Cognitive Bias and Therapy Choice in Breast Reconstruction Surgery Decision-Making

Area of Science:

• Behavioral economics
• Health psychology
• Medical decision-making

Background:

• Understanding information processing in healthcare is vital for efficient care delivery.
• Behavioral economics studies credence markets influenced by incentives, information asymmetry, and cognitive bias.
• Cognitive bias and framing effects can impact patient and surgeon choices in medical procedures.

Purpose of the Study:

• To explore how framing and behavioral bias influence decision-making in elective restorative surgery, specifically breast reconstruction.
• To investigate the prevalence of cognitive bias across patients, nurses, and surgeons.
• To identify factors influencing patient choice in breast reconstruction methods.

Main Methods:

• Cross-sectional survey data from 53 surgeons, 101 breast care nurses, and 689 breast cancer patients.
• Data collection included demographics, medical history, cognitive bias tests, and a behavioral framing experiment.
• Multivariate analysis identified correlates for implant-based reconstruction choice.

Main Results:

• Statistically significant differences in breast reconstruction preferences were observed between patients and nurses based on how options were framed (framing bias).
• No significant differences in the prevalence of eight common cognitive biases were found across surgeons, nurses, and patients.
• Patient age, body mass index, and self-perceived health were negative correlates for choosing implant-based reconstruction.

Conclusions:

• Cognitive bias is uniformly present across surgeons, nurses, and patients.
• Framing bias leads to inconsistent preferences for surgical therapy type among patients and nurses.
• Experience and education do not appear to mitigate the impact of cognitive biases on medical professionals' recommendations and patient choices.