title: Obstetrical outcome valuations by patients, professionals, and laypersons: differences within and between groups using three valuation methods.
abstract: BACKGROUND
  Decision-making can be based on treatment preferences of the patient, the doctor, or by guidelines based on lay people's preferences. We compared valuations assigned by three groups: patients, obstetrical care professionals, and laypersons, for health states involving both mother and (unborn) child. Our aim was to compare the valuations of different groups using different valuation methods and complex obstetric health outcome vignettes that involve both maternal and neonatal outcomes.
  
  
  METHODS
  Patients (n = 24), professionals (n = 30), and laypersons (n = 27) valued the vignettes using three valuation methods: visual analogue scale (VAS), time trade-off (TTO), and discrete choice experimentation (DCE). Each vignette covered five health attributes: maternal health ante partum, time between diagnosis and delivery, process of delivery, maternal outcome, and neonatal outcome. We used feasibility questionnaires, Generalization theory, test-retest reliability and within-group reliability to compare the valuation patterns between groups and methods. We assessed relative weights from each valuation method to test for consistency across groups.
  
  
  RESULTS
  Test-retest reliability was equal across groups, but different across methods: highest for VAS (ICC = 0.61-0.73), intermediate for TTO (ICC = 0.24-0.74) and lowest for DCE (kappa = 0.15-0.37). Within-group reliability was highest in all groups with VAS (ICC = 0.70-0.73), intermediate with DCE (kappa = 0.56-0.76) and lowest with TTO (ICC = 0.20-0.66). Effects of groups were smaller than effects of methods. Differences between groups were largest for severe health states.
  
  
  CONCLUSIONS
  Based on our results, decision making among laypersons should use TTO or DCE; patients should use VAS or TTO.
authors.affiliation: Dept, of Social Medicine, Academic Medical Centre - University of Amsterdam, The Netherlands. denise.bijlenga@gmail.com
authors.forename: Denise
authors.initials: D
authors.lastname: Bijlenga
authors.forename: Erwin
authors.initials: E
authors.lastname: Birnie
authors.forename: Ben Wj
authors.initials: BW
authors.lastname: Mol
authors.forename: Gouke J
authors.initials: GJ
authors.lastname: Bonsel
mesh_terms: D000328:Adult; D001290:Attitude; D001291:Attitude of Health Personnel; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008427:Maternal Health Services; D008875:Middle Aged; D009426:Netherlands; D007744:Obstetric Labor Complications / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*
references.citation: Qual Life Res. 1996 Dec;5(6):521-31
references.pmid: 8993098
references.citation: Am J Public Health. 2000 Aug;90(8):1241-7
references.pmid: 10937004
references.citation: Value Health. 2006 Jul-Aug;9(4):213-8
references.pmid: 16903990
references.citation: Med Decis Making. 1999 Jan-Mar;19(1):66-77
references.pmid: 9917022
references.citation: Pharmacoeconomics. 2000 Feb;17(2):151-65
references.pmid: 10947338
references.citation: Eur J Obstet Gynecol Reprod Biol. 2006 Mar 1;125(1):54-8
references.pmid: 16054286
references.citation: N Engl J Med. 1994 Jun 30;330(26):1895-6
references.pmid: 8196734
references.citation: Health Econ. 2000 Mar;9(2):109-26
references.pmid: 10721013
references.citation: Plast Reconstr Surg. 2003 Jul;112(1):312-20; discussion 321-2
references.pmid: 12832909
references.citation: J Health Econ. 2006 Sep;25(5):927-44
references.pmid: 16464513
references.citation: BMC Pregnancy Childbirth. 2007 Jul 10;7:12
references.pmid: 17623077
references.citation: BMJ. 2010 Dec 21;341:c7087
references.pmid: 21177352
references.citation: Health Econ. 2011 Nov;20(11):1392-406
references.pmid: 20967891
references.citation: JAMA. 1999 Jun 2;281(21):1991-7
references.pmid: 10359387
references.citation: Appl Health Econ Health Policy. 2003;2(4):213-24
references.pmid: 15119540
references.citation: Value Health. 2008 Jan-Feb;11(1):76-87
references.pmid: 18237362
references.citation: Birth. 1999 Sep;26(3):178-83
references.pmid: 10655818
references.citation: Qual Life Res. 1994 Aug;3(4):257-65
references.pmid: 7812278
references.citation: Med Decis Making. 2008 Jul-Aug;28(4):500-10
references.pmid: 18420835
references.citation: Gerontologist. 1986 Jun;26(3):303-8
references.pmid: 3721238
references.citation: Acta Psychiatr Scand. 1996 Nov;94(5):326-36
references.pmid: 9124079
references.citation: Inj Prev. 2008 Feb;14(1):5-10
references.pmid: 18245308
references.citation: Value Health. 2009 Jul-Aug;12(5):821-7
references.pmid: 19508667
references.citation: BMC Pregnancy Childbirth. 2007 Jul 27;7:14
references.pmid: 17662114
references.citation: Health Serv Res. 1973 Fall;8(3):228-45
references.pmid: 4761617
references.citation: BMC Pregnancy Childbirth. 2007 Jul 04;7:10
references.pmid: 17610715
references.citation: Health Serv Res. 1972 Summer;7(2):118-33
references.pmid: 5044699
references.citation: Soc Sci Med. 1997 Dec;45(11):1641-52
references.pmid: 9428084
references.citation: J Chronic Dis. 1978;31(11):697-704
references.pmid: 730825
references.citation: Qual Life Res. 2003 Sep;12(6):599-607
references.pmid: 14516169
references.citation: Pharmacoeconomics. 2007;25(3):223-37
references.pmid: 17335308
references.citation: Value Health. 2010 Mar-Apr;13(2):306-9
references.pmid: 19744288
references.citation: Lancet. 2009 Sep 19;374(9694):979-988
references.pmid: 19656558
references.citation: Psychiatr Serv. 2003 Aug;54(8):1124-8
references.pmid: 12883140
references.citation: Am J Psychiatry. 2003 Jun;160(6):1139-46
references.pmid: 12777273
references.citation: Med Decis Making. 2000 Jan-Mar;20(1):62-71
references.pmid: 10638538
references.citation: Biometrics. 1977 Mar;33(1):159-74
references.pmid: 843571