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Do Decision Biases Predict Bad Decisions? Omission Bias, Naturalness Bias, and Influenza Vaccination

^* To whom correspondence should be addressed. E-mail: dibonavm{at}mskcc.org.

	Abstract

Purpose. Numerous studies using hypothetical vignettes have demonstrated decision biases or deviations from utility theory. Do people who commit biases in questionnaire studies make worse real-world decisions than do less biased people? Methods. Two hundred seventy university faculty and staff participated in a questionnaire study in which they reported whether they accepted a free influenza vaccine offered at their work place. Influenza vaccine acceptance was the measure of real-world decision making. Participants responded to 3 hypothetical scenarios. Two scenarios measured the omission bias and described a vaccine (scenario 1) and a medication (scenario 2) that prevented a negative health outcome but that itself could cause the negative health outcome. The omission bias is a preference for not vaccinating or medicating even when the vaccine/medication lowers the total risk of the negative outcome. A 3rd scenario measured the naturalness bias by presenting a choice between 2 chemically identical medications, one extracted from a natural herb and the other synthesized in a laboratory. Preference for the natural medication indicated the naturalness bias. Results. The results indicated that a substantial proportion of participants exhibited these biases and that participants who exhibited these biases were less likely to accept the flu vaccine. Conclusions. To the extent that declining a free flu vaccine is a worse real-world decision, people who demonstrate the naturalness and omission biases in hypothetical scenarios make worse real-world decisions. Key words: omission bias; naturalness bias; influenza; vaccination. (Med Decis Making XXXX;XX:xx–xx)

First published on March 4, 2008, doi:10.1177/0272989X07312723

Medical Decision Making 2008;28:532.

A more recent version of this article appeared on July 1, 2008


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