Does Introducing Imprecision around Probabilities for Benefit and Harm Influence the Way People Value Treatments?
Background. Imprecision in estimates of benefits and harms around treatment choices is rarely described to patients. Variation in sampling error between treatment alternatives (e.g., treatments have similar average risks, but one treatment has a larger confidence interval) can result in patients fai...
| Publicado en: | Medical Decision Making Vol. 36; no. 4; pp. 490 - 503 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
May2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=114170659&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 114170659 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0272989X DKI jtl: Medical Decision Making issn: 0272989X maglogo: Y pubinfo: dt: May2016 vid: 36 iid: 4 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 114170659 114170659 114170659 10.1177/0272989X15600708 114170659 ppf: 490 ppct: 13 formats: tig: atl: Does Introducing Imprecision around Probabilities for Benefit and Harm Influence the Way People Value Treatments? aug: au: Bansback, Nick Harrison, Mark Marra, Carlo affil: Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, BC, Canada (NB) sug: subj: Attitude to Health Decision Making Uncertainty Patients Psychosocial Factors Human Canada Random Sample Surveys Arthritis, Rheumatoid Drug Therapy Life Expectancy Confidence ab: Background. Imprecision in estimates of benefits and harms around treatment choices is rarely described to patients. Variation in sampling error between treatment alternatives (e.g., treatments have similar average risks, but one treatment has a larger confidence interval) can result in patients failing to choose the option that is best for them. The aim of this study is to use a discrete choice experiment to describe how 2 methods for conveying imprecision in risk influence people’s treatment decisions. Methods. We randomized a representative sample of the Canadian general population to 1 of 3 surveys that sought choices between hypothetical treatments for rheumatoid arthritis based on different levels of 7 attributes: route and frequency of administration, chance of benefit, serious and minor side effects and life expectancy, and imprecision in benefit and side-effect estimates. The surveys differed in the way imprecision was described: 1) no imprecision, 2) quantitative description based on a range with a visual graphic, and 3) qualitative description simply describing the confidence in the evidence. Results. The analyzed data were from 2663 respondents. Results suggested that more people understood imprecision when it was described qualitatively (88%) versus quantitatively (68%). Respondents who appeared to understand imprecision descriptions placed high value on increased precision regarding the actual benefits and harms of treatment, equivalent to the value placed on the information about the probability of serious side effects. Both qualitative and quantitative methods led to small but significant increases in decision uncertainty for choosing any treatment. Limitations included some issues in defining understanding of imprecision and the use of an internet survey of panel members. Conclusions. These findings provide insight into how conveying imprecision information influences patient treatment choices. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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