Asking about understanding in choice surveys

Half of health researchers doing choice surveys (known as discrete choice experiments) ask respondents if they understood the survey. However, only around half of these go on to analyse the answers or use the results. This variation in practice was identified in a survey of health researchers, published recently in the journal Value in Health.

Choice surveys are increasingly used as a quantitative way to measure people’s preferences for health and healthcare. They are an exciting method that generates important insights for patient-centred care, but they are not without their drawbacks. Choice surveys often use medical terminology or assume an understanding of risks and probability, meaning they might be difficult for people to fill in accurately.

Our study also found that the questions researchers asked participants to assess their understanding varied widely. This suggests researchers aren’t sure the best way to ask whether people found their survey hard. It also makes it difficult to compare the results across different surveys. There is a need for researchers to have a set of questions specifically designed to ask about difficulty and understanding of choice surveys that they can all use consistently.

Overall, our results suggest that many researchers who use choice surveys to answer important health questions think it is valuable to make sure respondents understand the survey. But, they are not clear what questions to ask, or how to use the information. Our next step is to develop and test a series of questions to include in choice surveys that we are confident can give researchers useful information about participant understanding.