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Failure to Adopt Beneficial Therapies Caused by Bias in Medical Evidence Evaluation

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  • Scott K. Aberegg

    (The Ohio State University College of Medicine and Public Health, Department of Internal Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine; Johns Hopkins Medical Institutions, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, MD; scottaberegg@gmail.com)

  • Hal Arkes

    (The Ohio State University, Department of Psychology, Division of Health Sciences, Management and Policy, Center for Health Outcomes, Policy, and Evaluation Studies, Columbus, OH)

  • Peter B. Terry

    (Johns Hopkins Medical Institutions, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, MD)

Abstract

Background . Although it is known that many evidencebased therapies are underutilized, the causes of the research-practice gap are not well understood. The authors sought to determine if there is a bias in the evaluation of new evidence that leads to low rates of adoption of beneficial therapies compared to abandonment of harmful ones. Methods . Two case vignettes describing hypothetical clinical trials were administered to 2 independent samples of pulmonary and critical care practitioners. Each vignette was presented in 2 different ways; in one version, the results of the hypothetical trial showed that a treatment was harmful, and in the other version, the same treatment was shown to be beneficial. Prospective respondents from each sample were randomized to receive 1 version of each vignette (intersubject design). The main outcome was respondent's willingness to apply the results of the hypothetical trial to patient care. Results . There were 174 participants for trial 1 and 138 participants for trial 2 (enrollment rates of 44.2% and 41.8%, respectively). For trial 1, respondents were 2.3 times less likely to change clinical practice based on results indicating benefit as opposed to harm (33.3% v. 76.5%; P

Suggested Citation

  • Scott K. Aberegg & Hal Arkes & Peter B. Terry, 2006. "Failure to Adopt Beneficial Therapies Caused by Bias in Medical Evidence Evaluation," Medical Decision Making, , vol. 26(6), pages 575-582, November.
    • Handle: RePEc:sae:medema:v:26:y:2006:i:6:p:575-582
    DOI: 10.1177/0272989X06295362
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    References listed on IDEAS

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    1. Baron, Jonathan, 1997. "Confusion of Relative and Absolute Risk in Valuation," Journal of Risk and Uncertainty, Springer, vol. 14(3), pages 301-309, May-June.
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