Prevalence of Missing Values and Protest Zeros in Contingent Valuation in Dental Medicine
Background: The number of contingent valuation (CV) studies in dental medicine using willingness-to-pay (WTP) methodology has substantially increased in recent years. Missing values due to absent information (i.e., missingness) or false information (i.e., protest zeros) are a common problem in WTP s...
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doaj-dc890eeb575d4e3ab0ce4c450ff356952021-07-23T13:43:05ZengMDPI AGInternational Journal of Environmental Research and Public Health1661-78271660-46012021-07-01187219721910.3390/ijerph18147219Prevalence of Missing Values and Protest Zeros in Contingent Valuation in Dental MedicinePedram Sendi0Arta Ramadani1Michael M. Bornstein2Department of Oral Health and Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058 Basel, SwitzerlandDepartment of Oral Health and Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058 Basel, SwitzerlandDepartment of Oral Health and Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058 Basel, SwitzerlandBackground: The number of contingent valuation (CV) studies in dental medicine using willingness-to-pay (WTP) methodology has substantially increased in recent years. Missing values due to absent information (i.e., missingness) or false information (i.e., protest zeros) are a common problem in WTP studies. The objective of this study is to evaluate the prevalence of missing values in CV studies in dental medicine, to assess how these have been dealt with, and to suggest recommendations for future research. Methods: We systematically searched electronic databases (MEDLINE, Web of Science, Cochrane Library, PROSPERO) on 8 June 2021, and hand-searched references of selected reviews. CV studies in clinical dentistry using WTP for valuing a good or service were included. Results: We included 49 WTP studies in our review. Out of these, 19 (38.8%) reported missing values due to absent information, and 28 (57.1%) reported zero values (i.e., WTP valued at zero). Zero values were further classified into true zeros (i.e., representing the underlying preference of the respondent) or protest zeros (i.e., false information as a protest behavior) in only 9 studies. Most studies used a complete case analysis to address missingness while only one study used multiple imputation. Conclusions: There is uncertainty in the dental literature on how to address missing values and zero values in CV studies. Zero values need to be classified as true zeros versus protest zeros with follow-up questions after the WTP elicitation procedure, and then need to be handled differently. Advanced statistical methods are available to address both missing values due to missingness and due to protest zeros but these are currently underused in dental medicine. Failing to appropriately address missing values in CV studies may lead to biased WTP estimates of dental interventions.https://www.mdpi.com/1660-4601/18/14/7219dental medicinecontingent valuationwillingness-to-payhealth services researchoral public healthmissing values |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pedram Sendi Arta Ramadani Michael M. Bornstein |
spellingShingle |
Pedram Sendi Arta Ramadani Michael M. Bornstein Prevalence of Missing Values and Protest Zeros in Contingent Valuation in Dental Medicine International Journal of Environmental Research and Public Health dental medicine contingent valuation willingness-to-pay health services research oral public health missing values |
author_facet |
Pedram Sendi Arta Ramadani Michael M. Bornstein |
author_sort |
Pedram Sendi |
title |
Prevalence of Missing Values and Protest Zeros in Contingent Valuation in Dental Medicine |
title_short |
Prevalence of Missing Values and Protest Zeros in Contingent Valuation in Dental Medicine |
title_full |
Prevalence of Missing Values and Protest Zeros in Contingent Valuation in Dental Medicine |
title_fullStr |
Prevalence of Missing Values and Protest Zeros in Contingent Valuation in Dental Medicine |
title_full_unstemmed |
Prevalence of Missing Values and Protest Zeros in Contingent Valuation in Dental Medicine |
title_sort |
prevalence of missing values and protest zeros in contingent valuation in dental medicine |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1661-7827 1660-4601 |
publishDate |
2021-07-01 |
description |
Background: The number of contingent valuation (CV) studies in dental medicine using willingness-to-pay (WTP) methodology has substantially increased in recent years. Missing values due to absent information (i.e., missingness) or false information (i.e., protest zeros) are a common problem in WTP studies. The objective of this study is to evaluate the prevalence of missing values in CV studies in dental medicine, to assess how these have been dealt with, and to suggest recommendations for future research. Methods: We systematically searched electronic databases (MEDLINE, Web of Science, Cochrane Library, PROSPERO) on 8 June 2021, and hand-searched references of selected reviews. CV studies in clinical dentistry using WTP for valuing a good or service were included. Results: We included 49 WTP studies in our review. Out of these, 19 (38.8%) reported missing values due to absent information, and 28 (57.1%) reported zero values (i.e., WTP valued at zero). Zero values were further classified into true zeros (i.e., representing the underlying preference of the respondent) or protest zeros (i.e., false information as a protest behavior) in only 9 studies. Most studies used a complete case analysis to address missingness while only one study used multiple imputation. Conclusions: There is uncertainty in the dental literature on how to address missing values and zero values in CV studies. Zero values need to be classified as true zeros versus protest zeros with follow-up questions after the WTP elicitation procedure, and then need to be handled differently. Advanced statistical methods are available to address both missing values due to missingness and due to protest zeros but these are currently underused in dental medicine. Failing to appropriately address missing values in CV studies may lead to biased WTP estimates of dental interventions. |
topic |
dental medicine contingent valuation willingness-to-pay health services research oral public health missing values |
url |
https://www.mdpi.com/1660-4601/18/14/7219 |
work_keys_str_mv |
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