Table 2.
Recent preference studies relating to severity and end of lifea
| Author | Year | Sample size | Method | Perspective | Preference for severity? | Preference for end of life? |
|---|---|---|---|---|---|---|
| Chim et al. [21] | 2017 | 3080 | Choice | Personal, ex ante | Majority prefer to allocate money to severe rather than moderate; shifts towards moderate under effectiveness trade-off | Majority prefer to allocate equally, particularly under effectiveness trade-off |
| Kolasa and Lewandowski [54] | 2015 | 97 | PTO | Societal decision maker, ex ante | Heterogeneity: young prioritised on severity and capacity to benefit, but older people not prepared to trade off | – |
| Luyten et al. [52] | 2015 | 750 | DCE | What should be funded by government | Severity is significant in driving choice but less than patient characteristics and treatment effectiveness. Heterogeneity: preferences differ with respondent characteristics | |
| Richardson et al. [51] | 2016 | 662 | Relative social WTP | Societal decision maker, ex ante | Supports a severity effect, with a threshold; weighting varies with the condition’s description | – |
| Rowen et al. [45] | 2016 | 3669 | DCE | Which group the NHS should treat | Some effect of BOI but inconsistent | (Preference for end-of-life conditionsb) |
| Shiroiwa et al. [53] | 2016 | 1000 | Choice | Societal decision maker, ex ante | Similar proportion preferred severe and equal sharing | – |
| 1000 | DCE | Societal decision maker, ex ante | Preference for young, treatment over prevention, and severity | – | ||
| Skedgel et al. [46] | 2015 | 656 | DCE | Societal decision maker, ex ante | Aversion to poor final health state. Heterogeneity: two latent classes differ in preferences over initial health state |
Aversion to short initial life expectancy |
| Skedgel et al. [47] | 2015 | 604 | DCE and CSPC | Societal decision maker, ex ante | Preference for lower initial utility | No preference over untreated life expectancy in DCE, preference for longer life expectancy in CSPC |
| Skedgel [48] | 2016 | 1318 | DCE and CSPC | Societal decision maker, ex ante | Preference for prioritising severe initial health status; aversion to prioritising good initial and poorer final health status | No preference over untreated life expectancy |
| van de Wetering et al. [49] | 2015 | 1205 | DCE | Societal decision maker | Higher proportional shortfall not preferred in total sample. Heterogeneity: one of three latent classes showed preference to treat patients with low remaining health | – |
| van de Wetering et al. [50] | 2016 | 1001 | DCE | Societal decision maker | Severity shows some preference but unstable to adding in other parameters | – |
| van Exel et al. [44] | 2015 | 294 | Q-sort | How healthcare decisions should be made | Five viewpoints, one of which is severity and health maximising | Five viewpoints, one of which is life preservation |
| Wouters et al. [57] | 2017 | 46 | Q-sort | Personal, ex ante | – | Three viewpoints, none of which support preference for health gains in terminally ill patients |
DCE discrete-choice experiment, CSPC constant sum paired comparison, BOI burden of illness, NHS National Health Service, WTP willingness to pay, PTO Person Trade-Off
a Studies on severity and end of life published since the reviews of Gu et al. [15] and Chamberlain [55]
b The study by Rowen et al. [45] is included in the Chamberlain end-of-life review (although listed as the earlier draft of Brazier et al. [75]) and is therefore not discussed in this article