Meeting round-up: 7th Meeting of the International Academy of Health Preference Research

The 7th meeting of the International Academy of Health Preference Research (IAHPR) took place in Glasgow on Saturday 4th November 2017. The meeting was chaired by Karin Groothuis-Oudshoorn and Terry Flynn. It was preceded by a Friday afternoon symposium on the econometrics of heterogeneity, which I was unable to attend.

IAHPR is a relatively new organisation, describing itself as an ‘international network of multilingual, multidisciplinary researchers who contribute to the field of health preference research’. To minimise participants’ travel costs, IAHPR meetings are usually scheduled alongside major international conferences such as the meetings of iHEA, EuHEA and AHES (the Australian Health Economics Society). The November meeting took place just before the kick-off of the ISPOR European Congress (a behemoth by comparison). Most, but not all, of the attendees I spoke to, said that they would also be attending the ISPOR Congress.

The meeting was attended by 49 researchers from nine different countries. Nine were from the US, 16 from the UK, and 22 from elsewhere in the EU (sadly, I won’t be able to use the phrase ‘elsewhere in the EU’ for much longer). Understandably, the regional representation of the Glasgow meeting was quite different from that of the (July 2017) Boston meeting, where over 60% of the participants were based in the US.

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In total there were 12 podium presentations (half by student presenters) and about eight posters. Each podium presenter was allocated 12 minutes for their presentation and a further eight minutes for questions and group discussion. The poster authors were given the opportunity to briefly introduce themselves and their research to the group as part of an ‘elevator talks’ session.

Although all of the presentations focused on issues in stated preference research, the range of topics was quite broad, covering preferences between health outcomes, preferences between health services, conceptual and theoretical issues, experimental design approaches, and novel analytical techniques. Most of the studies presented applications of the DCE and best-worst scaling methods. Several presentations examined issues relating to preference heterogeneity and decision heuristics.

A personal highlight was Tabea Schmidt-Ott’s examination of the use of dominance tests to assess rational choice behaviour amongst survey respondents. She reported that such tests were included in a quarter of the health-related DCE studies published in 2015 (including many studies that had been led by IAHPR meeting attendees). Their inclusion had often been used to justify choices about which respondents to exclude from the final samples. Tabea concluded that dominance tests are a weak technique for assessing the rationality of people’s choice behaviour, as the observation of dominated choices can be explained by and accounted for in DCE models.

Overall, the IAHPR meeting was enjoyable and intellectually stimulating. The standard of the presentations and discussions was high, and it was a good forum for learning about the latest advances in stated preference research. It was quite DCE-dominated, so it would have been interesting to have had some representation from researchers who are sceptical about that methodology.

The next meeting will take place in Tasmania, to be chaired by Brendan Mulhern and Richard Norman.

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Meeting round-up: EuroQol Plenary Meeting 2017

The 34th Plenary Meeting of the EuroQol Group took place in Barcelona on 21st and 22nd September 2017. The local hosts of the meeting were Mike Herdman (UK-born but a Barcelona resident for many years), Juan Manuel Ramos-Goñi and Oliver Rivero-Arias. For the second year running, I chaired the Scientific Programme together with Anna Lugnér.

At its inception, the EuroQol Group was very much a northern European collaboration – the early versions of the EuroQol instrument (now known as the EQ-5D) were developed by researchers in the Netherlands, UK, Sweden, Finland and Norway – see here for an overview of the Group and its history. This year’s Plenary Meeting was attended by 111 participants (primarily academic researchers) representing 23 different countries spanning six continents.

As with previous Plenary Meetings, an HESG-style discussant format was followed – papers were pre-circulated to participants and presented by discussants rather than by authors. The parallel poster sessions also followed a discussant format, with approximately 10 minutes dedicated to the discussion of each poster. In total, 19 papers and 20 posters were presented. For the first time, the majority of the papers were lead-authored by women.

One of the themes of the meeting was a focus on the relationships and interactions between EQ-5D dimensions. A paper by Anna Selivanova compared health state values derived from discrete choice data both with and without interactions. Anna reported results demonstrating that interactions are important and that the interaction between mobility and self-care was the most salient. Another paper by Thor Gamst-Klaussen (represented at the meeting by co-author Jan Abel Olsen) explored the causal and effect nature of EQ-5D dimensions. The authors applied confirmatory tetrad analysis and confirmatory factor analysis to multi-country, cross-sectional data in order to test a conceptual framework depicting relationships among the five dimensions. The results suggest that the EQ-5D comprises both causal variables – mobility, pain/discomfort and anxiety/depression – and effect variables – self-care and usual activities.

An intriguing paper by John Hartman tested for differences in respondent characteristics, participation, response quality and EQ-5D-5L values depending on the device and connection used to access an online survey. The results showed systematic variability in participation and response quality, but the variability did not affect the resulting health state values. The findings could support extending the administration of valuation surveys to smaller devices (e.g. mobile phones) to obtain responses from younger, more ethnically diverse populations who have traditionally been found to be difficult to recruit.

Other topics covered in the programme included the views of UK decision makers on the role of well-being in resource allocation decisions, the development of a value set for the EQ-5D-Y (a version of the EQ-5D designed for use in children and adolescents), and the prevalence and impact of so-called ‘implausible’ health states.

The Plenary Meeting concluded with a guest presentation by Janel Hanmer of the University of Pittsburgh, followed by a reception at a restaurant on the Montjuïc hill overlooking the Barcelona harbour. The next EuroQol conference will be the Academy Meeting, which takes place in Budapest on 6-8 March 2018.

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Meeting round-up: EuroQol Plenary Meeting 2016

The 33rd Plenary Meeting of the EuroQol Group took place in Berlin on 15th and 16th September 2016. The meeting was hosted by Wolfgang Greiner of the University of Bielefeld. I chaired the Scientific Programme together with my co-chair Anna Lugnér.

Inspired by the HESG meeting, the EuroQol Plenary Meeting largely followed a discussant format whereby papers were pre-circulated to participants and presented by discussants rather than by authors. The parallel poster sessions also followed a discussant format, with approximately 10 minutes dedicated to the discussion of each poster. In total, 20 papers and 22 posters were presented at the Plenary Meeting, about half of which were lead-authored by non-EuroQol members.

As with previous Plenary Meetings, there was a strong focus on health state valuation issues. Three papers examined the extent to which the results of discrete choice experiments are influenced by the visual presentation of the choice tasks. Two other papers explored innovative methods – namely, ‘personal utility functions’ and ‘non-iterative time trade-off’ – that have been developed to overcome some of the biases and limitations of traditional stated preference techniques. Other papers of interest included a study by Nils Gutacker and colleagues in which a web tool was developed to present EQ-5D data to patients and GPs in order to facilitate shared decision making, and a comparison of seven new EQ-5D-5L value sets by Jan Abel Olsen and colleagues. One of the highlights of the poster sessions was Katherine Rogers et al.’s report of the translation, validation and reliability of the EQ-5D-5L in British Sign Language.

An exception to the usual discussant format was a debate about the use of public, patient and experienced-based values. Matthijs Versteegh, whose paper featured in a recent blog post, set out arguments in favour of using patient values in addition to general public values, and presenting two different ICERs to decision makers. In response, John Brazier pointed out some of the potential problems with Matthijs’s proposals. John argued instead for using ‘informed’ general public values or for amending the EQ-5D descriptive system to reflect more fully the experience of patients.

The Plenary Meeting concluded with a reception and dinner at a restaurant on top of the magnificent Reichstag (German Federal Parliament) building. Look out for the call for abstracts for next year’s Plenary Meeting, which will be posted on the EuroQol website in Spring 2017.