Discrete choice experiments to advance cardiovascular health

Despite high-quality evidence for effective interventions for prevention and control of cardiovascular disease (CVD), there are large gaps in adoption, implementation, and sustainment by patients and health workers.1 These gaps are partly driven by a limited focus on understanding preferences that underlie decision-making by patients, health workers, and other stakeholders. Originating in health economics, discrete choice experiments (DCEs) are a quantitative research method that can elicit stakeholder preferences to design implementation strategies to promote uptake, implementation, and sustained use of CVD interventions to reach global CVD targets.2 This viewpoint provides a brief overview of DCE methods, application in cardiovascular research, potential limitations, and the future of DCEs in CVD research to highlight their methodological role in advancing cardiovascular health. The methodological foundation of DCEs is grounded in Lancaster’s consumer theory, which proposes that individuals derive utility from the specific attributes of an intervention rather than from the intervention as a whole.3 Random Utility Theory complements this foundation by providing a probabilistic framework for modelling choices, assuming that individuals select the option that maximizes their overall utility, which is composed of both observable attributes and unobservable random factors.4 This approach quantifies the relative importance of attributes and trade-offs. Eliciting preferences is especially relevant in CVD prevention, where patients face complex regimens, health workers make time-sensitive decisions, and health systems confront questions of cost, value, and implementation.