title: Choice Blindness and Health-State Choices among Adolescents and Adults.
abstract: To assess the feasibility and validity of using a discrete choice experiment format to elicit health preferences in adolescents by comparing illogical choices and choice-blindness rates between adults and adolescents; and to explore the relationship between personality traits and health-state choices.
  
  
  
  A convenience sample of adults and adolescents (12 to 17 y old) were recruited from around Chicago, USA. A personality inventory was administered, followed by pairwise comparisons of 6 health-state scenarios which asked each candidate to select their preferred choice. Health-state descriptions were based on a simplified 3-dimension version of the EQ-5D (mobility, pain, depression, each with 3 levels). For 2 scenarios, the respondent's preferred choice was switched; if the respondent did not notice the switch they were considered "choice blind". Logistic regression evaluated the association of personality, gender, and age with choice blindness and health-state choice.
  
  
  
  Ninety-nine respondents were recruited (44% adults). Comparing adolescents to adults, there was no significant difference in the rate of illogical preferences (9% v. 12%) or in preferring dead to the worst health state (56% v. 64%) ( P > 0.05). Choice-blindness rates were significantly higher in adolescents (35%) than adults (9%) ( P < 0.01). The adjusted odds of choice blindness in adolescents was 6.6 (95% CI = 1.8 to 23.8; P = 0.004). Conscientiousness was significantly associated with health-state choice in 3 of the 6 models predicting health-state choice (using P < 0.1 as a threshold).
  
  
  
  The results of this exploratory study suggest it is feasible to conduct choice experiments in adolescents; however, adolescents are significantly more likely to demonstrate choice blindness. Psychological traits may be noteworthy predictors of health-state choices, with conscientiousness independently associated with several health-state choices.
authors.affiliation: Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA (EHL, SP).
authors.forename: Ernest H
authors.initials: EH
authors.lastname: Law
authors.affiliation: Second City Outcomes Research LLC, Chicago, IL, USA (ALP, SP).
authors.forename: Annika L
authors.initials: AL
authors.lastname: Pickard
authors.affiliation: Institute of Health Economics and Health Care Management, Hochschule Neubrandenburg, Neubrandenburg, Germany (AK).
authors.forename: Anika
authors.initials: A
authors.lastname: Kaczynski
authors.affiliation: Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA (EHL, SP).|Second City Outcomes Research LLC, Chicago, IL, USA (ALP, SP).|Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan (SP).
authors.forename: A Simon
authors.initials: AS
authors.lastname: Pickard
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002755:Choice Behavior; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D055815:Young Adult
keywords: adolescents; choice; decision-making; health; preference change