In patient-centered research, understanding the experiences, preferences, and decision-making processes of patients, caregivers, and healthcare professionals is key. But how do you explore these insights in a way that is ethical, controlled, and reflective of real-world complexity? This is where vignette studies come into play.

What is a vignette study?

A vignette study involves presenting participants with short, realistic descriptions of hypothetical scenarios, called vignettes. In healthcare research, these vignettes often describe patient cases or health states, clinical decisions, or care dilemmas. Participants are then asked to respond to the scenario, for example by choosing a treatment, sharing their preferences, or predicting an outcome¹.

Vignettes allow researchers to simulate real-world situations while controlling specific variables. This makes them a powerful tool for uncovering how people think, feel, and make decisions in healthcare settings¹.

Why use vignettes in patient-centered research?

• Vignettes reflect the complexity of real healthcare decisions. Instead of abstract survey questions, participants react to a specific situation – just as they would in a clinical setting².
• Patients, caregivers, healthcare professionals, and members of the public may all approach the same situation differently. Vignettes help explore those differences in a structured, comparative way.
• Topics like end-of-life care, disability, or treatment refusal can be difficult to explore directly. Vignettes offer a safe, ethical way to discuss these without putting real people at risk or discomfort.
• By varying elements within vignettes (e.g., patient age, symptoms, socioeconomic status), researchers can study how those factors influence decisions.
• Responses to vignettes can reveal gaps in understanding between patients/caregivers and clinicians, which can guide interventions that support better communication.

When to use a vignette study

Vignette studies are especially useful in the following situations³:

• Real-life observation isn’t possible (e.g., due to privacy concerns or ethical issues)
• You want to isolate specific variables in complex decisions
• You are testing new tools, guidelines, or interventions in a safe, simulated environment
• You need to compare responses across different groups, such as patients versus healthcare professional, or between demographic groups.

At Vitaccess, we have strong experience in conducting vignette studies, particularly to estimate patient and caregiver utility values when other methods, such as direct completion of the EQ-5D, are not suitable. We recently completed a vignette valuation study to estimate utility values for caregivers of patients with a rare life-limiting neuromuscular disease. We developed a series of vignettes representing caregiver health states at different stages of the patient’s disease. Vignette content was informed by desk research and input from healthcare professionals and caregivers. Vignettes were shown to members of the general public as part of a time trade-off exercise through which utility values for each caregiver health state were generated. Our client was able to use the utility values to raise awareness of caregiver burden and in health-economic modelling.

Final thoughts

In the growing movement toward patient-centered care, understanding how people respond to real-world complexity is vital. Vignette studies offer a bridge between controlled research and lived experience, making them a valuable tool.

Whether you’re exploring how patients perceive risk, how clinicians balance competing priorities, or how shared decision-making unfolds in practice, vignette studies provide a flexible, ethical, and insightful way to deepen your understanding of patient care.

If you’d like to get in touch with one of our experts to discuss our experience in designing and conducting vignette studies, email info@vitaccess.com.

References

1. Payton KSE and Gould JB,  Vignette research methodology: an essential tool for quality improvement collaboratives. Healthcare (Basel) 2022;11(1).

2. Sheringham J et al. The use of experimental vignette studies to identify drivers of variations in the delivery of health care: a scoping review. BMC Med Res Methodol 2021; 21(1): 81.

3. Matza LS et al.  Vignette-based utilities: usefulness, limitations, and methodological recommendations. Value Health 2021;24(6): 812-821.