Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, 2nd Floor Health Sciences Building, Foresterhill Campus, Ashgrove Road, Aberdeen, AB25 2ZD Scotland, United Kingdom.
Soc Sci Med. 2017 Mar;177:248-255. doi: 10.1016/j.socscimed.2017.01.033. Epub 2017 Feb 10.
People often hold unduly positive expectations about the outcomes of medicines and other healthcare products. Here the following explanation is tested: people who have a positive outcome tend to tell more people about their disease/treatment than people with poor or average outcomes. Akin to the file drawer problem in science, this systematically and positively distorts the information available to others.
If people with good treatment outcomes are more inclined to tell others, then they should also be more inclined to write online medical product reviews. Therefore, average treatment outcomes in these reviews should be more positive than those found in randomised controlled trials (RCTs). Data on duration of treatment and outcome (i.e., weight/cholesterol change) were extracted from user-generated health product reviews on Amazon.com and compared to RCT data for the same treatments using ANOVA. The sample included 1675 reviews of cholesterol reduction (Benecol, CholestOff) and weight loss (Orlistat) treatments and the primary outcome was cholesterol change (Bencol and CholestOff) or weight change (Orlistat).
In three independent tests, average outcomes reported in the reviews were substantially more positive than the outcomes reported in the medical literature (η = 0.01 to 0.06; p = 0.04 to 0.001). For example, average cholesterol change following use of Benecol is -14 mg/dl in RCTs and -45 mg/dl in online reviews.
People with good treatment outcomes are more inclined to share information about their treatment, which distorts the information available to others. People who rely on word of mouth reputation, electronic or real life, are likely to develop unduly positive expectations.
人们常常对药物和其他医疗产品的疗效抱有不切实际的积极期望。本研究旨在验证以下解释：治疗效果好的患者比治疗效果差或一般的患者更倾向于向他人讲述自己的疾病/治疗情况。类似于科学中的档案抽屉问题，这种情况会系统地、积极地扭曲他人可获得的信息。
如果治疗效果好的患者更倾向于告诉他人，那么他们也应该更倾向于在网上撰写医疗产品评论。因此，这些评论中的平均治疗效果应该比随机对照试验（RCT）中发现的更积极。从亚马逊网站上的用户生成的健康产品评论中提取治疗持续时间和结果（即体重/胆固醇变化）的数据，并使用 ANOVA 比较相同治疗的 RCT 数据。该样本包括 1675 份关于降低胆固醇（Benecol、CholestOff）和减肥（奥利司他）治疗的评论，主要结果是胆固醇变化（Benecol 和 CholestOff）或体重变化（奥利司他）。
在三个独立的测试中，评论中报告的平均结果明显比医学文献中报告的结果更为积极（η=0.01 至 0.06；p=0.04 至 0.001）。例如，在 RCT 中，使用 Benecol 后胆固醇平均变化为-14mg/dl，而在在线评论中为-45mg/dl。
治疗效果好的患者更倾向于分享有关其治疗的信息，从而扭曲他人可获得的信息。依赖口碑（无论是电子的还是现实生活中的）的人可能会产生不切实际的积极期望。
