Interpretation of graphic data by patients in a general medicine clinic
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Objective:To assess how patients use graphic data to decide on preferences between alternative treatments.
Design:Cross-sectional survey of patients, physicians, and medical students. The physicians and medical students served as a control group with which to compare the patients’ responses.
Setting:A university-based Department of Veterans Affairs Medical Center.
Participants:152 patients seen in a general medicine clinic, 57 medical students, and 11 physicians.
Measurements and results:Subjects were given a survival graph showing the patient outcomes for two different unidentified treatments for an unidentified serious disease. They were asked to indicate which treatment they preferred and which portion(s) of the curves most influenced their preference. A large majority of both patients and health professionals preferred the treatment that had worse short-term and better long-term survival. Eleven percent of patients and 51% of health professionals identified mid-curve data (points other than the curve endpoints) as most influencing their preferences.
Conclusions:A graphic survival curve appears to provide enough information to assess patient preferences between two alternative treatments. Patients appeared to differ from physicians and medical students in their interpretation of the curves.
- Mazur, DJ, Hickam, DH (1990) Treatment preferences of patients and physicians: influences of summary data when framing effects are controlled. Med Decis Making 10: pp. 2-5 CrossRef
- McNeil, BJ, Pauker, SG, Sox, HC (1982) On the elicitation of preferences for alternative therapies. N Engl J Med 306: pp. 1259-62 CrossRef
- Mountain, CT The relationship of prognosis to morphology and the anatomic extent of disease: studies of a new clinical staging system. In: Israel, L, Chahinian, AP eds. (1976) Lung cancer: natural history, prognosis, and therapy. Academic Press, New York, pp. 107-40
- Mountain, CV, Carr, DT, Anderson, WAD (1974) A system for clinical staging of lung cancer. Am J Roentgenol Radium Ther Nucl Med 120: pp. 130-8
- Hilton, G (1960) Present position relating to cancer of the lung: results with radiotherapy alone. Thorax 15: pp. 17-8
- Fischhoff, B, Slovic, P, Lichtenstein, S Knowing what you want: measuring labile values. In: Wallsten, T eds. (1980) Cognitive processes in choice and decision behavior. Erlbaum, Hillsdale, NJ, pp. 117-41
- Kahneman, D, Tversky, A (1979) Prospect theory: an analysis of decision under risk. Econometrica 47: pp. 263-91 CrossRef
- Tversky, A, Kahneman, D (1981) The framing of decisions and the psychology of choice. Science 211: pp. 453-8 CrossRef
- Kahneman, D, Tversky, A (1984) Choices, values, and frames. Am Psychologist 39: pp. 341-50 CrossRef
- O’Connor, AMC, Boyd, NF, Trichler, DL (1985) Eliciting preferences for alternative cancer drug treatments: the influence of framing, medium, and rater variables. Med Decis Making 5: pp. 453-63 CrossRef
- Eraker, SA, Sox, HC (1981) Assessment of patients’ preferences for therapeutic outcomes. Med Decis Making 1: pp. 29-39 CrossRef
- Llewellyn-Thomas, H, Sutherland, HJ, Tibshirani, R, Ciampi, A, Till, JE, Boyd, NF (1982) The measurement of patients’ values in medicine. Med Decis Making 2: pp. 449-62 CrossRef
- Llewellyn-Thomas, H (1984) Describing health states: methodologic issues in obtaining values for health states. Med Care 22: pp. 543-52 CrossRef
- O’Connor, AMC (1987) Eliciting preferences for alternative drug therapies in oncology: influence of treatment outcome description, elicitation technique, and treatment experience on preferences. J Chronic Dis 40: pp. 811-8 CrossRef
- Sox, HC, Blatt, MA, Higgins, MC, Marton, KI (1988) Medical decision making. Butterworths, Boston
- McNeil, BJ, Weichselbaum, R, SG, Pauker (1978) Fallacy of the five-year survival in lung cancer. N Engl J Med 299: pp. 1397-401 CrossRef
- Interpretation of graphic data by patients in a general medicine clinic
Journal of General Internal Medicine
Volume 5, Issue 5 , pp 402-405
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- cognitive attitudes
- cognitive biases
- framing effect
- informed consent
- medical decision making
- summary data
- Industry Sectors