Framing effect debiasing in medical decision making

Almashat, Sammy; Ayotte, Brian J.; Edelstein, Barry A.; Margrett, Jennifer A.

doi:10.1016/j.pec.2007.11.004

Cited by 109 publications

(117 citation statements)

References 24 publications

(37 reference statements)

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“…full patient 62,64 This is particularly important because in the real-world setting, patients may not often be provided with full information, in an accessible and comparable format, immediately after the initial trial offer. Third, women's trial preferences change when they receive more information and/or have time to consider the decision information.…”

Section: Discussionmentioning

confidence: 99%

Framing Options as Choice or Opportunity

Abhyankar

Summers²,

Velikova

et al. 2014

Med Decis Making

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Objective: Health professionals must enable patients to make informed decisions about healthcare choices through unbiased presentation of all options. This study examined whether presenting the decision as 'opportunity' rather than 'choice' biased individuals' preferences in the context of trial participation for cancer treatment.Method: Self-selecting healthy women (N=124) were randomly assigned to the following decision frames: opportunity to take part in the trial (opt-in), opportunity to be removed from the trial (opt-out), and choice to have standard treatment or take part in the trial (choice). The computer-based task required women to make a hypothetical choice about a real-world cancer treatment trial. The software presented the framed scenario, recorded initial preference, presented comprehensive and balanced information, traced participants' utilisation of information during decision making and recorded final decision. A post-task paper questionnaire assessed perceived risk, attitudes, subjective norm, perceived behavioural control and satisfaction with decision. Results:Framing influenced women's immediate preferences. Opportunity frames, whether opt-in or opt-out, introduced a bias as they discouraged women from choosing standard treatment. Using the choice frame avoided this bias. The opt-out opportunity frame also affected women's perceived social norm; women felt others endorsed the trial option. The framing bias was not present once patients had had the opportunity to view detailed information on the options within a patient decision aid format. There were no group differences in information acquisition and final decisions. Sixteen per cent changed their initial preference after receiving full information. Conclusions:A 'choice' frame, where all treatment options are explicit is less likely to bias preferences. Presentation of full information in parallel, option-by-attribute format is likely to 'de-bias' the decision frame. Tailoring of information to initial preferences would be ill-advised as preferences may change following detailed information.

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Section: Discussionmentioning

confidence: 99%

Framing Options as Choice or Opportunity

Abhyankar

Summers²,

Velikova

et al. 2014

Med Decis Making

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“…For example, research has demonstrated the impact of framing in medical contexts, influencing decisions about the resuscitation of premature newborns (Haward, Murphy, & Lorenz, 2008), treatment options for cancer (Almashat, Ayotte, Edelstein, & Margrett, 2008) and likelihood of engaging in preventive health practices such as obtaining a mammogram (Banks, Salovey, Greener, Rothman, Moyer, Beauvais, & Epel, 1995). Framing has been 6 found to be particularly influential when interpreting ambiguous situations.…”

Section: Introductionmentioning

confidence: 99%

Framing and perceptions of stalking: the influence of conduct severity and the perpetrator–target relationship

Scott

Rajakaruna

Sheridan

2013

Psychology, Crime & Law

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Research has demonstrated that the way in which questions are presented (i.e., framed) has the capacity to influence responses to subsequent questions (Tourangeau & Rasinski, 1988).In the context of stalking, perception research has often been framed in terms of whether or not particular behaviours constitute stalking. The current research investigates whether the framing of the opening question (question frame), conduct severity and the perpetrator-target relationship influence perceptions of stalking. Two studies employed experimental 3 × 3 independent factorial designs: one to examine question frame and conduct severity, the other to examine question frame and the perpetrator-target relationship. Participants in both studies (total N = 449) were presented with vignettes and asked to answer six questions relating to the behaviour described. Question frame was found to impact on the classification of behaviour, with a greater proportion of participants indicating that the behaviour represented harassment or stalking rather than an illegal act. Consistent with previous research, conduct severity and the perpetrator-target relationship influenced perceptions of stalking. However, there was no evidence to suggest that the framing of the opening question influenced these perceptions. The implications of these findings for previous perception research are discussed.

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“…58 To our knowledge, however, few empirical studies have evaluated methods for avoiding or making salient the effects of framing. 59 Visual aids have been proposed as a potentially promising method for communicating risks. They can improve understanding of risks associated with different treatments, screenings, and lifestyles ( [60][61][62][63][64][65][66] ; but see 67 ) and promote consideration of beneficial treatments that have side effects.…”

Section: Introductionmentioning

confidence: 99%

“…Last but not least, people differ in the extent to which they benefit from visual aids. For instance, icon arrays-that is, visual representations symbolizing patients 11,59,65 -are useful for enhancing comprehension of risk reduction in people with low numeracy skills. 61 In a similar vein, it is not known whether certain types of visual aids are more appropriate for low-numeracy individuals and other types for those with high numeracy.…”

Section: Introductionmentioning

confidence: 99%