How the manner of presentation of data influences older patients in determining their treatment preferences.
OBJECTIVE
To assess how the manner of presentation of graphic data to older patients influences their treatment preferences.


METHODS
Cross-sectional structured interviews with patients.


METHODS
A university-based Department of Veterans Affairs Medical Center.


METHODS
One hundred sixty-six consecutive patients (mean age = 64.8 years, range of ages 29-82) seen in a Department of Veterans Affairs general medicine clinic.


METHODS
Five pairs of 5-year survival curves were presented to patients. Each pair was composed of two survival curves for alternative unidentified treatments for an unidentified medical condition. Curve A (LT = better long-term, worse short-term survival) was fixed throughout all curve pairs. Curve B (ST = better short-term, worse long-term survival) changed in each curve pair, showing incrementally better chances of short-term survival across the five curve pairs. Patients were randomly assigned to view the curve pairs in forward (increasing short-term survival) or backward (decreasing short-term survival) order.


RESULTS
Order is a significant predictor of patients' initial preferences for the short-term survival curve (P = 0.0004) as well as their willingness to shift preferences during presentation of the five curve pairs. Patients > or = 65 were more likely to initially choose the ST curve in forward order presentation than patients < 65. More educated patients generally were less likely to prefer the ST curve under both elicitation orders.


CONCLUSIONS
The data indicate that the method of eliciting patients' preferences strongly influenced their expressed preferences, and that these preferences may have predictable relationships with demographic characteristics such as age.
Mazur
D J
DJ
Department of Veterans Affairs Medical Center, Oregon Health Sciences University, Portland.
Merz
J F
JF
D000328:Adult; D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D003142:Communication; D003430:Cross-Sectional Studies; D003626:Data Display; D003657:Decision Making; D004522:Educational Status; D006787:Hospitals, Veterans; D006801:Humans; D008017:Life Expectancy; D008875:Middle Aged; D009922:Oregon; D010358:Patient Participation; D013223:Statistics as Topic; D015996:Survival Rate