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.
cognitive attitudes cognitive biases framing effect informed consent medical decision making preferences summary data