Treatment decision-making and the form of risk communication: results of a factorial survey.
Treatment decision-making and the form of risk communication: results of a factorial survey.
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DOI：
10.1186/1472-6947-4-20
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发表时间：
2004-11-16
影响因子：
3.5
通讯作者：
Wills, Celia E
中科院分区：
文献类型：
--
作者：
Hembroff, Larry A;Holmes-Rovner, Margaret;Wills, Celia E
背景：预防性治疗的潜在使用者通常必须评估有关治疗风险和获益的复杂信息。本研究的目的是评估相对和绝对风险信息对患者决策的影响，在典型的健康信息为patients.METHODS：析因实验在密歇根州的成年人，非制度化，讲英语的人口的电话调查。平均面试时间为23分钟。主题和样本设计：952随机选择的成年人在密歇根州的家庭随机数字拨号样本。完成率为54.3%。结果：当提供关于预防骨骼疾病药物的乳腺癌额外风险的假设信息时，与基线率相比，受访者建议女性朋友服用药物的意愿降低（66.8% =是）。相对风险信息的下降幅度更大。与基线情况相比，关于药物预防心脏病的其他益处信息增加了向女性朋友推荐药物的意愿，但绝对和相对风险格式之间没有差异。当提供有关乳腺癌风险增加和心脏病风险降低的信息时，典型的受访者似乎会做出与预期效用理论一致的理性决策，但信息呈现格式会影响选择。那些11% - 33%的决策相反的医学指征更有可能是西班牙裔，老年人，受过更多教育，吸烟者，并有孩子在home.Conclusions：在典型的健康风险信息的情况下，相对风险信息导致受访者作出非规范性的决定，“纠正”时，框架使用绝对风险信息。这一人群样本一般理性的决定时，提出了绝对的风险信息，即使在电话采访的背景下，需要记住率。缺乏性别和种族的影响表明，提出绝对风险信息的标准策略可能会改善患者的决策。
BACKGROUND: Prospective users of preventive therapies often must evaluate complex information about therapeutic risks and benefits. The purpose of this study was to evaluate the effect of relative and absolute risk information on patient decision-making in scenarios typical of health information for patients.METHODS: Factorial experiments within a telephone survey of the Michigan adult, non-institutionalized, English-speaking population. Average interview lasted 23 minutes. Subjects and sample design: 952 randomly selected adults within a random-digit dial sample of Michigan households. Completion rate was 54.3%.RESULTS: When presented hypothetical information regarding additional risks of breast cancer from a medication to prevent a bone disease, respondents reduced their willingness to recommend a female friend take the medication compared to the baseline rate (66.8% = yes). The decrease was significantly greater with relative risk information. Additional benefit information regarding preventing heart disease from the medication increased willingness to recommend the medication to a female friend relative to the baseline scenario, but did not differ between absolute and relative risk formats. When information about both increased risk of breast cancer and reduced risk of heart disease were provided, typical respondents appeared to make rational decisions consistent with Expected Utility Theory, but the information presentation format affected choices. Those 11% - 33% making decisions contrary to the medical indications were more likely to be Hispanic, older, more educated, smokers, and to have children in the home.CONCLUSIONS: In scenarios typical of health risk information, relative risk information led respondents to make non-normative decisions that were "corrected" when the frame used absolute risk information. This population sample made generally rational decisions when presented with absolute risk information, even in the context of a telephone interview requiring remembering rates given. The lack of effect of gender and race suggests that a standard strategy of presenting absolute risk information may improve patient decision-making.