Value and discrete choices in the context of rare diseases

Background

The proliferation of discrete choice models in healthcare, mostly but not exclusively based on data from discrete choice experiments has occurred in many areas. Applications of these methods include, among other things, consumer-based purchasing choices such as cigarettes and alcohol; preferences for health-based fiscal policies; clinical settings such as patients’ treatment options; quality of life measurement; and estimating non-inferiority margins for clinical trials.

The economic paradigm of utility maximisation underlies almost all applications of choice analyses in health economics and more widely in health sciences. This has proven an invaluable tool for establishing preferences. In many health settings, however, the notion of utility is arguably far-removed from its origins in neoclassical economics. Moreover, the settings in which these methods are used are appreciably different from each other yet share a common behavioural assumption. Whilst statistical models conveniently operationalise analyses, important ontological questions arise surrounding the nature of value in such diverse settings. Answering these questions will allow researchers a clearer understanding of the outputs they derive and the comparability of their findings.

The aim of this DPhil is to explore the theoretical and philosophical underpinnings of choice analyses in the context of health behaviours. It will seek to understand what value means in the context of health-based decision making. Empirical work in the context of rare diseases will be used to understand value in a setting which is distinct from economics and shares clinical features with other areas of healthcare.  

RESEARCH EXPERIENCE, RESEARCH METHODS AND TRAINING

This project will provide experience and training in:

• literature review methods
• ethics and philosophical understandings of value
• choice theory
• design and implementation of surveys and stated choice experiments
• statistical choice modelling.

The student will conduct a programme of work that will involve a comprehensive review of the literature to identify current understanding of choices and value as pertains to choice-making in health settings. With this, and drawing from philosophical themes, concepts of value in health will be set out. There will then be experiments devised to demonstrate concepts. The project will be designed by the student in conjunction with the supervisors and will involve some philosophical theory, some theoretical health economics and some experimental work in the context of rare diseases.

prospective student

This project would suit a candidate with an interest and background in one or more of economics, health economics, ethics, or philosophy. The candidate will hold a Master’s degree or equivalent in one of these fields and may have experience in a research environment in an academic or private sector. They may have theoretical, quantitative, or qualitative skills, but must be able to demonstrate willingness to learn new approaches.