Influence of Anchoring on Miscarriage Risk Perception Associated with Amniocentesis

Abstract

One factor women consider when deciding whether to pursue amniocentesis is the risk of miscarriage. People use mechanisms like anchoring, or the prior belief regarding the magnitude of risk, as a frame of reference for new information. This study aimed to determine a woman's perception of miscarriage risk associated with amniocentesis before and after genetic counseling and to determine what factors anchor a woman's perception of miscarriage risk. One hundred thirteen women being seen for prenatal genetic counseling and possible amniocentesis at six Houston clinics participated in the two‐part anonymous survey. While most women (56.7 %) perceived the risk as low or average pre‐counseling and indicated the numeric risk of amniocentesis as <1 %, significantly more patients (73 %) correctly identified the numeric risk as <1 % post‐counseling (p < 0.0001). However, the majority of patients’ qualitative risk perception did not change after the genetic counseling session (60 %). Those who changed their feeling about the risk after counseling showed a decreased perception of the risk (p < 0.0001). Participants who elected amniocentesis had a significantly lower perception of the risk (p = 0.017) whereas those who declined amniocentesis were more likely to view the risk as high (p = 0.004). The only two anchoring factors that had an effect were having a friend or relative with a personal or family history of a genetic disorder (p = 0.001) and having a child already (p = 0.038); both were associated with a lower risk perception. The lack of significant factors may reflect the uniqueness of each patient's risk assessment framework and reinforces the importance of genetic counseling to elucidate individual concerns, particularly as non‐invasive prenatal testing becomes more widely available and further complicates the prenatal testing landscape.

Cognitive Biases of Consumers’ Risk Perception of Foodborne Diseases in China: Examining Anchoring Effect

“…Based on the questionnaires proposed by Kahneman and Tversky [25], Nuccio et al [54], and Jacowitz and Kahneman [55], three questionnaires were designed for the control, high anchor, and low anchor groups in this study, in order to verify the existence of self-generated and experimenter-provided anchoring effects. Furthermore, the questionnaires were revised based on a pre-survey conducted in Wuxi, Jiangsu Province, China to ensure validity.…”

Developing a Broadly Applicable Measure of Risk Perception

“…Five studies (6%) combined probability only measures with affect (e.g., Armas, Ionescu, & Posner, ; Ram & Chand, ; Rübsamen et al., ). Finally, two studies combined the use of general and affect measures (Nuccio et al., ; O'Neill, Brereton, Shahumyan, & Clinch, ). The studies that combined probability only items with affect items illustrate how some measures, while theoretically incomplete, may still be effective.…”

Referencing BRCA in hereditary cancer risk discussions: In search of an anchor in a sea of uncertainty

“…These findings add to the existing literature on anchoring. While patients' use of anchoring is typically considered to originate prior to a clinical encounter (Gates, 2004;Nuccio et al, 2015;Senay & Kaphingst, 2009), this study illustrates how the information clinicians provide to patients may work as an external anchor. (Kuchenbaecker et al, 2017;Powers et al, 2018).…”

“…We use the North Carolina Clinical Genomic Evaluation by NextGen Exome Sequencing (NCGENES), a larger study of patients with suspected hereditary genetic conditions, to examine how genetic counselors and clinical geneticists communicate results for breast cancer genes beyond BRCA1 and BRCA2 to patients. Previous research on anchoring in clinical settings has used surveys and interviews to reveal how patients can come into appointments with preconceived anchors that shape their understandings of clinical information (Gates, 2004; Nuccio et al, 2015; Senay & Kaphingst, 2009; Shiloh & Saxe, 1989). Because of these prior beliefs or experiences to which patients anchor, it can be difficult for clinicians to change patients' perceptions of risk (Shiloh & Saxe, 1989; Wertz, Sorenson, & Heeren, 1986).…”