Peng Jiaxi, Li Hongzheng, Miao Danmin, Feng Xi, Xiao Wei
Department of Psychology, Fourth Military Medical University, Xi'an, China.
Iran Red Crescent Med J. 2013 Feb;15(2):161-5. doi: 10.5812/ircmj.8469. Epub 2013 Feb 5.
Considerable reports concerned the framing effect in medical situations. But quite few of them noticed to explore the differences among the various kinds of framing effects.
In the present study, five different types of framing effects were examined and the effect sizes of them were compared.
Medical decision making problems concerning medicine effect evaluation, patient's compliance, treatment and doctor options selection were established. All the problems were described in both positive and negative frames. 500 undergraduates as participants were randomly divided into ten groups. Participants from each group were asked to finish one decision making task.
ALL THE FRAMES THAT WERE EXAMINED LEADED TO SIGNIFICANT FRAMING EFFECTS: When the Asia Disease Problem was described in a positive frame, the participants preferred the conservative frame than the risky one, while if in a negative frame, the preference reversed (P < 0.01). If the drug effect was described as "of 100 patients taking this kind of medicine, 70 patients became better", people tended to make more positive evaluations, compared with described as "of 100 patients taking this kind of medicine, 30 patients didn't become better" (P < 0.01). Doctors' advices were respectively described in a baneful or beneficial frame and the former one resulted in a better compliance (P < 0.05). If treatment options were described with a survival rate, people tended to choose risky option, while if described with a mortality rate, people tended to choose conservative option (P < 0.05). The number sized framing effect was also tested to be significant (P < 0.01). The five types of framing effects were small to big in effect size.
Medical decision making can be affected by frame descriptions. Attentions should be paid on the standardization of description in medical practice.
大量报告关注了医疗情境中的框架效应。但其中很少有人注意到探索各种框架效应之间的差异。
在本研究中，考察了五种不同类型的框架效应，并比较了它们的效应大小。
建立了关于药物疗效评估、患者依从性、治疗和医生选项选择的医疗决策问题。所有问题均用正向和负向框架进行描述。500名本科生作为参与者被随机分为十组。每组参与者被要求完成一项决策任务。
所有被考察的框架都导致了显著的框架效应：当亚洲疾病问题用正向框架描述时，参与者更喜欢保守框架而非风险框架，而如果用负向框架描述，偏好则相反（P < 0.01）。如果药物效果被描述为“服用这种药的100名患者中，70名患者病情好转”，与描述为“服用这种药的100名患者中，30名患者病情未好转”相比，人们倾向于做出更积极的评价（P < 0.01）。医生的建议分别用有害或有益框架进行描述，前者导致更好的依从性（P < 0.05）。如果治疗选项用生存率描述，人们倾向于选择风险选项，而如果用死亡率描述，人们倾向于选择保守选项（P < 0.05）。数量大小框架效应也被测试为显著（P < 0.01）。五种类型的框架效应在效应大小上由小到大。
医疗决策会受到框架描述的影响。在医疗实践中应注意描述的标准化。
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