Article

Journal of Clinical Psychology in Medical Settings

, Volume 11, Issue 3, pp 211-216

First online:

Modeling Patient Decision-Making: The Role of Base-Rate and Anecdotal Information

  • Angela K. FreymuthAffiliated withDepartment of Psychiatry, Division of Neuropsychology, University of Michigan Email author 
  • , George F. RonanAffiliated withDepartment of Psychology, Central Michigan UniversityDepartment of Psychiatry, Division of Neuropsychology, University of Michigan

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Abstract

Guidelines for managing patient–physician relationships often stem from either paternalistic or shared decision-making perspectives. Despite a number of advantages shown for the shared decision-making model, questions remain as to whether lay people make the most optimal decisions about their health care. This study explored the influence of anecdotal and base-rate information on health-care decisions. Three hundred and seventeen undergraduates read two vignettes describing a fictitious disease, followed by a description of two potential treatment protocols. The comparison treatment was 50% effective and accompanied by an anecdote that described a patient whose treatment resulted in an ambiguous outcome. A second treatment was presented as 30, 50, 70, or 90% effective, and accompanied by an anecdote that described a patient whose treatment resulted in a positive, ambiguous, or negative outcome. Subjects weighted anecdotal information more heavily than base-rate, or statistical, information when the anecdotal information was clearly positive or negative. Subjects presented with ambiguous anecdotal information weighed base-rate information most heavily. Implications for enhancing patient decision-making are discussed.

patient decision-making medical decision-making clinical decision-making anecdote base-rate