Exploiting order effects to improve the quality of decisions

Area of Science:

• Medical Decision Making
• Health Informatics
• Patient Engagement

Background:

• Patient decision aids (PtDA) are crucial for informed healthcare choices.
• The presentation order of information in PtDAs can influence patient decision-making.
• Obstructive sleep apnea (OSA) treatment selection involves complex trade-offs.

Purpose of the Study:

• To investigate how the order of information in a PtDA affects treatment choices for obstructive sleep apnea (OSA).
• To determine if prioritizing patient-valued attributes improves treatment concordance.

Main Methods:

• 643 participants simulated OSA diagnosis and treatment selection.
• A value clarification exercise identified key treatment attributes for each participant.
• Participants were randomized to view information with attributes ordered by personal importance (last, first) or a pre-specified order.

Main Results:

• Presenting information aligned with individual priorities (most important first) led to treatment choices more concordant with informed values.
• This order effect was particularly significant in younger individuals.
• Usable data was obtained from 510 participants.

Conclusions:

• The sequence of information in PtDAs significantly impacts patient choices for OSA treatments.
• Optimizing information order can enhance the quality of patient decisions.
• Personalized information sequencing in PtDAs offers a strategy to improve patient engagement and choice concordance.