Preference Paths and Their Kaizen Tasks for Small Samples.

backgroundStated preference research currently lacks a form of evidence that is well suited for small samples. A preference path is a sequence of two or more choices showing the evolution of an object following an adaptive process.

objectivesThe aims were to introduce preference paths and their kaizen tasks and to demonstrate how to analyze their evidence using a small sample.

methodsTwenty respondents were assigned the same 16 profiles generated from an orthogonal array based on the five attributes of the EQ-5D-5L descriptive system. Each kaizen task began with an opt-out paired comparison (i.e., choosing between the initial 10-year profile and the opt-out "dying immediately"), followed by choosing three changes, and ended with a second paired comparison (final profile versus opt-out) if the respondent chose opt-out initially. By maximum likelihood with respondent clusters, we estimated the 20 main effects using conditional logit and Zermelo-Bradley-Terry (ZBT) specifications.

resultsApart from demonstrating heterogeneity and profile effects, all main effect estimates were non-negative, and most were significant (15 for logit and all 20 for ZBT; p value < 0.05). Under the logit and ZBT specifications, the value of the worst EQ-5D-5L profile (55555) is - 0.920 quality-adjusted life years (QALYs) or - 1.478 QALYs, respectively. Furthermore, the findings illustrate a log-linear relationship between the logit and ZBT main effects.

conclusionThis paper demonstrates the feasibility of a stated-preference study that estimates 20 main effects using path evidence from 20 respondents (16 kaizen tasks, 15-min interviews). This approach shows promise for future application in stated-preference research, particularly in small samples.