Sutphin J, DiSantostefano RL, Leach C, Hauber B, Mansfield C. Exploring decisional conflict with measures of numeracy and optimism in a stated preference survey. MDM Policy Pract. 2021 Nov 13;6(2):238146832. doi: 10.1177/23814683211058663


OBJECTIVES: Low optimism and numeracy is associated with difficulty or lack of participation in making treatmentrelated health care decisions. We investigated whether low optimism and low self-reported numeracy scores were associated with evidence of difficulty making decisions in a discrete-choice experiment (DCE).

METHODS: Preferences for a treatment to delay type 1 diabetes were elicited using a DCE among 1,501 parents in the United States. Respondents chose between two hypothetical treatments or they could choose no treatment (opt out) in a series of choice questions. The survey included a measure of optimism and a measure of subjective numeracy. We used latent class analyses where membership probability was predicted by optimism and numeracy scores.

RESULTS: Respondents with lower optimism scores had a higher probability of membership in a class with disordered preferences (P value for optimism coefficient = 0.032). Those with lower self-reported numeracy scores were more likely to be in a class with a strong preference for opting out and disordered preferences (P = 0.000) or a class with a preference for opting out and avoiding serious treatment-related risks (P = 0.015).

CONCLUSIONS: If respondents with lower optimism and numeracy scores are more likely to choose to opt out or have disordered preferences in a DCE, it may indicate that they have difficulty completing choice tasks.

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