title: Calculating Preference Weights for the Labor and Delivery Index: A Discrete Choice Experiment on Women's Birth Experiences.
abstract: OBJECTIVE
  The aim of this study was to calculate preference weights for the Labor and Delivery Index (LADY-X) to make it suitable as a utility measure for perinatal care studies.
  
  
  METHODS
  In an online discrete choice experiment, 18 pairs of hypothetical scenarios were presented to respondents, from which they had to choose a preferred option. The scenarios describe the birth experience in terms of the seven LADY-X attributes. A D-efficient discrete choice experiment design with priors based on a small sample (N = 110) was applied. Two samples were gathered, women who had recently given birth and subjects from the general population. Both samples were analyzed separately using a panel mixed logit (MMNL) model. Using the panel mixed multinomial logit (MMNL) model results and accounting for preference heterogeneity, we calculated the average preference weights for LADY-X attribute levels. These were transformed to represent a utility score between 0 and 1, with 0 representing the worst and 1 representing the best birth experience.
  
  
  RESULTS
  In total, 1097 women who had recently given birth and 367 subjects from the general population participated. Greater value was placed on differences between bottom and middle attribute levels than on differences between middle and top levels. The attributes that resulted in larger utility increases than the other attributes were "feeling of safety" in the sample of women who had recently given birth and "feeling of safety" and "availability of professionals" in the general population sample.
  
  
  CONCLUSIONS
  By using the derived preference weights, LADY-X has the potential to be used as a utility measure for perinatal (cost-) effectiveness studies.
authors.affiliation: Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: f.r.gartner@lumc.nl.
authors.forename: Fania R
authors.initials: FR
authors.lastname: Gärtner
authors.affiliation: Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
authors.forename: Esther W
authors.initials: EW
authors.lastname: de Bekker-Grob
authors.affiliation: Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Stiggelbout
authors.affiliation: TNO Child Health, Leiden, The Netherlands.
authors.forename: Marlies E
authors.initials: ME
authors.lastname: Rijnders
authors.affiliation: Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Liv M
authors.initials: LM
authors.lastname: Freeman
authors.affiliation: Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Middeldorp
authors.affiliation: Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Kitty W M
authors.initials: KW
authors.lastname: Bloemenkamp
authors.affiliation: Department of Gynecology and Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Esteriek
authors.initials: E
authors.lastname: de Miranda
authors.affiliation: Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: M Elske
authors.initials: ME
authors.lastname: van den Akker-van Marle
mesh_terms: D000328:Adult; D000465:Algorithms; D002755:Choice Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D036801:Parturition / Q000523:psychology*; D057240:Patient Preference; D061214:Patient Safety; D018743:Perinatal Care / Q000592:standards; D010817:Physician-Patient Relations; D011247:Pregnancy; D011594:Psychometrics; D019984:Quality Indicators, Health Care; D011795:Surveys and Questionnaires
keywords: birth experience; preferences; tariff; utility