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Promoting Reflection on Medical Maximizing-Minimizing Preferences May Create Undesired Effects on Decisions About Low-Benefit and High-Benefit Care

BACKGROUND: Medical maximizing-minimizing (MM) preferences predict a variety of medical decisions. We tested whether informing people about their MM preferences and asking them to reflect on the pros and cons of that preference would improve medical decisions when clear clinical recommendations exis...

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Autores principales: Zikmund-Fisher, Brian J., Shaffer, Victoria A., Scherer, Laura D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7863160/
https://www.ncbi.nlm.nih.gov/pubmed/33598547
http://dx.doi.org/10.1177/2381468320987498
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author Zikmund-Fisher, Brian J.
Shaffer, Victoria A.
Scherer, Laura D.
author_facet Zikmund-Fisher, Brian J.
Shaffer, Victoria A.
Scherer, Laura D.
author_sort Zikmund-Fisher, Brian J.
collection PubMed
description BACKGROUND: Medical maximizing-minimizing (MM) preferences predict a variety of medical decisions. We tested whether informing people about their MM preferences and asking them to reflect on the pros and cons of that preference would improve medical decisions when clear clinical recommendations exist. METHODS: We surveyed 1219 US adults age 40+ that were sampled to ensure a 50%/50% distribution of medical maximizers versus minimizers. Participants either received no MM feedback (Control) or received feedback about their MM type and instructions to reflect on how that MM type can be helpful in some circumstances and problematic in others (Reflection). All participants then completed five hypothetical decision scenarios regarding low-value care services (e.g., head computed tomography scan for mild concussion) and three about high-value care (e.g., flu vaccination). RESULTS: There were no significant differences between the Control and Reflection groups in five of eight scenarios. In three scenarios (two low-benefit and one high-benefit), we observed small effects in the nonhypothesized direction for the MM subgroup least likely to follow the recommendation (e.g., maximizers in the Reflection group were more likely to request low-benefit care). CONCLUSIONS: Asking people to reflect on their MM preferences may be a counterproductive strategy for optimizing patient decision making around quality of care.
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spelling pubmed-78631602021-02-16 Promoting Reflection on Medical Maximizing-Minimizing Preferences May Create Undesired Effects on Decisions About Low-Benefit and High-Benefit Care Zikmund-Fisher, Brian J. Shaffer, Victoria A. Scherer, Laura D. MDM Policy Pract Brief Report BACKGROUND: Medical maximizing-minimizing (MM) preferences predict a variety of medical decisions. We tested whether informing people about their MM preferences and asking them to reflect on the pros and cons of that preference would improve medical decisions when clear clinical recommendations exist. METHODS: We surveyed 1219 US adults age 40+ that were sampled to ensure a 50%/50% distribution of medical maximizers versus minimizers. Participants either received no MM feedback (Control) or received feedback about their MM type and instructions to reflect on how that MM type can be helpful in some circumstances and problematic in others (Reflection). All participants then completed five hypothetical decision scenarios regarding low-value care services (e.g., head computed tomography scan for mild concussion) and three about high-value care (e.g., flu vaccination). RESULTS: There were no significant differences between the Control and Reflection groups in five of eight scenarios. In three scenarios (two low-benefit and one high-benefit), we observed small effects in the nonhypothesized direction for the MM subgroup least likely to follow the recommendation (e.g., maximizers in the Reflection group were more likely to request low-benefit care). CONCLUSIONS: Asking people to reflect on their MM preferences may be a counterproductive strategy for optimizing patient decision making around quality of care. SAGE Publications 2021-01-29 /pmc/articles/PMC7863160/ /pubmed/33598547 http://dx.doi.org/10.1177/2381468320987498 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Brief Report
Zikmund-Fisher, Brian J.
Shaffer, Victoria A.
Scherer, Laura D.
Promoting Reflection on Medical Maximizing-Minimizing Preferences May Create Undesired Effects on Decisions About Low-Benefit and High-Benefit Care
title Promoting Reflection on Medical Maximizing-Minimizing Preferences May Create Undesired Effects on Decisions About Low-Benefit and High-Benefit Care
title_full Promoting Reflection on Medical Maximizing-Minimizing Preferences May Create Undesired Effects on Decisions About Low-Benefit and High-Benefit Care
title_fullStr Promoting Reflection on Medical Maximizing-Minimizing Preferences May Create Undesired Effects on Decisions About Low-Benefit and High-Benefit Care
title_full_unstemmed Promoting Reflection on Medical Maximizing-Minimizing Preferences May Create Undesired Effects on Decisions About Low-Benefit and High-Benefit Care
title_short Promoting Reflection on Medical Maximizing-Minimizing Preferences May Create Undesired Effects on Decisions About Low-Benefit and High-Benefit Care
title_sort promoting reflection on medical maximizing-minimizing preferences may create undesired effects on decisions about low-benefit and high-benefit care
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7863160/
https://www.ncbi.nlm.nih.gov/pubmed/33598547
http://dx.doi.org/10.1177/2381468320987498
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