PtDAs assist patients in clarifying and communicating the values they place on different features of treatment options. By doing so, they can help patients make informed decisions in consultation with their physicians, an approach known as shared decision making [2]. Developers of PtDAs Selleck isocitrate dehydrogenase inhibitor strive to improve the quality of treatment choices, or decision quality. A quality choice has been defined as one that is both informed and value concordant; that is the patient’s choice is based on knowledge of options and outcomes, including accurate perceptions of risk, such that the chosen option matches the patient’s personal values [3]. A wealth of research has

sought to improve PtDAs so that patients receive accurate and well-described information [4]. However, evidence suggests that simply providing patients with accurate information does not always lead to quality decision-making [5]. Often, informed patients must make difficult trade-offs [6]. When a patient is faced with complex and unfamiliar information, their trade-offs can be

overridden by subtle cognitive biases [7] and [8]. In the case of PtDAs, this may lead to patients choosing options that are not concordant with their personal values. This study focusses on a cognitive bias caused by order effects. The psychology literature has established that the order in which www.selleckchem.com/products/MS-275.html information is presented can influence people’s judgments [9], [10] and [11].

People can be influenced by a recency bias – they may remember the most recent information they receive better than earlier information and, as a result, their perceptions can be disproportionately influenced by this recent information [12]. Accordingly, patients who learn about treatment benefits first and risk information second might better remember the risks, and make treatment choices that are more influenced by this recently received risk information. People can also be influenced by a primacy bias – they may better consider the information listed first rather than last, particularly here the list is long [13]. In these circumstances, patients might give more weight to information provided earlier relative to information Paclitaxel mouse given further down a list [14]. These types of biases are a potential problem to developers of PtDAs who seek to inform patients about treatment options in a neutral manner. Information, such as harms or benefits, must be presented in some order within a PtDA, but since developers choose this order they may inadvertently influence the patient to choose a particular option. While other studies have sought to minimize the influence of such order effects [15], this study seeks to exploit these effects by simplifying the task for patients faced with complex decisions.