Does labeling prenatal screening test results as negative or positive affect a woman's responses?
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We tested whether adding interpretive labels (eg, "negative test") to prenatal genetic screening test results changes perceived risk and preferences for amniocentesis. STUDY DESIGN: Women (N = 1688) completed a hypothetical pregnancy scenario on the Internet. We randomly assigned participants into 2 groups: high risk of fetal chromosomal problems (12.5/1000) or low risk (2/1000). After prenatal screening, estimated risk was identical (5/1000) for all participants, but results were provided either alone or with interpretive labels. RESULTS: When receiving test results without labels, all participants react similarly. With labels, the participants who received "positive" or "abnormal" results reported a higher perceived risk (P < .001), greater worry (P < .001), and greater interest in amniocentesis (57% vs 37%; P < .001) than did the participants who received "negative" or "normal" results. CONCLUSION: Interpretive labels for test results can induce larger changes to a woman's risk perception and behavioral intention than can numeric results alone, which create decision momentum. This finding has broad clinical implications for patient-provider communication.
Related Topics:
Obstetrics,
Doctor-patient communication,
Risk communication,
Numeracy,
The experience of being at risk
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Does labeling prenatal screening test results as negative or positive affect a woman's responses? Zikmund-Fisher BJ, Fagerlin A, Keeton K, Ubel PA. American Journal of Obstetrics and Gynecology. 197:528.e1-528.e6, 2007.
Brian Zikmund-Fisher, PhD
Brian J. Zikmund-Fisher studied economics and psychology at Swarthmore College before getting his doctorate in behavioral decision theory at Carnegie Mellon University. Although Dr. Zikmund-Fisher began his academic career in behavioral economics, he moved from studying consumer choice to medical...
Angela Fagerlin, PhD
Angie Fagerlin studied psychology and literature at Hope College and received her PhD in experimental (cognitive) psychology at Kent State University. Her primary research focus is testing methods for communicating the risks and benefits of treatment to patients (e.g., in decision aids). Her other...
Peter Ubel, MD
Peter A. Ubel, MD, is Professor of Medicine and Professor of Psychology at the University of Michigan; a primary care physician at the Ann Arbor Veterans Affairs Medical Center; Associate Director of the Michigan Robert Wood Johnson Clinical Scholars Program; and Director of the Center for...