Published December 14, 2011
A new study led by a UB researcher contradicts the widely held belief that changing how medical professionals phrase health care information affects patients’ choices.
Common sense tells us that how we say things matters at least as
much as what we say. This may not be the case, however, with
messages regarding health care options, according to Elie
A. Akl, MD, PhD, the study’s lead author and an assistant
professor of medicine, family
medicine and social and
Akl led a large-scale review, synthesizing data from 35
studies involving 16,342 participants to determine how
framing—presenting the same option in different
ways—affects health consumers’ choices.
If framing strongly influenced such decisions, it “would provide clinical and public health practice with an easy to use, inexpensive tool that could actually improve public health,” he says.
The study found the opposite: Framing shows “little if any consistent effect on behavior” in making a wide range of health choices, including using sunscreen, taking antihypertensive medications, using condoms, making follow-up appointments after abnormal Pap tests, scheduling mammograms and getting screened for HIV and prostate cancer.
The study results tally with other systematic reviews
investigating what psychologists call the “framing
“While framing may improve a patient’s perceptions of a specific screening test, or his or her intentions to undergo it,” Akl says, “a multitude of other factors come into play and end up affecting behavior.”
How much information the patient gets, how personalized a message is and the use of statistics and visual information also shape our choices, as well as other factors, such as health services’ accessibility.
Concentrating on framing may obscure other avenues for improving
patients’ understanding of and compliance with treatment, Akl
says. The paper urges “a balanced presentation when producing
patient information or decision aids,” emphasizing potential
risks and benefits equally. Without “evidence for the
superiority of one frame over the other,” patients may be
best served by more broad-based messaging strategies.
Akl suggests that framing might have a more noticeable effect in certain circumstances, such as discussing particular health conditions. “Future research needs to investigate these conditions,” he says.
The study, “Framing of Health Information Messages”, appears in the Cochrane Database of Systematic Reviews.