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A matter of perspective: choosing for others differs from choosing for yourself in making treatment decisions.

Publication ,  Journal Article
Zikmund-Fisher, BJ; Sarr, B; Fagerlin, A; Ubel, PA
Published in: Journal of general internal medicine
June 2006

Many people display omission bias in medical decision making, accepting the risk of passive nonintervention rather than actively choosing interventions (such as vaccinations) that result in lower levels of risk.Testing whether people's preferences for active interventions would increase when deciding for others versus for themselves.Survey participants imagined themselves in 1 of 4 roles: patient, physician treating a single patient, medical director creating treatment guidelines, or parent deciding for a child. All read 2 short scenarios about vaccinations for a deadly flu and treatments for a slow-growing cancer.Two thousand three hundred and ninety-nine people drawn from a demographically stratified internet sample.Chosen or recommended treatments. We also measured participants' emotional response to our task.Preferences for risk-reducing active treatments were significantly stronger for participants imagining themselves as medical professionals than for those imagining themselves as patients (vaccination: 73% [physician] & 63% [medical director] vs 48% [patient], Ps<.001; chemotherapy: 68% & 68% vs 60%, Ps<.012). Similar results were observed for the parental role (vaccination: 57% vs 48%, P=.003; chemotherapy: 72% vs 60%, P<.001). Reported emotional reactions were stronger in the responsible medical professional and parental roles yet were also independently associated with treatment choice, with higher scores associated with reduced omission tendencies (OR=1.15 for both regressions, Ps<.01).Treatment preferences may be substantially influenced by a decision-making role. As certain roles appear to reinforce "big picture" thinking about difficult risk tradeoffs, physicians and patients should consider re-framing treatment decisions to gain new, and hopefully beneficial, perspectives.

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Published In

Journal of general internal medicine

DOI

EISSN

1525-1497

ISSN

0884-8734

Publication Date

June 2006

Volume

21

Issue

6

Start / End Page

618 / 622

Related Subject Headings

  • Physician-Patient Relations
  • Patient Satisfaction
  • Patient Participation
  • Influenza Vaccines
  • Humans
  • General & Internal Medicine
  • Decision Making
  • Choice Behavior
  • 4206 Public health
  • 4203 Health services and systems
 

Citation

APA
Chicago
ICMJE
MLA
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Zikmund-Fisher, B. J., Sarr, B., Fagerlin, A., & Ubel, P. A. (2006). A matter of perspective: choosing for others differs from choosing for yourself in making treatment decisions. Journal of General Internal Medicine, 21(6), 618–622. https://doi.org/10.1111/j.1525-1497.2006.00410.x
Zikmund-Fisher, Brian J., Brianna Sarr, Angela Fagerlin, and Peter A. Ubel. “A matter of perspective: choosing for others differs from choosing for yourself in making treatment decisions.Journal of General Internal Medicine 21, no. 6 (June 2006): 618–22. https://doi.org/10.1111/j.1525-1497.2006.00410.x.
Zikmund-Fisher BJ, Sarr B, Fagerlin A, Ubel PA. A matter of perspective: choosing for others differs from choosing for yourself in making treatment decisions. Journal of general internal medicine. 2006 Jun;21(6):618–22.
Zikmund-Fisher, Brian J., et al. “A matter of perspective: choosing for others differs from choosing for yourself in making treatment decisions.Journal of General Internal Medicine, vol. 21, no. 6, June 2006, pp. 618–22. Epmc, doi:10.1111/j.1525-1497.2006.00410.x.
Zikmund-Fisher BJ, Sarr B, Fagerlin A, Ubel PA. A matter of perspective: choosing for others differs from choosing for yourself in making treatment decisions. Journal of general internal medicine. 2006 Jun;21(6):618–622.
Journal cover image

Published In

Journal of general internal medicine

DOI

EISSN

1525-1497

ISSN

0884-8734

Publication Date

June 2006

Volume

21

Issue

6

Start / End Page

618 / 622

Related Subject Headings

  • Physician-Patient Relations
  • Patient Satisfaction
  • Patient Participation
  • Influenza Vaccines
  • Humans
  • General & Internal Medicine
  • Decision Making
  • Choice Behavior
  • 4206 Public health
  • 4203 Health services and systems