Modeling Patient Decision-Making: The Role of Base-Rate and Anecdotal Information
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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.
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REFERENCES
- Deber, R. B. (1994). Physicians in health care management: The patient-physician partnership: Changing roles and the desire for information. Canadian Medical Association, 151 ,171–176.Google Scholar
- Greenfield, S., Kaplan, S., & Ware, J. E. (1985). Expanding patient involvement in care: Effects on patient outcomes. Annals of Internal Medicine, 102 ,520–528.PubMedGoogle Scholar
- Kahneman,D., & Tversky,A. (1973). On the psychology of prediction. Psychological Review, 80 ,237–251.Google Scholar
- Lerman, C. E., Brody, D. S., Caputo, G. C., Smith, D. G., Lazaro, C. G., & Wolfson, H. G. (1990). Patients' perceived involvement in care scale: Relationship to attitudes about illness and medical care. Journal of General Internal Medicine, 5 ,29–33.PubMedGoogle Scholar
- Mahler, H. I. M., & Kulik, J. A. (1990). Preferences in health care involvement, perceived control and surgical recovery: A prospective study. Social Science Medicine,31 ,743–751.CrossRefPubMedGoogle Scholar
- Moyer, A., & Solovey, P. (1998). Patient participation in treatment decision making and the psychological consequences of breast cancer surgery. Women's Health: Research on Gender, Behavior, and Policy,4 ,103–116.Google Scholar
- Raghunathan, R., & Pham, M. (1999). All negative moods are notequal: Motivational influences of anxiety & sadness on decision making. Organizational Behavior and the Human Decision Processes, 1 ,56–77.CrossRefGoogle Scholar
- Redelmeier, D. A., Rozin, P., & Kahneman,D. (1993). Understanding patient's decisions: Cognitive and emotional perspectives. JAMA, 270 ,72–76.CrossRefPubMedGoogle Scholar
- Speedling, E. J., & Rose,D.N. (1985). Building and effective doctor-patient relationship: From patient satisfaction to patient participation. Social Science Medicine,21 ,115–120.CrossRefPubMedGoogle Scholar
- Tversky, A., & Kahneman, D. (1971). Belief in the law of small numbers. Psychological Bulletin, 6 ,105–110Google Scholar