How Framing Bias Impacts Preferences for Innovation in Bone Tissue Engineering

Area of Science:

• Biomaterials Science
• Tissue Engineering
• Surgical Innovation
• Behavioral Economics

Background:

• Translating biomaterial and tissue engineering innovations to clinical practice remains a challenge, with few successes reaching the bedside.
• A potential disconnect exists between the perspectives of surgeons and biomaterial scientists/tissue engineers (BS&orTE), hindering clinical translation.
• Bone tissue engineering is a high-priority research area, yet clinical translation for bone defect treatments faces obstacles.

Purpose of the Study:

• To investigate whether surgeons and BS&orTE exhibit similar or different cognitive biases when processing information related to bone defect treatment options.
• To explore the psychological underpinnings that may contribute to the limited translation of tissue engineering innovations.
• To analyze decision-making biases in bone defect treatment by comparing surgeon and BS&orTE perspectives using a cognitive framing experiment.

Main Methods:

• An online survey incorporating a behavioral economics cognitive framing experiment was employed for data collection.
• Participants included 208 surgeons and 59 BS&orTE, recruited via convenience sampling at a conference (October 2022 - March 2023).
• The study analyzed cognitive framing effects on the evaluation of bone defect treatment options, such as autologous bone graft transplantation and Ilizarov bone transport.

Main Results:

• No significant differences in positive-negative cognitive framing biases were found between the surgeon and BS&orTE groups.
• Framing bias in surgical decision-making for bone defects does not appear to differ substantially based on occupation.
• Within the surgeon group, significant differences emerged: positive framing led to lower ranking of autologous bone grafts and higher ranking of Ilizarov bone transport compared to negative framing (p < 0.05).

Conclusions:

• Cognitive framing biases in the context of bone defect treatment decision-making are comparable between surgeons and BS&orTE.
• The findings suggest that psychological factors related to framing may not be the primary barrier to clinical translation in bone tissue engineering.
• Further research is needed to understand the nuanced differences in decision-making within professional groups to facilitate the 'bench to bedside' transition.