IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v31y2011i2p338-353.html

Are Medical Outcomes Fungible? A Survey of Voters, Medical Administrators, and Physicians

Author

Listed:
  • Michael L. DeKay

Abstract

Purpose. Many analyses of medical treatments entail the aggregation of health outcomes over patients and over time. This study assessed the extent to which voters, medical administrators, and physicians consider such aggregation to be appropriate. In addition, the study assessed whether this perceived fungibility of outcomes moderates the difference between treatment recommendations in single-play decisions (for 1 patient on 1 occasion) and those in repeated-play decisions (for several patients or for 1 patient on several occasions). Methods. In a 5-contact mail survey of registered voters ( n = 182 , response rate = 52 %), medical administrators ( n = 123 , 35 %), and physicians ( n = 95 , 26 %), respondents rated the fungibility of outcomes and indicated their preferred action in 1 of 3 scenarios involving changes in life expectancy or the duration of pain. They evaluated a risky, positive-expected-value treatment in a single-play decision, then in a repeated-play decision, and again in a repeated-play decision after they viewed the distribution of possible net outcomes. Results. Perceived fungibility varied substantially across respondents in all groups, with voters giving higher fungibility ratings than administrators or physicians. Respondents’ strength-of-preference ratings for treatment increased from single-play to repeated-play decisions, but these increases were moderated by perceived fungibility, as expected. When outcomes were considered fungible, treatments were much more attractive in repeated-play decisions than in single-play decisions. When outcomes were considered nonfungible, there was essentially no difference between single- and repeated-play decisions. Conclusions. Recommendations regarding risky medical treatments with positive expectations appear to depend, in part, on opinions about whether it is reasonable to aggregate medical outcomes over patients or over time. Such opinions vary widely among physicians and others.

