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The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
Decision making and framing effects in multiple sclerosis
Laura Zamarian1, Thomas Berger1,2, Marie-Theres Pertl1
1Medical University Innsbruck, Innsbruck, Austria.
Background:
Previous studies reported reduced decision-making abilities for patients with multiple sclerosis (MS) relative to healthy controls (HC). This study aimed to evaluate whether these problems arise when sampling information or when pondering about the evidence collected.
Methods:
In a cross-sectional, controlled study, 43 relapsing-remitting MS patients (RRMS; Expanded Disability Status Scale 1.5, range 0-4) and 53 HC performed an information sampling task ('beads task'), a health-related framing task, and neuropsychological background tests.
Results:
In the beads task, patients collected as much information as HC prior to a decision. However, there were twice as many patients as HC making irrational decisions, that is, decisions against the evidence collected (RRMS: 26/43, 60%; HC: 16/53, 30%; p = 0.003). Compared to HC, patients also showed a stronger framing effect, that is, they were more strongly biased by the way health-related information was presented (p < 0.05, Cohen's d = 0.5). Overall, the framing effect predicted whether a participant would make irrational decisions (OR 2.12, 95% CI 1.29-3.49, p < 0.001).
Conclusions:
Predecisional information sampling is intact in RRMS. However, compared to HC, patients are more likely to make irrational decisions and to be biased by the way health-related information is framed. This warrants caution in communication, especially in the medical context, with patients.
Insights
Patients with multiple sclerosis (MS) gather information effectively but make more irrational decisions and are swayed by framing. This highlights the need for careful communication with MS patients.
Area of Science:
- Neuroscience
- Psychology
- Medical Research
Background:
- Previous research indicates impaired decision-making in multiple sclerosis (MS) patients compared to healthy controls (HC).
- This study investigates whether decision-making deficits in MS stem from information sampling or evidence evaluation.
- Understanding these deficits is crucial for managing MS patient care.
Purpose of the Study:
- To determine if multiple sclerosis (MS) patients exhibit difficulties in information sampling or in evaluating collected evidence during decision-making.
- To assess the impact of framing effects on decision-making in MS patients.
- To identify potential communication strategies for healthcare providers interacting with MS patients.
Main Methods:
- A cross-sectional, controlled study involving 43 relapsing-remitting MS (RRMS) patients and 53 HC.
- Participants completed an information sampling task (beads task) and a health-related framing task.
- Neuropsychological background tests were administered to all participants.
Main Results:
- MS patients collected information similarly to HC but made irrational decisions twice as often (60% vs. 30%).
- Patients with MS demonstrated a significantly stronger framing effect than HC, indicating greater bias from information presentation.
- The framing effect was a significant predictor of irrational decision-making in all participants.
Conclusions:
- Information sampling processes appear intact in relapsing-remitting MS (RRMS) patients.
- RRMS patients are more prone to making irrational decisions and are more susceptible to framing biases compared to HC.
- Findings underscore the importance of cautious and clear communication, particularly in medical contexts, when interacting with MS patients.
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