IDENTIFY & REDUCE COGNITIVE BIASES OF DECISION AIDS

认识到患者价值观在医疗决策中的重要性，研究人员已经开始开发决策辅助工具，告知患者与可用治疗方案相关的各种危害和益处的可能性。决策辅助工具有很大的潜力来帮助患者做出明智的决定。 但它们也可能会影响患者的决定。 我们的总体目标是确定患者使用决策辅助工具时可能发生的认知偏见，并测试减少这些偏见的方法。 我们已经确定了四个认知偏见，特别是相关的决策辅助工具的设计：框架效应：人们的治疗选择取决于治疗的好处是在生存率或死亡率方面的框架。患者评价的不当影响：患者关于治疗的可取性或不可取性的评价影响治疗选择，与治疗有效性的统计信息无关。增加第三种治疗方案后的偏好逆转：一个人谁喜欢治疗方案A超过B可能更喜欢B后，增加第三种选择。结果信息的不当影响：增加有关治疗结果的信息可能会不当影响患者的选择。我们将开发决策辅助材料，使用书面和计算机化的调查管理给公众，与三分之一的样本有癌症相关的经验。 我们的目标不是在面临困难临床情况的患者身上测试决策辅助工具，而是开发可以产生这种决策辅助工具的方法--创建决策辅助工具的一般原则，这些决策辅助工具将增加患者对治疗选择的理解，而不会引入认知偏见。

In recognition of the importance of patient values in medical decisions, researchers have begun developing decision aids that inform patients about the probability of various harms and benefits associated with available treatment alternatives. Decision aids have great potential to help patients make informed decisions. But they could also bias patients' decisions. Our overall objective is to identify cognitive biases that are likely to occur when patients use decision aids and test ways to reduce these biases. We have identified four cognitive biases that are especially relevant to the design of decision aids: Framing effects: People's treatment choices depend on whether treatment benefits are framed in terms of survival or mortality. Undue influence of patient testimonials: Patient testimonials regarding the desirability or undesirability of a treatment influence treatment choices independent of statistical information about treatment effectiveness. Preference reversal after addition of a third treatment option: A person who prefers treatment option A over B may prefer B after the addition of a third option. Undue influence of outcome information: The addition of information about treatment outcomes may unduly influence patients' choices. We will develop decision aid materials using written and computerized surveys administered to the general public, with one-third of the sample having cancer-related experience. Our goal is not to test decision aids on patients facing difficult clinical situations but, instead, to develop methods by which such decision aids can be produced - general principles for the creation of decision aids that will increase patients' understanding of their treatment choices without introducing cognitive bias.