MEDICAL DECISION-MAKING IN SITUATIONS THAT OFFER MULTIPLE ALTERNATIVES
MEDICAL DECISION-MAKING IN SITUATIONS THAT OFFER MULTIPLE ALTERNATIVES
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DOI：
10.1001/jama.1995.03520280048038
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发表时间：
1995-01-25
影响因子：
120.7
通讯作者：
SHAFIR, E
中科院分区：
文献类型：
--
作者：
REDELMEIER, DA;SHAFIR, E
客观。-为了确定涉及多个选项的情况是否会矛盾地影响人们选择一个选项，如果可用的选项较少，则会被拒绝。邮寄调查包含医疗方案制定的两个版本之一。两组医生：安大略家庭医生学院的成员（应答率=77%; n=287）和北美症状性颈动脉内膜切除术试验的神经学家和神经外科医生（应答率=84%; n=352）。一组属于安大略省议会的立法者（答复率=32%; n=41）。每种设想的基本版本都提出了两种选择。扩大后的版本提出了三个选择：原来的两个加第三个。这两个版本包含相同的信息，并随机分配。参与者的治疗结果。-在一个涉及骨关节炎患者的场景中，家庭医生在决定两种药物时比在决定一种药物时更不可能开药（53% vs 72%; P
Objective.-To determine whether situations involving multiple options can paradoxically influence people to choose an option that would have been declined if fewer options were available.Design.-Mailed survey containing medical scenarios formulated in one of two versions.Participants.-Two groups of physicians: members of the Ontario College of Family Physicians (response rate=77%; n=287) and neurologists and neurosurgeons affiliated with the North American Symptomatic Carotid Endarterectomy Trial (response rate=84%; n=352). One group of legislators belonging to the Ontario Provincial Parliament (response rate=32%; n=41).Intervention.-The basic version of each scenario presented a choice between two options. The expanded version presented three options: the original two plus a third. The two versions otherwise contained identical information and were randomly assigned.Outcome Measures.-Participants' treatment recommendations.Results.-ln one scenario involving a patient with osteoarthritis, family physicians were less likely to prescribe a medication when deciding between two medications than when deciding about only one medication (53% vs 72%; P