The effect of framing on surrogate optimism bias: A simulation study

Journal of Critical Care
Dev PatelAmber E Barnato

Abstract

To explore the effect of emotion priming and physician communication behaviors on optimism bias. We conducted a 5 × 2 between-subject randomized factorial experiment using a Web-based interactive video designed to simulate a family meeting for a critically ill spouse/parent. Eligibility included age at least 35 years and self-identifying as the surrogate for a spouse/parent. The primary outcome was the surrogate's election of code status. We defined optimism bias as the surrogate's estimate of prognosis with cardiopulmonary resuscitation (CPR) > their recollection of the physician's estimate. Of 373 respondents, 256 (69%) logged in and were randomized and 220 (86%) had nonmissing data for prognosis. Sixty-seven (30%) of 220 overall and 56 of (32%) 173 with an accurate recollection of the physician's estimate had optimism bias. Optimism bias correlated with choosing CPR (P < .001). Emotion priming (P = .397), physician attention to emotion (P = .537), and framing of CPR as the social norm (P = .884) did not affect optimism bias. Framing the decision as the patient's vs the surrogate's (25% vs 36%, P = .066) and describing the alternative to CPR as "allow natural death" instead of "do not resuscitate" (25% vs 37%, P = .035) decre...Continue Reading

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Citations

Feb 5, 2019·Annals of the American Thoracic Society·Andrew J FoyMichael J Green
Nov 7, 2019·Annals of Neurology·James L Bernat
Aug 12, 2020·Journal of Perinatology : Official Journal of the California Perinatal Association·Babina NayakMarlyse F Haward
May 23, 2020·Annals of the American Thoracic Society·Dustin C KrutsingerKatherine R Courtright
Aug 6, 2021·American Journal of Perinatology·Danielle LoReMarin Arnolds

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