Framing effects in medical situations: distinctions of attribute, goal and risky choice frames

Abstract

Objective: To verify whether three different framing effects (risky choice, attribute and goal) exist in simulated medical situations and to analyse any differences.

Methods: Medical decision-making problems were established, relating to medical skill evaluation, patient compliance and a selection of treatment options. All problems were described in positive and negative frame conditions.

Results: Significantly more positive evaluations were made if the doctor's medical records were described as 'of 100 patients, 70 patients became better' compared with those described as 'of 100 patients, 30 patients didn't become better'. Doctor's advice described in a negative frame resulted in significantly more decisions to comply, compared with advice described in a positive frame. Treatment options described in terms of survival rates resulted in significantly more adventurous choices compared with options described in terms of mortality rates. Decision-making reversal appeared in the risky choice and attribute frames, but not the goal frame.

Conclusions: Framing effects were shown to exist in simulated medical situations, but there were significant differences among the three kinds of such effects.

Keywords: Framing effects; decision-making confidence; simulated medical situations.