A study published in Medical Decision Making found laypeople and physicians judged hypothetical patients more negatively when they shared incorrect health beliefs, particularly when those beliefs were central to managing the patient's condition.

"Our results suggest roadblocks to sharing information because laypeople believe there is a penalty for incorrect beliefs, and physicians confirm this impression," noted the study investigators.

Methods

The researchers surveyed three groups:

• 185 U.S. adults aged 18-64 (66.5% male, 74.6% White, 41.1% with bachelor's/associate degree)
• 311 adults with and without type 2 diabetes (36.2% male, 77.9% White, 43.1% with bachelor's/associate degree)
• 207 primary care physicians (48.3% male, 61.3% White, 100% with MD/DO degree)

Participants rated hypothetical patient vignettes on a 0-100 scale, assessing how they thought physicians would perceive the patients, the patients' ability to manage diabetes, and the patients' trust in doctors. The vignettes varied in the reasonableness (true, reasonably wrong, unreasonably wrong, conspiracy theories) and relevance (central vs. peripheral to diabetes management) of the health beliefs shared. Ratings were averaged into a composite impression score.

The researchers conducted 4 (reasonableness) × 2 (relevance) repeated-measures ANOVAs for each sample. For the sample comparing people with and without diabetes experience, diabetes experience (none vs. having type 2 diabetes) was included as a between-subjects factor.

Results

Repeated-measures ANOVAs revealed that across all samples, participants judged patients more negatively as shared beliefs became more unreasonable, with the harshest judgments for unreasonable beliefs central to diabetes care.

Effect sizes (partial eta squared, η²ᵨ) for the main effects of reasonableness ranged from 0.460 to 0.73, relevance from 0.071 to 0.26, and the reasonableness × relevance interaction from 0.119 to 0.22 (all P < .001).

In the diabetes sample, a significant reasonableness × relevance × disease experience interaction (P = .001, η²ᵨ = 0.017) indicated that participants with diabetes did not show the centrality effect for the most unreasonable statements.

Conclusions

The authors concluded that patients may avoid disclosing health beliefs to physicians due to fear of negative judgment, potentially creating barriers to shared decision-making. They suggested that physicians should receive training on common health misconceptions and be informed about these findings.

The study had limitations, including the use of sparse patient descriptions, which may have focused attention on the shared beliefs, and not assessing participants' diabetes knowledge or ability to identify incorrect statements. The authors noted that future research should examine how shared information influences perceptions in real-world clinical interactions and patient outcomes and explore tailoring beliefs to each participant's knowledge.

The authors declared having no competing interests.