Bryan S, Buxton M, Sheldon R, Grant A
Health Economics Research Group, Brunel University, Uxbridge, UK.
Health Econ. 1998 Nov;7(7):595-603. doi: 10.1002/(sici)1099-1050(1998110)7:7<595::aid-hec381>3.0.co;2-e.
The conventional approach to the diagnosis and treatment of severe knee injuries is arthroscopy, a minimally invasive surgical procedure. Since arthroscopy is an invasive technique that carries risks, magnetic resonance imaging (MRI) is increasingly being used for diagnosis. MRI is potentially associated with diagnostic and therapeutic 'impacts', in that arthroscopy can be avoided. This paper reports a discrete choice conjoint analysis exercise that assessed the value placed on such 'impacts' by potential patients and investigated the degree to which respondents were willing to trade between process and outcome. The marginal rates of substitution between attributes were estimated. The results suggest that the diagnostic and therapeutic 'impacts' of MRI were valued by many respondents. The study has highlighted a number of important issues for the design and analysis of future health-related conjoint studies, including the use of treatment cost as an attribute, dealing with data from lexicographic respondents, and distinguishing between points of indifference and missing data.
