- Design
- preregistered online experimental analogue study, 2x2 manipulation of warmth and competence
- Population
- 349 adults with moderate somatic symptom burden, mean age 29.9 years, 79% women
- Primary outcome
- rated likelihood of serious disease after a normal test result
- Effect
- high warmth and high competence each lowered perceived likelihood of serious disease and reduced desire for further testing
Three hundred and forty-nine people reporting moderate somatic symptom burden watched a videotaped consultation in which a doctor reported a normal diagnostic test. The words were identical every time. What varied was the doctor's manner: warmth high or low, competence high or low.
Participants who saw the warm, competent version rated the likelihood of serious disease as lower, and were less inclined to seek a second opinion or further testing. A mediation analysis suggested the mechanism runs through how much weight people placed on the diagnostic information itself - a warm and competent delivery made the normal result count for more.
This is an online analogue study in a young convenience sample, mean age 29.9 and 79% women, watching a video rather than sitting in a consultation. It cannot tell you the size of the effect in a real clinic. What it does establish, under controlled conditions where nothing else differed, is the direction: a normal result does not reassure on its own. Reassurance is one of the commonest things done in general practice and one of the least examined, and this says the manner is not decoration around the information - it is part of how the information is received.
- Say the result and then say what you conclude from it - patients do not infer the conclusion.
- Name the serious condition you have excluded, rather than only that the test was normal.
- Ask what the patient was worried about before giving the result; reassurance has to meet the fear.
- A request for repeat testing often signals reassurance that did not land, not disbelief in the test.
- Sending a normal result by message or portal removes the delivery entirely - follow up the ones that mattered.
Why it matters
It reframes the manner of delivering a normal result as part of the intervention rather than as bedside courtesy.
Don't overread it
An online video experiment in a young convenience sample - the direction is credible, the magnitude in real practice is not established.
The statistics, in plain English
An experimental analogue design is strong on internal validity and weak on external: because only the doctor's manner varied, the difference in what participants believed can be attributed to it with confidence. But a video watched by people with a mean age of 29.9 is not a consultation, and effect sizes measured this way routinely shrink in real practice.
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