Suggested Citation

  • Michael L. DeKay, 2011. "Are Medical Outcomes Fungible? A Survey of Voters, Medical Administrators, and Physicians," Medical Decision Making, , vol. 31(2), pages 338-353, March.
    • Handle: RePEc:sae:medema:v:31:y:2011:i:2:p:338-353
    DOI: 10.1177/0272989X10373146
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X10373146
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X10373146?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Thomas Langer & Martin Weber, 2001. "Prospect Theory, Mental Accounting, and Differences in Aggregated and Segregated Evaluation of Lottery Portfolios," Management Science, INFORMS, vol. 47(5), pages 716-733, May.
    2. Uri Gneezy & Jan Potters, 1997. "An Experiment on Risk Taking and Evaluation Periods," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 112(2), pages 631-645.
    3. Shu Li, 2003. "The role of Expected Value illustrated in decision-making under risk: single-play vs multiple-play," Journal of Risk Research, Taylor & Francis Journals, vol. 6(2), pages 113-124, March.
    4. Daniel Kahneman & Dan Lovallo, 1993. "Timid Choices and Bold Forecasts: A Cognitive Perspective on Risk Taking," Management Science, INFORMS, vol. 39(1), pages 17-31, January.
    5. Leclerc, France & Schmitt, Bernd H & Dube, Laurette, 1995. "Waiting Time and Decision Making: Is Time like Money?," Journal of Consumer Research, Journal of Consumer Research Inc., vol. 22(1), pages 110-119, June.
    6. Michael L. DeKay & John C. Hershey & Mark D. Spranca, & Peter A. Ubel & David A. Asch, 2006. "Are medical treatments for individuals and groups like single-play and multiple-play gambles?," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 1, pages 134-145, November.
    7. Amos Tversky & Daniel Kahneman, 1991. "Loss Aversion in Riskless Choice: A Reference-Dependent Model," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 106(4), pages 1039-1061.
    8. Shlomo Benartzi & Richard H. Thaler, 1999. "Risk Aversion or Myopia? Choices in Repeated Gambles and Retirement Investments," Management Science, INFORMS, vol. 45(3), pages 364-381, March.
    9. Richard H. Thaler & Amos Tversky & Daniel Kahneman & Alan Schwartz, 1997. "The Effect of Myopia and Loss Aversion on Risk Taking: An Experimental Test," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 112(2), pages 647-661.
    10. Alexander Klos & Elke U. Weber & Martin Weber, 2005. "Investment Decisions and Time Horizon: Risk Perception and Risk Behavior in Repeated Gambles," Management Science, INFORMS, vol. 51(12), pages 1777-1790, December.
    11. Langer, Thomas & Weber, Martin, 2005. "Myopic prospect theory vs. myopic loss aversion: how general is the phenomenon?," Journal of Economic Behavior & Organization, Elsevier, vol. 56(1), pages 25-38, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. José Antonio Robles-Zurita & José Luis Pinto-Prades, 2015. "Randomness beliefs and decisions on risky medical treatments," Working Papers 15.16, Universidad Pablo de Olavide, Department of Economics.
    2. Michael L. DeKay & Dan R. Schley & Seth A. Miller & Breann M. Erford & Jonghun Sun & Michael N. Karim & Mandy B. Lanyon, 2016. "The persistence of common-ratio effects in multiple-play decisions," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 11(4), pages 361-379, July.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Michael L. DeKay & Dan R. Schley & Seth A. Miller & Breann M. Erford & Jonghun Sun & Michael N. Karim & Mandy B. Lanyon, 2016. "The persistence of common-ratio effects in multiple-play decisions," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 11(4), pages 361-379, July.
    2. Stefan Zeisberger & Thomas Langer & Martin Weber, 2012. "Why does myopia decrease the willingness to invest? Is it myopic loss aversion or myopic loss probability aversion?," Theory and Decision, Springer, vol. 72(1), pages 35-50, January.
    3. Hueber, Laura & Schwaiger, Rene, 2022. "Debiasing through experience sampling: The case of myopic loss aversion," Journal of Economic Behavior & Organization, Elsevier, vol. 198(C), pages 87-138.
    4. Schwaiger, Rene & Hueber, Laura, 2021. "Do MTurkers exhibit myopic loss aversion?," Economics Letters, Elsevier, vol. 209(C).
    5. Alexander Klos, 2013. "Myopic loss aversion: Potential causes of replication failures," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 8(5), pages 617-629, September.
    6. Arpan Jani, 2021. "An agent-based model of repeated decision making under risk: modeling the role of alternate reference points and risk behavior on long-run outcomes," Journal of Business Economics, Springer, vol. 91(9), pages 1271-1297, November.
    7. Rene Schwaiger & Laura Hueber, 2021. "Do MTurkers Exhibit Myopic Loss Aversion?," Working Papers 2021-12, Faculty of Economics and Statistics, Universität Innsbruck.
    8. José Antonio Robles-Zurita & José Luis Pinto-Prades, 2015. "Randomness beliefs and decisions on risky medical treatments," Working Papers 15.16, Universidad Pablo de Olavide, Department of Economics.
    9. Langer, Thomas & Weber, Martin, 2005. "Myopic prospect theory vs. myopic loss aversion: how general is the phenomenon?," Journal of Economic Behavior & Organization, Elsevier, vol. 56(1), pages 25-38, January.
    10. Michael L. DeKay & John C. Hershey & Mark D. Spranca, & Peter A. Ubel & David A. Asch, 2006. "Are medical treatments for individuals and groups like single-play and multiple-play gambles?," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 1, pages 134-145, November.
    11. Aloysius, John A., 2005. "Ambiguity aversion and the equity premium puzzle: A re-examination of experimental data on repeated gambles," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 34(5), pages 635-655, October.
    12. Hardin, Andrew M. & Looney, Clayton Arlen, 2012. "Myopic loss aversion: Demystifying the key factors influencing decision problem framing," Organizational Behavior and Human Decision Processes, Elsevier, vol. 117(2), pages 311-331.
    13. Elizabeth C. Webb & Suzanne B. Shu, 2017. "Is broad bracketing always better? How broad decision framing leads to more optimal preferences over repeated gambles," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 12(4), pages 382-395, July.
    14. Langer, Thomas & Weber, Martin, 2008. "Does commitment or feedback influence myopic loss aversion?: An experimental analysis," Journal of Economic Behavior & Organization, Elsevier, vol. 67(3-4), pages 810-819, September.
    15. Venkatraman, Srinivasan & Aloysius, John A. & Davis, Fred D., 2006. "Multiple prospect framing and decision behavior: The mediational roles of perceived riskiness and perceived ambiguity," Organizational Behavior and Human Decision Processes, Elsevier, vol. 101(1), pages 59-73, September.
    16. Emily Haisley & Romel Mostafa & George Loewenstein, 2008. "Myopic risk-seeking: The impact of narrow decision bracketing on lottery play," Journal of Risk and Uncertainty, Springer, vol. 37(1), pages 57-75, August.
    17. Haim Levy & Moshe Levy, 2021. "Prospect theory, constant relative risk aversion, and the investment horizon," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-21, April.
    18. Iturbe-Ormaetxe, Iñigo & Ponti, Giovanni & Tomás, Josefa, 2019. "Is it myopia or loss aversion? A study on investment game experiments," Economics Letters, Elsevier, vol. 180(C), pages 36-40.
    19. John Beshears & James J. Choi & David Laibson & Brigitte C. Madrian, 2017. "Does Aggregated Returns Disclosure Increase Portfolio Risk Taking?," The Review of Financial Studies, Society for Financial Studies, vol. 30(6), pages 1971-2005.
    20. Neszveda, G., 2019. "Essays on behavioral finance," Other publications TiSEM 05059039-5236-42a3-be1b-3, Tilburg University, School of Economics and Management.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:31:y:2011:i:2:p:338-353. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.