THE FRAMING EFFECT OF RELATIVE AND ABSOLUTE RISK

objective: To test whether a patient's perception of benefit is influe nced by whether the benefit is presented in relative or absolute terms . Design: Questionnaire-based study. Setting: A general medicine outpa tient clinic at a rural tertiary care center associated with a medical school. Patients: 470 of 511 consecutive patients who agreed to answe r a questionnaire while waiting for their clinic visit. Mean age was 4 9.1 years, 62.1% were female, and 51.9% had at least one year of educa tion beyond high school. Main outcome measures: Patient response to th e choice of two equally efficacious medications for the management of a hypothetical serious disease. The benefit of one medication was stat ed in relative terms, the other in absolute terms, Patients could choo se either medication alone, indicate indifference to the choice of med ication, or choose not to answer. Main results: 56.8% of the patients chose the medication whose benefit was in relative terms. 14.7% chose the medication whose benefit was in absolute terms. Only 15.5% were in different to the choice of medication. The patients preferred the medi cation whose benefit was in relative terms across a wide range of ages and educational levels. Further questioning suggested that the patien ts thought benefit was greater when expressed in relative terms becaus e they ignored the underlying risk of disease and assumed it was one. Conclusions: The ''framing'' of benefit (or risk) in relative versus a bsolute terms may have a major influence on patient preference.