This paper is only available as a PDF. To read, Please Download here.
Abstract
purpose: To determine whether alternative methods of presenting a contrast between the same two quantities in descriptions of research results could lead to different treatment decisions by physicians.
subjects and methods: We conducted a survey of practicing physicians and of faculty and fellows in training programs in clinical epidemiology and social science research methods. Each questionnaire presented results from a published study of either hypertension or hypercholesterolemia in two different ways: once as the relative change in the outcome rate and once as the absolute change in the outcome rate. We asked respondents to read each summary and indicate how the information contained in the summary would influence decisions about treatment.
results: Of the 235 physicians who completed the questionnaire, 108 (46%) gave different responses to the same results presented in different ways. Of these, 97 (89.8%) indicated a stronger inclination to treat patients after reading of the relative change in the outcome rate (p <0.0001).
conclusion: The manner of presentation of results can influence physicians' judgments about the treatment of patients.
References
- The road from research to new diagnosis and therapy.Science. 1978; 200: 931-937
- Fraud, distortion, delusion, and consensus: the problems of human and natural deception in epidemiologic science.Am J Med. 1988; 84: 475-478
- A method for assessing the quality of a randomized controlled trial.Controlled Clin Trials. 1981; 2: 31-49
- Reporting on methods in clinical trials.N Engl J Med. 1982; 306: 1332-1337
- An additional basic science for clinical medicine: III. The challenges of comparison and measurement.Ann Intern Med. 1983; 99: 705-712
- Statistical problems in the reporting of clinical trials.in: A survey of three medical journals. 6.03 ed. N Engl J Med. 317. 1987: 426-432
- Epidemiology.in: Little, Brown and Company, Boston1970: 237-239
- Statistical indexes of contrast.in: Clinical epidemiology: the architecture of clinical research. WB Saunders Company, Philadelphia1985: 118-127
- An assessment of clinically useful measures of the consequences of treatment.N Engl J Med. 1988; 318: 1728-1733
- Kahneman D Slovic P Tversky A Judgment under uncertainty: heuristics and biases. Cambridge University Press, New York1982
- Interpretation by physicians of clinical laboratory results.N Engl J Med. 1979; 299: 999-1001
- When doctors meet numbers.Am J Med. 1981; 71: 991-998
- On the elicitation of preferences for alternate therapies.N Engl J Med. 1982; 306: 1259-1262
- Problems in the handling of clinical and research evidence by medical practitioners.Arch Intern Med. 1983; 143: 1971-1975
- Improving structured abstracts.Ann Intern Med. 1989; 111 ([letter]): 764
- Treatment of mild hypertension and the reduction of cardiovascular mortality: the “of or by” dilemma.JAMA (Chicago). 1983; 249: 399-400
- The need for clarification of percent risk reduction data in clinical cardiovascular trial reports.J Am Coll Cardiol. 1989; 13: 764-766
- Treating hypercholesterolemia.in: How should practicing physicians interpret the published data for patients?6.03 ed. N Engl J Med. 321. 1989: 676-680
- A technique for the measurement of attitudes.Arch Psychol (Frankf). 1932; 22: 1-55
- JAMA (Chicago). 1979; 242: 2562-2571
- JAMA (Chicago). 1984; 251: 351-364
- 6.03 ed. SAS/STAT user's guide release. SAS Institute, Inc, Cary, North Carolina1988
- Analyzing data from ordered categories.in: Bailar III, JC Mosteller F Medical uses of statistics. N Engl J Med Books, Waltham, Massachusetts1986: 235-258
- 6.03 ed. SAS/STAT user's guide release. SAS Institute Inc, Cary, North Carolina1988: 530
- (Aristotle)Rhetoric. 5th ed. Methuen and Company, New York1964: 271 (Quoted in Ross D, Aristotle)
- Judgment under uncertainty: heuristics and biases.Science. 1974; 185: 1124-1131
- The framing of decisions and the rationality of choice.Science. 1981; 211: 453-458
- Systematic errors in medical decision making: judgment limitations.J Gen Intern Med. 1987; 2: 183-187
- Clinical epidemiology: a basic science for clinical medicine.in: Little, Brown and Company, Boston1985: 245-269
- Cognitive psychology and medical judgment: some downfalls of studying pitfalls.Medical decision making. 1991; 11: 169-170
Article info
Publication history
Accepted:
September 15,
1991
Received:
April 10,
1991
Footnotes
☆At the time of the study, Dr. Arnold was a Robert Wood Johnson Foundation/Veteran's Administration Clinical Scholar, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
Identification
Copyright
© 1992 Published by Elsevier Inc.
User license
Creative Commons Attribution – NonCommercial – NoDerivs (CC BY-NC-ND 4.0) | How you can reuse
Elsevier's open access license policy

Creative Commons Attribution – NonCommercial – NoDerivs (CC BY-NC-ND 4.0)
Permitted
For non-commercial purposes:
- Read, print & download
- Redistribute or republish the final article
- Text & data mine
- Translate the article (private use only, not for distribution)
- Reuse portions or extracts from the article in other works
Not Permitted
- Sell or re-use for commercial purposes
- Distribute translations or adaptations of the article
Elsevier's open access license policy