Background. When a given option is presented along with two alternatives, similar to each other, healthcare professionals choose it more often than when it is presented with just one of the alternatives. This inconsistent decision pattern may depend on the conflict generated from choosing between two highly similar options. Objective. To generalize the effect by using realistic scenarios that involve two alternatives displaying various degrees of similarity. Methods. One hundred fifty-five psychiatrists, 149 gynecologists and 89 nurse managers had to indicate the treatment they would recommend in clinical scenarios containing either three options, or just two of them. The similarity between the two alternatives varied across scenarios, ranging from a very high (psychiatric scenario) to an only moderately high (nursing management scenario) to a limited level (gynecological scenario). Results. Professionals chose the focal option more often when both alternatives were available. The paradoxical effect occurred for all scenarios, namely, when the alternatives were medication variants (psychiatric scenario), when most of the features they shared produced their effect at a different extent in the two cases (nursing management scenario), and some of their consequences were at variance (gynecological problem). Conclusions. The context of available options affects professionals’ choices when the alternatives are similar but also when they present diverging features. Professionals need to be aware of such a source of practice variability, and encouraged to consider each option per se, before they compare the available options.
The context of available options affects healthcare decisions:A generalization study
GIROTTO, VITTORIO;
2012-01-01
Abstract
Background. When a given option is presented along with two alternatives, similar to each other, healthcare professionals choose it more often than when it is presented with just one of the alternatives. This inconsistent decision pattern may depend on the conflict generated from choosing between two highly similar options. Objective. To generalize the effect by using realistic scenarios that involve two alternatives displaying various degrees of similarity. Methods. One hundred fifty-five psychiatrists, 149 gynecologists and 89 nurse managers had to indicate the treatment they would recommend in clinical scenarios containing either three options, or just two of them. The similarity between the two alternatives varied across scenarios, ranging from a very high (psychiatric scenario) to an only moderately high (nursing management scenario) to a limited level (gynecological scenario). Results. Professionals chose the focal option more often when both alternatives were available. The paradoxical effect occurred for all scenarios, namely, when the alternatives were medication variants (psychiatric scenario), when most of the features they shared produced their effect at a different extent in the two cases (nursing management scenario), and some of their consequences were at variance (gynecological problem). Conclusions. The context of available options affects professionals’ choices when the alternatives are similar but also when they present diverging features. Professionals need to be aware of such a source of practice variability, and encouraged to consider each option per se, before they compare the available options.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
