Mason, Helen, Marissa Collins, Neil McHugh, Jon Godwin, Job Van Exel, Cam Donaldson, Rachel Baker (2018, May). Is “end of life” a special case? Connecting Q with survey methods to measure societal support for views on the value of life‐extending treatments. Health Economics, 27(5), 819-831.

Abstract: Preference elicitation studies reporting societal views on the relative value of end‐of‐life treatments have produced equivocal results. This paper presents an alternative method, combining Q methodology and survey techniques (Q2S) to determine the distribution of 3 viewpoints on the relative value of end‐of‐life treatments identified in a previous, published, phase of this work. These were Viewpoint 1, “A population perspective: value for money, no special cases”; Viewpoint 2, “Life is precious: valuing life‐extension and patient choice”; and Viewpoint 3, “Valuing wider benefits and opportunity cost: the quality of life and death.” A Q2S survey of 4,902 respondents across the United Kingdom measured agreement with these viewpoints; 37% most agreed with Viewpoint 1, 49% with Viewpoint 2, and 9% with Viewpoint 3. Regression analysis showed associations of viewpoints with gender, level of education, religion, voting preferences, and satisfaction with the NHS. The Q2S approach provides a promising means to investigate how in‐depth views and opinions are represented in the wider population. As demonstrated in this study, there is often more than 1 viewpoint on a topic and methods that seek to estimate that averages may not provide the best guidance for societal decision‐making.

Helen Mason <>, Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK.

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