Failure to Adopt Beneficial Therapies Caused by Bias in Medical Evidence Evaluation

Scott K. Aberegg, Hal Arkes and Peter B. Terry
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Scott K. Aberegg: The Ohio State University College of Medicine and Public Health, Department of Internal Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine; Johns Hopkins Medical Institutions, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, MD; scottaberegg@gmail.com
Peter B. Terry: Johns Hopkins Medical Institutions, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, MD

Medical Decision Making, 2006, vol. 26, issue 6, 575-582

Abstract: Background . Although it is known that many evidencebased therapies are underutilized, the causes of the research-practice gap are not well understood. The authors sought to determine if there is a bias in the evaluation of new evidence that leads to low rates of adoption of beneficial therapies compared to abandonment of harmful ones. Methods . Two case vignettes describing hypothetical clinical trials were administered to 2 independent samples of pulmonary and critical care practitioners. Each vignette was presented in 2 different ways; in one version, the results of the hypothetical trial showed that a treatment was harmful, and in the other version, the same treatment was shown to be beneficial. Prospective respondents from each sample were randomized to receive 1 version of each vignette (intersubject design). The main outcome was respondent's willingness to apply the results of the hypothetical trial to patient care. Results . There were 174 participants for trial 1 and 138 participants for trial 2 (enrollment rates of 44.2% and 41.8%, respectively). For trial 1, respondents were 2.3 times less likely to change clinical practice based on results indicating benefit as opposed to harm (33.3% v. 76.5%; P

Keywords: cognitive bias; evidence-based medicine; decision analysis (search for similar items in EconPapers)
Date: 2006
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:26:y:2006:i:6:p:575-582

DOI: 10.1177/0272989X06295362

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