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Updated: Mar 23, 2026
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Published on: September 19, 2012
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Survival or Mortality: Does Risk Attribute Framing Influence Decision-Making Behavior in a Discrete Choice
Jorien Veldwijk1, Brigitte A B Essers2, Mattijs S Lambooij3
1Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Summary
Attribute framing significantly impacts decision-making. Positive framing of survival increased dominant choices, while negative framing of mortality led to risk-seeking behavior in genetic screening choices.
Area of Science:
- Behavioral Economics
- Health Decision Science
- Risk Perception
Background:
- Attribute framing, a cognitive bias, influences decision-making by presenting information in a positive or negative light.
- Understanding framing effects is crucial for designing effective health communication and choice experiments.
- Genetic screening for colorectal cancer (CRC) involves complex risk-benefit trade-offs, making it susceptible to framing.
Purpose of the Study:
- To investigate how positive versus negative attribute framing affects respondent choices and preferences in a discrete choice experiment (DCE).
- To analyze the impact of framing on decision-making behavior and attribute importance in the context of colorectal cancer (CRC) genetic screening.
Main Methods:
- A discrete choice experiment (DCE) with two versions (positive and negative risk framing) was administered to a representative Dutch sample (aged 55-65).
- The DCE included four attributes related to CRC genetic screening participation, with the risk attribute framed as survival probability (positive) or mortality probability (negative).
- Panel mixed-logit models were employed to estimate attribute importance and compare preferences between the two framing conditions.
Main Results:
- Positive framing (survival) led to 56% ranking it as most important, versus 8% for negative framing (mortality).
- Respondents exhibited significantly more dominant choices based on survival probability compared to mortality probability.
- Attribute framing substantially altered attribute-level estimates and revealed distinct preference structures between the positively and negatively framed groups.
Conclusions:
- The way risk information is framed significantly influences how individuals perceive and value that risk.
- Positive risk framing promotes more decisive, dominant choices, whereas negative framing encourages risk-seeking behavior.
- Attribute framing is a critical consideration in designing discrete choice experiments (DCEs) and expert interviews for health decisions.
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