome in the losses lottery for timeliness.
Fig 2
Fig 2. Risk premiums plotted against probability of the worst outcome in the losses lottery for FPR.
Fig 3
Fig 3. Risk premiums plotted against probability of the best outcome in the gains lottery for timeliness.
Fig 4
Fig 4. Risk premiums plotted against probability of the best outcome in the gains lottery for FPR.
Fig 5
Fig 5. Plot of median utility (gains and losses) for timeliness.
Fig 6
Fig 6. Plot of median utility (gains and losses) for FPR.
Fig 7
Fig 7. Bar chart of reference point for timeliness in days.
Fig 8
Fig 8. Bar chart of reference point for FPR (per 10,000).
See this image and copyright information in PMC

References

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