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Framing Options as Choice or Opportunity

Author

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  • Purva Abhyankar
  • Barbara A. Summers
  • Galina Velikova
  • Hilary L. Bekker

Abstract

Objective . Health professionals must enable patients to make informed decisions about health care choices through unbiased presentation of all options. This study examined whether presenting the decision as “opportunity†rather than “choice†biased individuals’ preferences in the context of trial participation for cancer treatment. Methods. Self-selecting healthy women ( N = 124) were randomly assigned to the following decision frames: opportunity to take part in the trial (opt-in), opportunity to be removed from the trial (opt-out), and choice to have standard treatment or take part in the trial (choice). The computer-based task required women to make a hypothetical choice about a real-world cancer treatment trial. The software presented the framed scenario, recorded initial preference, presented comprehensive and balanced information, traced participants’ use of information during decision making, and recorded final decision. A posttask paper questionnaire assessed perceived risk, attitudes, subjective norm, perceived behavioral control, and satisfaction with decision. Results . Framing influenced women’s immediate preferences. Opportunity frames, whether opt-in or opt-out, introduced a bias as they discouraged women from choosing standard treatment. Using the choice frame avoided this bias. The opt-out opportunity frame also affected women’s perceived social norm; women felt that others endorsed the trial option. The framing bias was not present once participants had had the opportunity to view detailed information on the options within a patient decision aid format. There were no group differences in information acquisition and final decisions. Sixteen percent changed their initial preference after receiving full information. Conclusions. A “choice†frame, where all treatment options are explicit, is less likely to bias preferences. Presentation of full information in parallel, option-by-attribute format is likely to “de-bias†the decision frame. Tailoring of information to initial preferences would be ill-advised as preferences may change following detailed information.

Suggested Citation

  • Purva Abhyankar & Barbara A. Summers & Galina Velikova & Hilary L. Bekker, 2014. "Framing Options as Choice or Opportunity," Medical Decision Making, , vol. 34(5), pages 567-582, July.
    • Handle: RePEc:sae:medema:v:34:y:2014:i:5:p:567-582
    DOI: 10.1177/0272989X14529624
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    References listed on IDEAS

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    1. Brown, R.F & Butow, P.N & Ellis, P & Boyle, F & Tattersall, M.H.N, 2004. "Seeking informed consent to cancer clinical trials:: describing current practice," Social Science & Medicine, Elsevier, vol. 58(12), pages 2445-2457, June.
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    1. Elizabeth R. Eisenhauer & Alan R. Tait & Soo Young Rieh & Cynthia M. Arslanian-Engoren, 2019. "Participants’ Understanding of Informed Consent for Biobanking: A Systematic Review," Clinical Nursing Research, , vol. 28(1), pages 30-51, January.
    2. Abhyankar, Purva & Velikova, Galina & Summers, Barbara & Bekker, Hilary L., 2016. "Identifying components in consent information needed to support informed decision making about trial participation: An interview study with women managing cancer," Social Science & Medicine, Elsevier, vol. 161(C), pages 83-91.
    3. Gustafsson, Peter & Nilsson, Peter & David, Lucinda & Marañon, Antonia, 2021. "Framing energy choices in consumer decision-making Evidence from a random experiment in Sweden," Papers in Innovation Studies 2021/14, Lund University, CIRCLE - Centre for Innovation Research.

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