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Influencing Pain Inferences Using Random Numerical Anchoring: Randomized Controlled Trial.

ABSTRACT: BACKGROUND:Numerical anchoring occurs when exposure to a numeric quantity influences a person's subsequent judgment involving other quantities. This could be applicable to the evaluation of pain, where exposure to an unrelated number before the evaluation of pain could influence pain ratings. OBJECTIVE:This study aimed to determine whether exposure to a random numeric anchor influences subsequent pain intensity ratings of a hypothetical patient. METHODS:In this study, 385 participants read a vignette describing a patient with chronic pain before being randomly assigned to one of four groups. Groups 1 and 2 spun an 11-wedge number wheel (0-10), which was, unbeknown to the participants, programmed to stop on a high number (8) or a low number (2), respectively. Group 3 spun a similar letter wheel (A-K), which was programmed to stop on either the letter C or I (control 1). Group 4 did not spin a wheel (control 2). Participants were then asked to rate the patient's pain intensity using a 0 to 10 numeric rating scale. RESULTS:The high-number group rated the patient's pain (median 8, IQR 2) significantly higher than the letter wheel control (median 7, IQR 2; P=.02) and the low-number group (median 6, IQR 2; P<.001). The low-number group rated the pain significantly lower than controls 1 and 2 (median 7, IQR 2; both P=.045). CONCLUSIONS:Pain ratings were influenced by prior exposure to a random number with no relevant information about the patient's pain, indicating anchoring had occurred. However, contrary to the traditional definition of anchoring where anchoring occurs even when participants are unaware of the anchor's influence, in this study, the anchoring effect was seen only in participants who believed that the anchor had influenced them. This suggests that anchoring effects could potentially occur among health care providers tasked with evaluating a patient's pain and should be evaluated further.

SUBMITTER: Lewinson RE

PROVIDER: S-EPMC7091028 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Influencing Pain Inferences Using Random Numerical Anchoring: Randomized Controlled Trial.

Lewinson Rebecca Elizabeth RE Katz Joel D JD

JMIR human factors 20200309 1

<h4>Background</h4>Numerical anchoring occurs when exposure to a numeric quantity influences a person's subsequent judgment involving other quantities. This could be applicable to the evaluation of pain, where exposure to an unrelated number before the evaluation of pain could influence pain ratings.<h4>Objective</h4>This study aimed to determine whether exposure to a random numeric anchor influences subsequent pain intensity ratings of a hypothetical patient.<h4>Methods</h4>In this study, 385 p ...[more]

PMID: 32149719

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Project description:BackgroundChronic (ie, long-term) elevated stress is associated with a number of mental and physical health conditions. Mindfulness meditation mobile apps are a promising tool for stress self-management that can overcome several barriers associated with in-person interventions; however, to date, poor app-based intervention adherence has limited the efficacy of these mobile health tools. Anchoring, or pairing, a new behavior with an existing routine has been shown to effectively establish habits that are maintained over time, but this strategy typically only works for those with high initial motivation and has yet to be tested for maintaining meditation with a mobile app.ObjectiveThis study will test novel combinations of behavioral economics-based incentives with the anchoring strategy for establishing and maintaining adherence to an effective dose of meditation with a mobile app.MethodsThis 16-week study will use a 5-arm, parallel, partially blinded (participants only), randomized controlled design. We will implement a fractional factorial study design that varies the use of self-monitoring messages and financial incentives to support participants' use of their personalized anchoring strategy for maintaining adherence to a ≥10 minute-per-day meditation prescription during an 8-week intervention period, followed by an 8-week postintervention observation period. Specifically, we will vary the use of self-monitoring messages of either the target behavior (ie, meditation tracking) or the outcome associated with the target behavior (ie, mood symptom tracking). We will also vary the use of financial incentives conditional on either meditation at any time of day or meditation performed at approximately the same time of day as participants' personalized anchors.ResultsContinuous meditation app use data will be used to measure weekly meditation adherence over the 16-week study period as a binary variable equal to 1 if participants complete ≥10 minutes of meditation for ≥4 days per week and 0 otherwise. We will measure weekly anchoring plan adherence as a binary variable equal to 1 if participants complete ≥10 minutes of meditation within +1 or -1 hour of the timing of their chosen anchor on ≥4 days per week and 0 otherwise. In addition to these primary measures of meditation and anchoring plan adherence, we will also assess the secondary measures of stress, anxiety, posttraumatic stress disorder, sleep disturbance, and meditation app habit strength at baseline, week 8, and week 16.ConclusionsThis study will fill an important gap in the mobile health literature by testing novel intervention approaches for establishing and maintaining adherence to app-based mindfulness meditation. If successful, this study will identify an accessible and scalable stress self-management intervention that can help combat stress in the United States.Trial registrationClinicalTrials.gov NCT05217602; https://clinicaltrials.gov/ct2/show/NCT05217602.International registered report identifier (irrid)DERR1-10.2196/39930.

Dataset Information

Influencing Pain Inferences Using Random Numerical Anchoring: Randomized Controlled Trial.

Publications

Influencing Pain Inferences Using Random Numerical Anchoring: Randomized Controlled Trial.

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