Re: Are Preferences for COX-2 Inhibitors Influenced by the Certainty Effect?

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We¹ve been brainwashed by the TV ads!!!!

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> Journal of Rheumatology

> March 2004

>

> Are Preferences for Cyclooxygenase-2 Inhibitors Influenced by the

> Certainty Effect?

> LIANA FRAENKEL, DICK R. WITTINK, JOHN CONCATO, and TERRI FRIED

>

> ABSTRACT.

>

> Objective. To test whether the widespread use of cyclooxygenase-2

> (COX-2) inhibitors may be mediated in part by the certainty effect,

> i.e., by a perception that COX-2 inhibitors eliminate the risk of

> serious gastrointestinal (GI) events in contrast to merely reduce their

> risk.

>

> Methods. Patients' preferences for conventional nonsteroidal

> antiinflammatory drugs (NSAID) and COX-2 inhibitors for treatment of

> arthritis were predicted across a range of absolute risks of GI events

> using an Adaptive Conjoint Analysis survey.

>

> Results. Preferences for COX-2 inhibitors were much stronger when the

> risk of serious GI events was eliminated in contrast to reduced, even

> though the absolute risk reduction (ARR) was the same. Few patients

> (22%) preferred COX-2 inhibitors when the risk associated with NSAID and

> COX-2 inhibitors was 4% and 2%, respectively (ARR = 2%). In contrast,

> the majority (90%) preferred COX-2 inhibitors when the risk associated

> with NSAID and COX-2 inhibitors was 2% and 0%, respectively (ARR = 2%).

> We obtained similar findings regardless of the ARR.

>

> Conclusion. The willingness shown by older adults to pay for COX-2

> inhibitors may reflect a misperception of the risk of toxicity

> associated with these medications. (J Rheumatol 2004;31:591-3)

>

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> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org

>

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