Does It Matter How You Ask? Assessing the Impact of Failure or Effectiveness Framing on Preferences for Antibiotic Treatments in a Discrete Choice Experiment

Abstract

Purpose Studies assessing framing effects in discrete choice experiments (DCE) primarily focused on attributes related to mortality/survival information. Little is known about framing effects for other attributes in health-related DCEs. This study aimed to investigate how framing treatment outcome as effective, failure, or a combined frame impacts respondent choices and DCE outcomes. Patients and Methods Three Bayesian D-efficient designed DCE surveys measuring preferences for antibiotic treatments were randomly distributed to a representative sample of the Swedish population aged 18–65 years (n=1119). Antibiotic treatments were described using five attributes. Four attributes were static: Contribution to Antibiotic Resistance, Treatment Duration, Likelihood of Side-Effects, and Costs. A fifth treatment attribute was framed in three ways: Effectiveness, Failure Rate, or both. Mixed logit models were used to analyze attribute level estimates, importance value, and choice predictions. Results Significant differences between the frames were found for the parameter estimates of the attributes of Treatment Duration and Likelihood of Side-Effects, but not Treatment Outcome which was the alternatively framed attribute. Contribution to Antibiotic Resistance and Costs were the most important attributes for all participants regardless of framing. Choice predictions for the “best option” antibiotic only slightly differed between the groups based on the frame seen (95.2–92.4%). Conclusion Our study showed that attribute framing can impact preferences regardless of the attribute’s importance value in alternative valuation. However, the practical implication of this effect may be limited. A theoretical discussion is needed to identify how researchers should accommodate and report any potential framing effect in their studies.

“The power imbalance was blown out the window”: developing and implementing creative workshops to enhance communication of statistics in patient and public involvement in clinical trials

“…This would mean the outputs can be reused to raise awareness about treatment important differences and their potential impact in treatments available to patients. Final workshop participants had a range of numeracy levels, and their average was in line with other general population groups [ 30 ], however we had a lower proportion of participants with low numeracy when compared with general research participants [ 31 , 32 ]. Given art-based methods such as the creative workshops are expected to make research topics more accessible [ 12 ], future work should focus on recruiting a larger proportion of participants with low numeracy levels and explore the role and impact creative workshops can have on their involvement in numerical aspects of research.…”

Research Priorities to Increase Confidence in and Acceptance of Health Preference Research: What Questions Should be Prioritized Now?

“…However, it may also reflect a lack of awareness of previous work in this area. Recent publications have highlighted decision criteria that can be used to guide method selection [ 23 , 24 ], and previous research has been published on internal validity tests and patient comprehension [ 25 – 27 ], attribute presentation and framing [ 28 – 31 ], the number of attributes [ 32 ], and educational materials [ 16 , 33 , 34 ] thus this finding may reflect a variability in awareness of the contribution of this previous work. As the amount of methodological research available increases, there will be a need to provide consolidated and updated dissemination resources.…”