The topic we learned this week is “Doctors and Patients’ Susceptibility to Framing Bias: A Randomized Trial.” This study sought to determine which risk framing format corresponds best to comprehensive multi-faceted information, and to compare framing bias in doctors and in patients.
The study conducted two randomized mail surveys that included a hypothetical scenario among doctors and among patients recently discharged from hospital. The doctor survey primarily explored doctors’ opinions about policy issue; the patient survey, primarily a patient satisfaction survey, was exempted from full review.
The scenario described a hypothetical clinical trial in which a new treatment provided a survival benefit over the old treatment, but caused more digestive side-effects. Four basic risk formats were used in both surveys: 1) survival proportions, 2) mortality proportions, 3) relative mortality reduction, and 4) all three presentations of risk. The latter was considered to be the fully informed condition. The respondent was asked how the new treatment compared with the old treatment.
The result of this study confirms that presentation of study results in terms of absolute mortality risks leads to least biased perceptions of the benefit of a new treatment, when a combination of three risk formats is used as the reference. In comparison, relative presentations of benefit cause an optimistic bias, and survival proportions induce a pessimistic bias. Doctors are just as prone to these biases as patients
The main limitation of the study is that only one situation was depicted. Another limitation is that we do not know whether our“comprehensive information” condition achieved its purpose for all respondents.