Med Decis Making - Framing Options as Choice or Opportunity: Does the Frame Influence Decisions?

Tópicos

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Resumo

JECTIVE: . Health professionals must enable patients to make informed decisions about health care 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.METHODS: 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' use of information during decision making, and recorded final decision. A posttask paper questionnaire assessed perceived risk, attitudes, subjective norm, perceived behavioral 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 that others endorsed the trial option. The framing bias was not present once participants 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 percent 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.

Resumo Limpo

jectiv health profession must enabl patient make inform decis health care choic unbias present option studi examin whether present decis opportun rather choic bias individu prefer context trial particip cancer treatmentmethod selfselect healthi women n random assign follow decis frame opportun take part trial optin opportun remov trial optout choic standard treatment take part trial choic computerbas task requir women make hypothet choic realworld cancer treatment trial softwar present frame scenario record initi prefer present comprehens balanc inform trace particip use inform decis make record final decis posttask paper questionnair assess perceiv risk attitud subject norm perceiv behavior control satisfact decisionresult frame influenc women immedi prefer opportun frame whether optin optout introduc bias discourag women choos standard treatment use choic frame avoid bias optout opportun frame also affect women perceiv social norm women felt other endors trial option frame bias present particip opportun view detail inform option within patient decis aid format group differ inform acquisit final decis sixteen percent chang initi prefer receiv full informationconclus choic frame treatment option explicit less like bias prefer present full inform parallel optionbyattribut format like debia decis frame tailor inform initi prefer illadvis prefer may chang follow detail inform

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