Trial reportJournal of general internal medicine1994
Prescribing propensity: influence of life-expectancy gains and drug costs.
Trial report in Journal of general internal medicine, 1994. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Using alternative statistical formats for presenting risks and risk reductions.The Cochrane database of systematic reviews · 2011Pooled it
- American society of clinical oncology clinical practice guideline update on the use of pharmacologic interventions including tamoxifen, raloxifene, and aromatase inhibition for breast cancer risk reduction.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2009Guideline
- The effects of information framing on the practices of physicians.Journal of general internal medicine · 1999Pooled it
- Suitable trial designs and cohorts for preventive breast cancer agents.Nature reviews. Clinical oncology · 2013Review
- Understanding and expressing "Risk".Journal of the Saudi Heart Association · 2010Article
- How a well-grounded minimal important difference can enhance transparency of labelling claims and improve interpretation of a patient reported outcome measure.Health and quality of life outcomes · 2006Article
- Identifying patient preferences for communicating risk estimates: a descriptive pilot study.BMC medical informatics and decision making · 2001Article
- Applying the results of clinical trials to patients to general practice: perceived problems, strengths, assumptions, and challenges for the future.The British journal of general practice : the journal of the Royal College of General Practitioners · 1998Article
- Patients' prerogatives and perceptions of benefit.BMJ (Clinical research ed.) · 1996Article
- Evidence based purchasing: understanding results of clinical trials and systematic reviews.BMJ (Clinical research ed.) · 1995Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether physician willingness to prescribe drugs for primary prevention of cardiovascular disease is influenced by information about the resultant life-expectancy gains (presented in one of two formats) and about drug costs. MATERIALS AND
methodsMailed survey (four versions randomly allocated) asking physicians to assess hypothetical preventive interventions with outcomes expressed either as averaged or as stratified gains in life expectancy (e.g., average gain of 15 weeks, versus 5% of treated patients gain 2 to 6 years, 10% gain up to 2 years, and 85% remain unchanged). Both costs and gains were varied to high and low values. The subjects rated their willingness to prescribe treatments on an 11-point scale from "strongly oppose" to "strongly favor."
participantsInternists randomly selected from two Canadian academic centers (n = 330).
results231 usable responses were received (76% of the deliverable questionnaires). For low-yield scenarios typical of very effective primary prevention strategies, the physicians gave significantly higher ratings in response to stratified life-expectancy data than to equivalent averaged data (p < 0.0001). The same trend was not observed for high-yield scenarios (p = NS). The ratings were strongly influenced by cost: 34% of the physicians reversed their treatment decisions in response to a tenfold price increase. Despite this, the rankings of the treatments differed from those expected on the basis of cost-effectiveness criteria (p < 0.0001).
conclusionsPhysician enthusiasm for a therapy designed to prolong life expectancy may be influenced by the format in which that life-expectancy gain is presented. Knowledge of drug cost also affects physicians' choices, but their greater focus on treatment effects causes their rankings to depart from those expected with cost-effectiveness criteria.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.