All framing effects are not created equal: Low convergent validity between two classic measurements of framing

Effects of COVID-19 vaccine safety framing on parental reactions

As a major concern shared by parents globally, COVID-19 vaccine safety is typically being messaged to the public in a negative frame in many countries. However, whether the COVID-19 vaccine safety framing have an effect on parents when vaccinating their children is unclear. Here we implement an online survey with a convenience sample of 3,861 parents living in mainland China, all over 18 years old and with at least one child under 18. The parents were randomly assigned to receive information about COVID-19 vaccine safety in either a negative frame (incidence of side effects) or a positive frame (the inverse incidence of side effects), to compare parental reactions to a range of questions about communication, risk perception, trust, involvement and behavioral intention. We found that parents were more likely to regard vaccine safety as relevant to policy support and as a higher priority for government when receiving positively framed information (p = 0.002). For some specific subgroups, parents in positive framing group showed lower risk perception and higher trust (p<0.05). This suggests that positive framing of COVID-19 vaccine safety messages show more effective performance than negative framing in terms of involvement, as well as trust and risk perception in specific subgroups, which may lead to a reflection on whether to adjust the current widespread use of negative framing. Our findings inform how governments and health care workers strategically choose the framing design of COVID-19 vaccine safety information, and have important implications for promoting COVID-19 vaccination in children in the future.

Is loss avoidance differentially rewarding in adolescents versus adults? Differences in ventral striatum and anterior insula activation during the anticipation of potential monetary losses

Avoiding loss is a crucial, adaptive guide to human behavior. While previous developmental research has primarily focused on gaining rewards, less attention has been paid to loss processing and its avoidance. In daily life, it is often unknown how likely an action will result in a loss, making the role of uncertainty in loss processing particularly important. By using functional magnetic resonance imaging, we investigated the influence of varying outcome probabilities (12%, 34%, and 67%) on brain regions implicated in loss processing (ventral striatum (VS), anterior insula (AI)) by comparing 28 adolescents (10-18 years) and 24 adults (22-32 years) during the anticipation of potential monetary loss.Overall, results revealed slower RTs in adolescents compared to adults with both groups being faster in the experimental (monetary condition) vs. control trials (verbal condition). Fastest RTs were observed for the 67% outcome probability in both age groups. An age group × outcome probability interaction effect revealed the greatest differences between the groups for the 12% vs. the 67% outcome probability. Neurally, both age groups demonstrated a higher percent signal change in the VS and AI during the anticipation of potential monetary loss versus the verbal condition. However, adults demonstrated an even greater activation of VS and AI than adolescents during the anticipation of potential monetary loss, but not during the verbal condition. This may indicate that adolescents differ from adults regarding their experience of avoiding losing monetary rewards.

Lay, professional, and artificial intelligence perspectives on risky medical decisions and COVID-19: How does the number of lives matter in clinical trials framed as gains versus losses?

Outcomes of clinical trials need to be communicated effectively to make decisions that save lives. We investigated whether framing can bias these decisions and if risk preferences shift depending on the number of patients. Hypothetical information about two medicines used in clinical trials having a sure or a risky outcome was presented in either a gain frame (people would be saved) or a loss frame (people would die). The number of patients who signed up for the clinical trials was manipulated in both frames in all the experiments. Using an unnamed disease, lay participants (experiment 1) and would-be medical professionals (experiment 2) were asked to choose which medicine they would have administered. For COVID-19, lay participants were asked which medicine should medical professionals (experiment 3), artificially intelligent software (experiment 4), and they themselves (experiment 5) favour to be administered. Broadly consistent with prospect theory, people were more risk-seeking in the loss frames than the gain frames. However, risk-aversion in gain frames was sensitive to the number of lives with risk-neutrality at low magnitudes and risk-aversion at high magnitudes. In the loss frame, participants were mostly risk-seeking. This pattern was consistent across laypersons and medical professionals, further extended to preferences for choices that medical professionals and artificial intelligence programmes should make in the context of COVID-19. These results underscore how medical decisions can be impacted by the number of lives at stake while revealing inconsistent risk preferences for clinical trials during a real pandemic.

Training in statistical analysis reduces the framing effect among medical students and residents in Argentina

PURPOSE

The framing effect refers to a phenomenon wherein, when the same problem is presented using different representations of information, people make significant changes in their decisions. This study aimed to explore whether the framing effect could be reduced in medical students and residents by teaching them the statistical concepts of effect size, probability, and sampling for use in the medical decision-making process.

METHODS

Ninety-five second-year medical students and 100 second-year medical residents of Austral University and Buenos Aires University, Argentina were invited to participate in the study between March and June 2017. A questionnaire was developed to assess the different types of framing effects in medical situations. After an initial administration of the survey, students and residents were taught statistical concepts including effect size, probability, and sampling during 2 individual independent official biostatistics courses. After these interventions, the same questionnaire was randomly administered again, and pre- and post-intervention outcomes were compared among students and residents.

RESULTS

Almost every type of framing effect was reproduced either in the students or in the residents. After teaching medical students and residents the analytical process behind statistical concepts, a significant reduction in sample-size, risky-choice, pseudo-certainty, number-size, attribute, goal, and probabilistic formulation framing effects was observed.

CONCLUSION

The decision-making of medical students and residents in simulated medical situations may be affected by different frame descriptions, and these framing effects can be partially reduced by training individuals in probability analysis and statistical sampling methods.