Preference Paths and Their Kaizen Tasks for Small Samples

BACKGROUND: Stated 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. OBJECTIVES: The aims were to introduce preference paths and their kaizen tasks and to demonstrate how to analyze their evidence using a small sample. METHODS: Twenty 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. RESULTS: Apart 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. CONCLUSION: This 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40271-021-00541-z.