The NICE Supplementary Guidance, first issued in 2009 and now enshrined in the Institute’s methods guide, specifies conditions under which ‘end of life’ treatments may be given higher priority than other health care interventions. This project seeks to examine whether a social preference exists for giving higher priority to life-extending, end of life treatments than to other treatments, using preference data elicited from the general public.
The project comprised two studies: (i) a small scale simple choice study designed to develop a better understanding of the reasons and principles underpinning people’s priority setting preferences and to establish whether the topic was worthy of further investigation using a larger scale study; and (ii) a large scale discrete choice experiment designed to provide a thorough and robust investigation of the preferences of a representative sample of the general public. Both studies asked respondents to complete a series of hypothetical scenarios which require respondents to choose which of two terminally ill patients they would prefer to treat, assuming that the health service has enough funds to treat one but not both of them.
Study (i) was preceded by a pilot that used a convenience sample of 21 members of staff and postgraduate students at the University of Sheffield. The pilot was conducted in April 2011 (see above for the link to the report). The main part of the study, which used a more representative sample of 50 respondents, was conducted in July 2011 (see above for the links to the published article and to a PowerPoint presentation of the findings).
Study (ii) was completed carried out using a web-based survey in February 2012. The sample comprised 3,969 members of the general public and is representative of the general population in terms of age and gender, and covers a range of social grades. See above for the link to the reports (full report and summary report available above) and to the published article.
A third study (iii) is planned for 2016.
Simple choice study (i)
KK Shah, A Tsuchiya, A Wailoo. Valuing health at the end of life: an empirical study of public preferences. European Journal of Health Economics 2014; 15 (4): 389-399
Valuing health at the end of life: DSU preference study (SMDM conference, Oslo, 2012)
Report of the pilot study
KK Shah, A Tsuchiya, A Wailoo. Valuing health at the end of life: an exploratory preference elicitation study. HEDS Discussion Paper 11/17 (December 2011)
Discrete choice experiment (ii)
Journal article, including updated analysis of the data
KK Shah, A Tsuchiya, A Wailoo. Valuing health at the end of life: a stated preference discrete choice experiment. Social Science & Medicine 2015; 124: 48-56
Valuing health at the end of life: a stated preference discrete choice experiment (December 2012).
Valuing health at the end of life (seminar at Erasmus University, Rotterdam, 2015)
Assessing technologies at the end of life: a review of empirical evidence (November 2009)