June 12 (UPI) -- A new study by the University of Michigan found that risk, benefit and cost are the main reasons why people put off having diagnostic testing done.
Researchers used Amazon Mechanical Turk to crowd source 1,000 survey participants age 18 and older who met Amazon's vetting requirements to participate in the survey. Each participant was paid $1 to participate.
"We try, in the health care community, to recommend things that are helpful," Dr. William Meurer, an associate professor of emergency medicine and neurology at Michigan Medicine and a member of the Michigan Center for Integrative Research in Critical Care, said in a press release. "But for defensive diagnostic testing, it can be somewhat of a gray area."
Researchers obtained demographic information on participants including age, gender and medical history. Participants were asked to imagine themselves in two hypothetical scenarios for diagnostic testing: low-risk chest pain and minor traumatic brain injury.
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They were then given three variables of benefit, risk and cost, and values for all three scenarios.
"We defined the benefit as the chance that the patient had a true-positive finding. The risk was defined as the chance of developing cancer within the next 10 years due to the radiation. And the cost was an additional out-of-pocket expense for the test," Meurer said.
Researchers found that when the risk from a diagnostic test increased significantly, participants who accepted the test decreased from 52.5 percent to 28.5 percent. When the benefit from a diagnostic test increased significantly, participants who accepted the test increased from 28.4 percent to 53.1 percent.
When the cost increased from $0 to $1,000, participants agreeing to the test decreased from 61.1 percent to 21.4 percent, making cost the most significant decision-making factor.
"We found that participants were more apt to get the diagnostic test if it was at a lesser cost," said Meurer. "It proved to us that people are potentially sensitive to getting an additional bill for diagnostic testing."
"In addition, if participants saw their chance of getting a disease was incredibly rare, they felt the sense that 'I might not have this disease, so I'm not willing to spend extra on it because there's not as much risk. When the risk exceeded the benefit, the number of participants interested went down at a remarkable rate."
The study was published in the June edition of the Academic Emergency Medicine journal.
