title: Exploiting order effects to improve the quality of decisions.
abstract: OBJECTIVE
  To examine the effect of ordering information in a patient decision aid (PtDA) about treatments for obstructive sleep apnea (OSA).
  
  
  METHODS
  We recruited 643 individuals to imagine that they had been diagnosed with OSA and to choose between treatment options. A value clarification exercise was used to determine which attributes of treatment mattered most to each individual. Before deciding on their preferred treatment option, we randomly assigned participants to view information with attributes in: a pre-specified order (Group 1), order of what mattered most last (Group 2), and first (Group 3).
  
  
  RESULTS
  Of the 510 participants who provided usable results, viewing information that mattered most first was associated with choosing the treatment option most concordant with their informed values. The order effect was most pronounced in younger individuals.
  
  
  CONCLUSIONS
  In this study of hypothetical patients, order effects were found to improve the information patients focussed on, potentially improving the quality of their decisions.
  
  
  CONCLUSIONS
  The order of information presented in a PtDA can inadvertently influence patients' choices. By tailoring information order for each patient, developers cannot only overcome this dilemma, but also make it simpler for patients to choose the option that is best for them.
authors: School of Population and Public Health, University of British Columbia, Vancouver, Canada; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Research Institute, Vancouver, Canada; Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, Canada. Electronic address: nick.bansback@ubc.ca.
authors: Nick
authors: N
authors: Bansback
authors: Department of Physiotherapy, University of British Columbia, Vancouver, Canada.
authors: Linda C
authors: LC
authors: Li
authors: Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, Canada; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada.
authors: Larry
authors: L
authors: Lynd
authors: School of Population and Public Health, University of British Columbia, Vancouver, Canada; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Research Institute, Vancouver, Canada.
authors: Stirling
authors: S
authors: Bryan
mesh_terms: D000328:Adult; D003142:Communication; D032882:Comprehension; D003657:Decision Making; D003661:Decision Support Techniques; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D057240:Patient Preference; D018570:Risk Assessment; D020181:Sleep Apnea, Obstructive / Q000628:therapy*
keywords: Cognitive biases; Decision aids; Order effects