Framing Effects on Decision-Making for Diagnostic Genetic Testing: Results from a Randomized Trial
Genetic testing is increasingly part of routine clinical care. However, testing decisions may be characterized by regret as findings also implicate blood relatives. It is not known if genetic testing decisions are affected by the way information is presented (i.e., framing effects). We employed a ra...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-06-01
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| Series: | Genes |
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| Online Access: | https://www.mdpi.com/2073-4425/12/6/941 |
| _version_ | 1797529508331388928 |
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| author | Andrew A. Dwyer Hongjie Shen Ziwei Zeng Matt Gregas Min Zhao |
| author_facet | Andrew A. Dwyer Hongjie Shen Ziwei Zeng Matt Gregas Min Zhao |
| author_sort | Andrew A. Dwyer |
| collection | DOAJ |
| description | Genetic testing is increasingly part of routine clinical care. However, testing decisions may be characterized by regret as findings also implicate blood relatives. It is not known if genetic testing decisions are affected by the way information is presented (i.e., framing effects). We employed a randomized factorial design to examine framing effects on hypothetical genetic testing scenarios (common, life-threatening disease and rare, life-altering disease). Participants (<i>n</i> = 1012) received one of six decision frames: choice, default (<i>n</i> = 2; opt-in, opt-out), or enhanced choice (<i>n</i> = 3, based on the Theory of Planned Behavior). We compared testing decision, satisfaction, regret, and decision cognitions across decision frames and between scenarios. Participants randomized to ‘choice’ were least likely to opt for genetic testing compared with default and enhanced choice frames (78% vs. 83–91%, <i>p</i> < 0.05). Neither satisfaction nor regret differed across frames. Perceived autonomy (behavioral control) predicted satisfaction (B = 0.085, <i>p</i> < 0.001) while lack of control predicted regret (B = 0.346, <i>p</i> < 0.001). Opting for genetic testing did not differ between disease scenarios (<i>p</i> = 0.23). Results suggest framing can nudge individuals towards opting for genetic testing. These findings have important implications for individual self-determination in the genomic era. Similarities between scenarios with disparate disease trajectories point to possible modular approaches for web-based decisional support. |
| first_indexed | 2024-03-10T10:14:51Z |
| format | Article |
| id | doaj.art-9715f0e6243f4700b5ce1346519131d2 |
| institution | Directory Open Access Journal |
| issn | 2073-4425 |
| language | English |
| last_indexed | 2024-03-10T10:14:51Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Genes |
| spelling | doaj.art-9715f0e6243f4700b5ce1346519131d22023-11-22T00:53:59ZengMDPI AGGenes2073-44252021-06-0112694110.3390/genes12060941Framing Effects on Decision-Making for Diagnostic Genetic Testing: Results from a Randomized TrialAndrew A. Dwyer0Hongjie Shen1Ziwei Zeng2Matt Gregas3Min Zhao4William F. Connell School of Nursing, Boston College, Chestnut Hill, MA 02467, USADepartment of Measurement, Evaluation, Statistics and Assessment, Lynch School of Education, Boston College, Chestnut Hill, MA 02467, USADepartment of Measurement, Evaluation, Statistics and Assessment, Lynch School of Education, Boston College, Chestnut Hill, MA 02467, USADepartment of Research Services, Boston College, Chestnut Hill, MA 02467, USACarroll School of Management, Boston College, Chestnut Hill, MA 02467, USAGenetic testing is increasingly part of routine clinical care. However, testing decisions may be characterized by regret as findings also implicate blood relatives. It is not known if genetic testing decisions are affected by the way information is presented (i.e., framing effects). We employed a randomized factorial design to examine framing effects on hypothetical genetic testing scenarios (common, life-threatening disease and rare, life-altering disease). Participants (<i>n</i> = 1012) received one of six decision frames: choice, default (<i>n</i> = 2; opt-in, opt-out), or enhanced choice (<i>n</i> = 3, based on the Theory of Planned Behavior). We compared testing decision, satisfaction, regret, and decision cognitions across decision frames and between scenarios. Participants randomized to ‘choice’ were least likely to opt for genetic testing compared with default and enhanced choice frames (78% vs. 83–91%, <i>p</i> < 0.05). Neither satisfaction nor regret differed across frames. Perceived autonomy (behavioral control) predicted satisfaction (B = 0.085, <i>p</i> < 0.001) while lack of control predicted regret (B = 0.346, <i>p</i> < 0.001). Opting for genetic testing did not differ between disease scenarios (<i>p</i> = 0.23). Results suggest framing can nudge individuals towards opting for genetic testing. These findings have important implications for individual self-determination in the genomic era. Similarities between scenarios with disparate disease trajectories point to possible modular approaches for web-based decisional support.https://www.mdpi.com/2073-4425/12/6/941genetic testinggenetic counsellingdecision-makingchoice architecturetheory of planned behaviorhereditary breast and ovarian cancer |
| spellingShingle | Andrew A. Dwyer Hongjie Shen Ziwei Zeng Matt Gregas Min Zhao Framing Effects on Decision-Making for Diagnostic Genetic Testing: Results from a Randomized Trial Genes genetic testing genetic counselling decision-making choice architecture theory of planned behavior hereditary breast and ovarian cancer |
| title | Framing Effects on Decision-Making for Diagnostic Genetic Testing: Results from a Randomized Trial |
| title_full | Framing Effects on Decision-Making for Diagnostic Genetic Testing: Results from a Randomized Trial |
| title_fullStr | Framing Effects on Decision-Making for Diagnostic Genetic Testing: Results from a Randomized Trial |
| title_full_unstemmed | Framing Effects on Decision-Making for Diagnostic Genetic Testing: Results from a Randomized Trial |
| title_short | Framing Effects on Decision-Making for Diagnostic Genetic Testing: Results from a Randomized Trial |
| title_sort | framing effects on decision making for diagnostic genetic testing results from a randomized trial |
| topic | genetic testing genetic counselling decision-making choice architecture theory of planned behavior hereditary breast and ovarian cancer |
| url | https://www.mdpi.com/2073-4425/12/6/941 |
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