Document Detail

The influence of treatment effect size on willingness to adopt a therapy.
MedLine Citation:
PMID:  19498080     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Physicians are slow to adopt novel therapies, and the reasons for this are poorly understood. The authors sought to determine if the size of the treatment effect of a novel therapy influences willingness to adopt it. METHODS: We developed 2 experimental vignette pairs describing a trial of a therapy for a hypothetical disease that showed a statistically significant mortality benefit. The size of the mortality effect was varied in vignettes of a pair (3% v. 10%). The 2 experimental vignette pairs differed in whether study enrollment was reported. Vignettes were mailed to a random sample of physicians using an intersubject design. The main study outcome was respondents' willingness to adopt the hypothetical therapy, based on the results of the hypothetical trial. RESULTS: There were 124 and 89 respondents to vignette pairs 1 and 2, respectively. In vignette pair 1, 91% versus 71% of respondents adopted the therapy when it reduced mortality by 10% and 3%, respectively (P = 0.0058). For vignette pair 2, 88% versus 51% of respondents adopted the therapy when it reduced mortality by 10% and 3%, respectively (P = 0.0002). In both vignette pairs, nonadopters were more likely than adopters to report side effects of the therapy as a principal reason for their decision. CONCLUSIONS: In this study, respondents were less likely to adopt a lifesaving therapy if its associated mortality reduction was 3% compared to 10%. Because most therapies for major medical conditions reduce mortality within or below this range, and because there were no opportunity costs associated with the adoption of the therapy, we believe that this effect represents a bias. Further investigation will be required to determine its prevalence and mechanism.
Scott K Aberegg; James M O'Brien; Paneez Khoury; Roocha Patel; Hal R Arkes
Publication Detail:
Type:  Journal Article     Date:  2009-06-04
Journal Detail:
Title:  Medical decision making : an international journal of the Society for Medical Decision Making     Volume:  29     ISSN:  0272-989X     ISO Abbreviation:  Med Decis Making     Publication Date:    2009 Sep-Oct
Date Detail:
Created Date:  2009-11-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109073     Medline TA:  Med Decis Making     Country:  United States    
Other Details:
Languages:  eng     Pagination:  599-605     Citation Subset:  IM    
Pioneer Valley Hospital, West Valley City, UT.
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