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. 2020 Sep 1;25(9):681-691.
doi: 10.1080/10810730.2020.1838003. Epub 2020 Oct 28.

Framing the Clinical Encounter: Shared Decision-Making, Mammography Screening, and Decision Satisfaction

Ellie F Yang  1 , Dhavan V Shah  1 , Elizabeth S Burnside  2 , Terry A Little  2 , Natalie Garino  3 , Claire Elise Campbell  1
Affiliations

Framing the Clinical Encounter: Shared Decision-Making, Mammography Screening, and Decision Satisfaction

Ellie F Yang et al. J Health Commun. .

Abstract

The study examines whether physicians' framing of clinical interactions is related to patient shared decision-making (SDM) satisfaction when using a clinical decision support tool (CDST) concerning mammographic screening. To answer this question, we combined (a) system log data from a CDST, (b) content coding of the physicians' message framing while using the CDST, and (c) a post-visit patient survey to assess SDM satisfaction concerning screening mammography. Results suggest that two types of message frames - consequence frames and numerical frames - moderated the relationship of the CDST on SDM satisfaction. When the CDST displayed low risk of breast cancer for a patient, physicians were able to improve the cognitive aspects of SDM satisfaction by framing the consequences of mammography screening in positive terms. However, when the physician delivered the numerical information in relative, rather than absolute terms, the patient's SDM satisfaction was reduced. Our study advances previous message framing effect research in health communication from experimental settings to clinical encounters. It also discusses the importance of delivering risk-congruent frames in clinical settings.

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Figures

Figure 1:
Figure 1:
Screenshot of the B-CARE tool1 1 Readers can access to the tool without EHR built-in at https://www.healthdecision.org/tool#/tool/mammo
Figure 2.
Figure 2.
Interaction effect of estimated risk and positive consequence frames
Figure 3.
Figure 3.
Interaction effect of estimated risk and relative numerical frames
See this image and copyright information in PMC

References

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