May 2008
Sun Mon Tue Wed Thu Fri Sat
        1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30 31

Authors' Committee

Chair:

Andy Eggers (Gov)

Members:

Weihua An (Soc)
Kevin Bartz (Stats)
Sebastian Bauhoff (HealthPol)
John Graves (HealthPol)
Justin Grimmer (Gov)
Jens Hainmueller (Gov)
Mike Kellermann (Gov)
Ellie Powell (Gov)
Gary King (Gov)

Weekly Research Workshop Sponsors

Alberto Abadie, Lee Fleming, Adam Glynn, Guido Imbens, Gary King, Kevin Quinn, Jamie Robins, Don Rubin, Chris Winship

Recent Comments

Recent Entries

Categories

Blogroll

Brad DeLong
Cognitive Daily
Complexity & Social Networks
Developing Intelligence
EconLog
The Education Wonks
Empirical Legal Studies
Free Exchange
Freakonomics
Health Care Economist
Junk Charts
Language Log
Law & Econ Prof Blog
Machine Learning (Theory)
Marginal Revolution
Mixing Memory
Mystery Pollster
New Economist
Political Arithmetik
Political Science Methods
Pure Pedantry
Science & Law Blog
Simon Jackman
Social Science++
Statistical modeling, causal inference, and social science

Archives

Notification

Powered by
Movable Type 3.34


« How do you get 7,000,000 cell phone records? | Main | The Changing Evidence Base of Political Science Research »

28 September 2007

Health Inequalities and Anchoring Vignettes

I have earlier written about using anchoring vignetttes to correct for biases in self-reported measures such as health outcomes (here and here). One issue with self-reports is that respondents may interpret identical questions in different ways. The idea of vignettes is use controlled scenarios to measure this bias and adjust the self-reports accordingly, so that they are informative about the actual health status.

An interesting application of this method is a paper by D'Uva et al (2006 working paper here), who use vignettes from the World Health Surveys to identify and correct reporting heterogeneities in Indonesia, China and India. Their objective is to establish whether the reporting differences affect measures of within-country inequality in several health domains (mobility, self-care etc). They find evidence for reporting heterogeneity but also suggest that the bias is not large in their data.

The paper also discusses in more detail two assumptions underlying the vignette method, ``response consistency'' and ``vignette equivalence'' (also discussed in King et al 2004).

``Response consistency'' requires that respondents assess their own health in the same way that they assess other people's health (i.e. the vignette scenarios). This may fail if there is strategic reporting, for example when one's reported health status could provide access to entitlement programs for which other people's health status is irrelevant. ``Vignette equivalence'' essentially requires that the scenarios in the vignettes are perceived similarly across respondents; no systematic differences are allowed. The authors suggest that a failure of this latter assumption may underlie findings with respect to age that are in contrast with other studies. Elderly people might interpret the vignette scenarios differently since they are more likely to have own experiences with the described health problems.

I am curious whether these assumptions have been tested in detail. This might also stimulate some thinking about what elements of self-reports we want to correct for, and whether the determinants of reporting biases are of their own interest.

Posted by Sebastian Bauhoff at September 28, 2007 8:08 AM

Comments

I am a postdoc research psychology fellow cross-training in public health. This is a fascinating and important area, and I have a couple thoughts.

Obviously it is often difficult or impossible to obtain anything more than self-rated health outcomes in large scale research (ie, epidemiologic surveys). Vignettes may possibly correct this under some conditions. However, my immediate impression is that there are some limitations it is important to be aware of.

In the paper on King's web site, he admits 2 key assumptions of the vignette method (p. 4): response consistency, or the the notion that "each respondent uses the survey response categories in the same way to answer the anchoring vignette and self-assessment questions" and vignette equivalence, or "the assumption that...levels of the variable represented in the vignette is understood by all respondent in the same way apart from random measurement error."

These are huge assumptions! People bring all sorts of idiosyncracy in perception to all survey items, including the vignettes proposed to correct initial items. Since people often employ different criteria to evaluate themselves vs. others, the first assumption that the response scale is being used similarly may well be violated in any given individual. Some are likely to apply the anchors more favorably to their own version of the question than the vignette (self-serving bias) while the reverse will be true in others (for instance, depressed people or those with self-denigrating tendencies will evaluate themselves worse, using the same set of anchors, than a hypothetical external person in the vignette).

Regarding the second assumption that respondents will perceive the vignette equivalently, this suffers from the initial problematic assumption that respondents will view the initial survey item in the same way! Simply wording the vignette with precise details does not help because people differ in the meaning and importance they attach to the same detail, or even the same descriptive word used. What is one supposed to do--develop another vignette to anchor the anchoring vignette?

These assumptions may be like ever-elusive normality assumptions in parametric models--rarely met. Having said this, perhaps this method is robust to violations of these 2 assumptions. I will certainly consider its applications in our group's research.

I also wonder to what extent this improves over a well-worded, precisely operationally defined survey item. So it may be more useful for ambiguous survey items, like the famous General Health item "In general, my health is...poor, fair, good, etc."

In the end, psychologists have been studying response biases and how to model them for decades using classical test theory, and more recently using item response theory. But these are typically back-end statistical methods of correcting for, modeling, or otherwise quantifying response biases in a set of already-collected questionnaire items. I think the potential contribution here is the possibility of front-end design which might alleviates some differential item functioning. It is interesting, and ultimately an empirical question whether this will help.

Posted by: Ben Chapman at October 13, 2007 10:26 AM

Notification

Enter e-mail address to receive notification of new comments to this entry

Post a comment




Remember Me?

(you may use HTML tags for style)