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Context and objective Shared decision making is especially advocated for preference-sensitive decisions. We investigated whether physicians' recommendations pull patients away from their preferred treatment option when making a preference-sensitive decision. Design, participants and methods Inpatients ( N = 102 with schizophrenia, N = 101 with multiple sclerosis) were presented with a hypothetical scenario (the choice between two drugs). They were first asked about their preferences concerning the two drugs and then they received a (fictitious) clinician's recommendation that was contrary to their preferences. Subsequently they made a final choice between the two drugs. Main outcome measures The main outcome measure was whether the patient followed the physician's advice in the hypothetical scenario. Thereby patient's (pre-recommendation) preferences served as a baseline. Results In the decision scenario, about 48% of the patients with schizophrenia and 26% of the patients with multiple sclerosis followed the advice of their physician and thus chose the treatment option that went against their initial preferences. Patients who followed their physician's advice were less satisfied with their decision than patients not following their physician's advice (schizophrenia: t = 2.61, P = 0.01; multiple sclerosis: t = 2.67, P = 0.009). Discussion and conclusions When sharing decisions with patients, physicians should be aware that their advice might influence patients' decisions away from their preferred treatment option. They should encourage their patients to identify their own preferences and help to find the treatment option most consistent with them. [ABSTRACT FROM AUTHOR]

In recent work we introduced a general, a weak, and a strong partitioning principles for the construction of multiple decision procedures as multiple testing or selection procedures. Partitioning principles can be viewed as natural extensions of the closure principle and sometimes yield more powerful decision procedures. In this article we consider the problem of establishing equivalence with the best with respect to k treatment means, where equivalence is defined in terms of a threshold value δ > 0. We reformulate the original selection problem as a multiple testing problem and develop various step-down and step-up procedures by applying the closure principle and partitioning principles. The new step-down procedure is shown to provide a uniform improvement over procedures currently in use. Moreover, we propose some projection methods that yield confidence intervals being compatible with stepwise tests and selection procedures. [ABSTRACT FROM AUTHOR]

Cronholm and Revusky [4] have proposed a rank test based on independent subexperiments for the comparison of a treatment effect with a control when the treatment is destructive but the control produces at most a transient effect. This article provides a thorough study of its performance under two sampling situations. With the aid of a computer, the exact small sample power of the test is evaluated for some important alternatives. A modification of the test is proposed for the situation where numerical measurements are available rather than merely the ranks within each stage. The modification is found to substantially improve the power. Both tests are shown to be unbiased. Finally, the Pitman asymptotic efficiencies are obtained and comparisons are made with the appropriate Wilcoxon tests. [ABSTRACT FROM AUTHOR]

A double sample test for a hypothesis concerning the mean mu of a normal random variable with unknown variance sigma[sup 2] is presented in this note. This test is an alternative to the usual single sample t test and is made by taking samples at two stages. After the first sample has been observed the hypothesis is rejected, accepted or a second sample is taken. This double sample test is a modification of a double sample test suggested by D. Owen. However, for the test being suggested here if the second sample is taken the information from the first sample is used in making the final decision. A table is included which is a tabulation of the rejection and acceptance points for various sample sizes and alpha = .05 and alpha = .01. Additional tables are included which give some power values and expected sample sizes for the new test and Owen's test. These power values are compared with power values of various single sample t tests. Conclusions about desirable sample sizes are presented for both the new test and Owen's test. [ABSTRACT FROM AUTHOR]