Effects of 0utcome Framing on Treatment Decisions in the Real World

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Abstract
This study was an in-depth examination of how 100 patients and physicians made treatment decisions about adjuvant therapy for breast cancer. Specifically, the authors examined how outcome framing was associated with these decisions. Based on other studies, it was hy pothesized that patients would choose more aggressive, nonstandard treatment regimens when outcomes were framed negatively, rather than positively. Contrary to these expecta tions, no significant associations were found between the framing of treatment outcomes and type of treatment chosen, or the acceptance or rejection of the physicians' treatment recommendations. Physicians practiced routinized communication patterns. Physicians tended to frame treatment outcomes similarly for all patients, regardless of severity of disease. It is concluded that the impact of outcome framing in real clinical situations is attenuated by verbal presentation of information and other factors more important to the decision process. Key words: outcome framing; decision making; adjuvant therapy; breast cancer. (Med Decis Making 1989;9:262-271)