OBJECTIVE: To assess the effect of providing structured information about the benefits and harms of mammography in differing frames
on women’s perceptions of screening.
DESIGN: Randomized control trial.
SETTING: General internal medicine academic practice.
PARTICIPANTS: One hundred seventy-nine women aged 35 through 49.
INTERVENTION: Women received 1 of 3 5-minute videos about the benefits and harms of screening mammography in women aged 40 to 49. These
videos differed only in the way the probabilities of potential outcomes were framed (positive, neutral, or negative).
MEASUREMENTS AND MAIN RESULTS: We measured the change in accurate responses to questions about potential benefits and harms of mammography, and the change
in the proportion of participants who perceived that the benefits of mammography were more important than the harms. Before
seeing the videos, women’s knowledge about the benefits and harms of mammography was inaccurate (82% responded incorrectly
to all 3 knowledge questions). After seeing the videos, the proportion that answered correctly increased by 52%, 43%, and
30% for the 3 knowledge questions, respectively, but there were no differences between video frames. At baseline, most women
thought the benefits of mammography outweighed the harms (79% positive frame, 80% neutral frame, and 85% negative frame).
After the videos, these proportions were similar among the 3 groups (84%, 81%, 83%, P=.93).
CONCLUSIONS: Women improved the accuracy of their responses to questions about the benefits and harms of mammography after seeing the
videos, but this change was not affected by the framing of information. Women strongly perceived that the benefits of mammography
outweighed the harms, and providing accurate information had no effect on these perceptions, regardless of how it was framed.
Key words decision making - informed consent - mammography - physician-patient relations
Results of this study were presented at the 24th Annual Society of General Internal Medicine meeting in San Diego, Calif,
May, 2001.
Grant support: This study was supported by the University of North Carolina Lineberger Comprehensive Cancer Center. Drs. Lewis
(grant number #00-180-01) and Pignone are supported by the American Cancer Society Cancer Control Career Development Award
for Primary Care Physicians. Dr. Sheridan was supported by National Research Services Award PHS#14001-14.