Information Framing in Medical Decision Making
Numerous studies from behavioral decision research have demonstrated that framing the same information differently can lead to different responses. In Chapter 1, I demonstrate that variations in the information presented in transplant program report cards alters participants’ evaluations of which programs are better performing and thus which programs are better choices for transplant candidates. Whereas historically, these report cards focused primarily on post-transplant outcomes, my work found that report cards featuring salient information about donor organ utilization rates (transplant outcomes categorized by quality of donor offers accepted), or overall survival rates (outcomes from both waitlist and transplanted patients) both lay evaluators and medical trainees evaluate transplant centers with open donor acceptance strategies more favorably than centers with conservative strategies. When report cards lacked this information, both populations preferred the more conservative strategies. In Chapter 2, I apply a behavioral decision science approach known as the mental models methodology in order to conceptualize women’s beliefs, attitudes, and perceived adherence practices about vaginal microbicide films, a novel antiretroviral drug delivery system that is effective in preventing sexual transmission of HIV. I find evidence that an instructional video designed to convey key information about barriers and misconceptions surrounding film use was effective at reducing women’s concerns on variables related to physical properties of the films and worries the insertion process itself. Finally in Chapter 3, I explore errors in lay reasoning about vaccine efficacy and an intervention to bring lay perceptions in line with normative efficacy calculations. I demonstrate that the tendency to consider vaccine efficacy rates using a normative (or lure) computation depends on the contextual information provided in the question format: people tend to more normative when calculating an efficacy rate, but tend to follow a lure strategy when they are asked to calculate the number of infections (given an efficacy rate). I show that a visual debiasing intervention explained the concept behind the efficacy rate was effective in increasing the proportion of normative responses to efficacy format questions and reducing the proportion of lure responses in illness format questions.
History
Date
2022-04-26Degree Type
- Dissertation
Department
- Social and Decision Sciences
Degree Name
- Doctor of Philosophy (PhD)