Table 2.
Results of Framing Studies (Treatment Scenarios)
| Study | Results | Effect Modifiers | Quality Criterion |
|---|---|---|---|
| Positive Versus Negative Framing (surgical treatment decision) | |||
| Gurm 200015 | Favored angioplasty in positive frame, P < .001. | Not examined. | 1b, 2a, 5a |
| McNeil 19828 | Favored surgery in positive frame, P < .001. | No significant interaction between input data (cumulative probability vs life expectancy), treatment identification, and framing. | 1b |
| Smith 199633 | Favored surgery in positive frame, P < .05 low cognition group. | Those with high need for cognition not influenced by framing, low group preferred surgery in positive frame. | 2a |
| Marteau 198922 | Favored surgery in positive frame (40% survival), P < .02. | No framing effect at 10%, 60%, or 90% chance of survival. | 2a |
| Wilson 198735 | Favored surgery in positive frame, P < .05. | Framing effect at 10%, 20%, 40%, and 60% survival but not at 80% survival. | 2a |
| McNeil 198824 | Favored surgery in positive frame, to lesser extent in mixed frame, P value not reported. | Not examined. | 4b |
| Rybash 198931 | Favored surgery in negative frame, P < .003. | More likely to choose surgery in negative frame when patient in scenario refused treatment (P < .03). | None reported |
| Positive Versus Negative Framing (medication treatment decision) | |||
| O'Connor 198926 | Toxic treatment favored in positive and mixed frame. Volunteers (50% survival) P < .0001, patients (10% survival) P < .01. | At lower levels of probability, decline in preference greater in negative frame. Higher preference scores in patients. | 1a, 1b, 2a, 4b |
| Jasper 200146 | No significant framing effect on intention to use medication, positively framed information decreased birth defect risk estimates, P < .05. | Not examined. | 1a, 1b, 2a, 5a |
| Bernstein 199911 | Favored drug in positive frame, over mixed frame (P < .005), mixed frame preferred over negative frame (P < .0001). | Results for segregated editing condition. | 2b, 4b, 5b |
| Jacoby 199317 | No significant framing effect. | Not examined. | 1a, 1b, 2a |
| Zimmerman 200036 | No significant framing effect. | Not examined. | 1a, 1b, 5b |
| Farrell 200145 | Blood transfusion rated as being safer in positive frame, P < .05. | No interaction between donation history, stress appraisals, and framing on perceived safety. | 2a, 5a |
| O'Connor 198525 | IV favored in positive and mixed frame. Visitors (treatment A 50%, treatment B 35% survival) P < .01, students (50%, 35% survival)P < .05. | No significant effect of professional status, gender, age, medium, and student class in treatment preferences. | 2a, 4b |
| Krishnamurthy 200144 Study 2 | See effect modifiers. | Those receiving attribute description more likely to discuss treatment in positive frame (P < .05), no significant frame effect for goal description. | 1b, 2a |
| Krishnamurthy 200144 Study 1 | See effect modifiers. | Those receiving attribute description more likely to discuss treatment in positive frame (P < .01); those receiving goal description more likely to discuss treatment in negative frame (P < .01). | 2a |
| Blumenschein 199843 | See effect modifiers. | Favored treatment in positive frame for standard gamble scenario (i.e., willing to risk mortality for good health), P < .01. No significantframing effect for time trade-offscenario. | 2a |
| Levin 198819 | Treatment rated as more effective in positive frame, P < .05. | Not examined. | 5a |
| Bier 199412 Studies 1 and 2 | Favored ambiguous treatment in positive frame (P < .05), unambiguous treatment in negative frame (not significant). | Optimistic subjects preferred ambiguous treatment in positive frame. | None reported |
| RRR Versus NNT or ARR (medication treatment decision) | |||
| Straus 200242 | Favored medication when framed as RRR, P value not reported. | Not examined. | 1a, 1b, 2b, 5b |
| Malenka 199321 | Preferred medication framed as RRR, reported as significant. | Those with higher education and/or being treated for condition more likely to select medication expressed as RRR. | 1a, 1b, 5b |
| Hux 199516 | Favored medication when framed as RRR, P < .0001. | No relation between demographic variables and willingness to take medication. | 1b, 5b |
| Misselbrook 200141 | Favored medication when framed as RRR, 95% confidence interval for RRR did not overlap with those for ARR, NNT, or personal probability. | No significant difference in responses by age, gender, housing tenure, and familiarity with stroke. Those with hypertension (P < .01) or taking other chronic medications (P < .0001) more likely to accept treatment framed as RRR. | 1b, 5b |
| Probability Versus Frequency (medication treatment decision) | |||
| Siegrist 199732 | See effect modifiers. | Willing to pay more for medication when framed as frequency, P < .05 for high risk group. | None reported |
Quality criterion met by each study: 1a, consecutive sample; 1b, representative target group; 2a, randomized parallel group; 2b, within-subjects order of presentation randomized; 3a, attempts blinding of researchers; 3b, attempts blinding of participants; 4a, no information control group; 4b, mixed frame control group; 5a, parallel groups comparable on baseline characteristics; 5b, within-subjects baseline characteristics reported.