Is Best–Worst Scaling Suitable for Health State Valuation? A Comparison with Discrete Choice Experiments
比较最佳-最差标度法（BWS）与离散选择实验（DCE）在健康效用指数估值中的表现，发现BWS数据稳定性、单调性和连续性较差，存在偏好逆转和决策偏差，建议谨慎使用。
Health utility indices (HUIs) are widely used in economic evaluation. The best-worst scaling (BWS) method is being used to value dimensions of HUIs. However, little is known about the properties of this method. This paper investigates the validity of the BWS method to develop HUI, comparing it to another ordinal valuation method, the discrete choice experiment (DCE). Using a parametric approach, we find a low level of concordance between the two methods, with evidence of preference reversals. BWS responses are subject to decision biases, with significant effects on individuals' preferences. Non parametric tests indicate that BWS data has lower stability, monotonicity and continuity compared to DCE data, suggesting that the BWS provides lower quality data. As a consequence, for both theoretical and technical reasons, practitioners should be cautious both about using the BWS method to measure health-related preferences, and using HUI based on BWS data. Given existing evidence, it seems that the DCE method is a better method, at least because its limitations (and measurement properties) have been extensively researched. Copyright © 2016 John Wiley & Sons, Ltd.