From the Guidelines
Healthcare providers can support patients in making informed decisions under uncertainty by applying behavioral economics principles that acknowledge cognitive biases and decision-making patterns, as recommended by the most recent guidelines 1. To achieve this, providers should first simplify complex medical information by using plain language, visual aids, and decision tools that present treatment options with clear risk-benefit ratios. They should frame information carefully, presenting both absolute and relative risks, and using positive framing alongside negative framing to give patients a balanced perspective. Some key strategies for effective communication include:
- Revisiting previous conversations regarding the patient’s values, goals of care, and treatment preferences 1
- Presenting information in small chunks and checking in frequently to assess understanding 1
- Using published decision aids to prepare patients and enhance communication and shared decision making during consultations 1
- Including family or caregivers when possible and acceptable to the patient 1
- Documenting discussions in the medical record 1 Providers should also implement shared decision-making approaches that involve patients in discussions about their values and preferences while acknowledging emotional factors that influence decisions. Default options can be structured to guide patients toward evidence-based choices while preserving autonomy, such as opt-out vaccination programs. Decision aids that incorporate anticipated regret questions help patients consider future emotional states. Healthcare systems should time important decisions appropriately, avoiding moments of high stress when possible, and build in cooling-off periods for major decisions. These approaches work because they address common cognitive shortcuts humans use when facing uncertainty, helping patients overcome present bias, loss aversion, and information overload to make decisions aligned with their long-term health goals and values, as supported by recent studies 1. By applying these principles, healthcare providers can support patients in making informed decisions under uncertainty, ultimately improving morbidity, mortality, and quality of life outcomes.
From the Research
Behavioral Economics in Healthcare Decision-Making
Healthcare providers can support patients in making informed decisions under uncertainty using behavioral economics by:
- Applying behavioral economics principles to present information in a clear and understandable manner, as suggested by 2
- Using decision aids to improve individual decisions, as indicated by 3
- Engaging patients and providers in a collaborative process to choose clinical options that reflect patient preferences, as discussed in 3
- Considering factors that influence patient decision-making, such as loss aversion, trust, and present-biased preference, as outlined in 4
Addressing Uncertainty in Medical Decision-Making
Uncertainty is a significant challenge in medical decision-making, affecting both physicians and patients, as noted in 5
- Physicians' uncertainty can impact decisions made by less-informed patients, highlighting the need for effective communication and decision-support strategies
- Behavioral economics can help address uncertainty by providing insights into how individuals make decisions under uncertainty, as discussed in 6
Strategies for Effective Decision-Making
To promote effective decision-making, healthcare providers can:
- Use systematic cost-effectiveness analysis to improve resource allocation decisions, as suggested by 3
- Incorporate quality of life and patient preferences into evidence-based guidelines, as recommended by 3
- Apply behavioral economics strategies to diverse healthcare circumstances, such as organ donation and transplantation, habitual choices, and decision fatigue, as outlined in 4