Framing Options as Choice or Opportunity: Does the Frame Influence Decisions?
Framing Options as Choice or Opportunity: Does the Frame Influence Decisions?
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DOI：
10.1177/0272989x14529624
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发表时间：
2014-07-01
影响因子：
3.6
通讯作者：
Bekker, Hilary L.
中科院分区：
文献类型：
--
作者：
Abhyankar, Purva;Summers, Barbara A.;Bekker, Hilary L.
目标。卫生专业人员必须通过不偏不倚地介绍所有选项，使患者能够就卫生保健选择做出明智的决定。这项研究考察了在参与癌症治疗试验的背景下，是否将决定描述为“机会”而不是“选择”“有偏见的个人”偏好。方法：研究方法。自选的健康妇女(N=124)被随机分配到以下决策框架：参加试验的机会(选择加入)、被排除试验的机会(选择退出)、选择接受标准治疗或参加试验(选择)。这项基于计算机的任务要求女性对现实世界的癌症治疗试验做出假设选择。该软件提供了框架方案，记录了初始偏好，提供了全面和平衡的信息，跟踪了参与者在决策过程中对信息的使用，并记录了最终决定。任务后问卷调查评估了感知风险、态度、主观规范、感知行为控制和对决策的满意度。结果。框架感影响了女性的直接偏好。机会框架，无论是选择加入还是选择退出，都引入了一种偏见，因为它们阻碍了女性选择标准治疗。使用选择框架避免了这种偏见。选择退出的机会框架也影响到妇女所认为的社会规范；妇女认为其他人赞同试验选择。一旦参与者有机会在患者决策辅助格式中查看有关选项的详细信息，框架偏见就不存在。在信息获取和最终决定方面没有群体差异。16%的人在收到完整信息后改变了最初的偏好。结论。“选择”框架，其中所有治疗选项都是明确的，不太可能偏向偏好。以并行的、逐个选项的格式呈现完整信息可能会对决策框架“去偏向”。根据最初的偏好调整信息是不明智的，因为偏好可能会在详细信息之后发生变化。
Objective. Health professionals must enable patients to make informed decisions about health care choices through unbiased presentation of all options. This study examined whether presenting the decision as "opportunity'' rather than "choice'' biased individuals' preferences in the context of trial participation for cancer treatment. Methods. Self-selecting healthy women (N = 124) were randomly assigned to the following decision frames: opportunity to take part in the trial (opt-in), opportunity to be removed from the trial (opt-out), and choice to have standard treatment or take part in the trial (choice). The computer-based task required women to make a hypothetical choice about a real-world cancer treatment trial. The software presented the framed scenario, recorded initial preference, presented comprehensive and balanced information, traced participants' use of information during decision making, and recorded final decision. A posttask paper questionnaire assessed perceived risk, attitudes, subjective norm, perceived behavioral control, and satisfaction with decision. Results. Framing influenced women's immediate preferences. Opportunity frames, whether opt-in or opt-out, introduced a bias as they discouraged women from choosing standard treatment. Using the choice frame avoided this bias. The opt-out opportunity frame also affected women's perceived social norm; women felt that others endorsed the trial option. The framing bias was not present once participants had had the opportunity to view detailed information on the options within a patient decision aid format. There were no group differences in information acquisition and final decisions. Sixteen percent changed their initial preference after receiving full information. Conclusions. A "choice'' frame, where all treatment options are explicit, is less likely to bias preferences. Presentation of full information in parallel, option-by-attribute format is likely to "de-bias'' the decision frame. Tailoring of information to initial preferences would be ill-advised as preferences may change following detailed information.