Hypothetical questions are a frequent tool of market researchers, lawyers and pollsters as a way of exploring individuals’ opinions about potential situations.

For example would you vote for candidate A if he or she was the parent of an illegitimate child? Such hypothetical questions can give an insight into motivation and attitudes. However it is assumed that since they are hypothetical they have little impact upon how an individual would actually vote for example.

But academics warn that such hypothetical questions can have more of an impact than we actually realise.

“What seems innocuous can have insidious effects on an individual,” says Baba Shive, a professor of marketing at the Stanford Graduate School of Business.

With colleague Gavan Fitzsimons, a professor of marketing and psychology at Duke University and colleagues from the University of Alberta School of Business and the University of Southern California, Prof Shiv says that such hypothetical questions can influence opinion and affect behaviour.

The researchers have discovered that while in general circumstances an individual will be unaffected by the stereotypes that he or she carries around, if the stereotype comes to the top of an individual’s mind it will have an impact on subsequent behaviour.

To prove their theory the researchers asked some prospective jurors whether, hypothetically speaking they would be influenced in their impartiality if they discovered that the defendant was a gang member. Even though the academics stressed that this was a hypothetical question, nevertheless they found that - on paper - the prospective jurors tended to deliver more guilty verdicts and to press for harsher sentences.

“Even if you alert people that this situation is hypothetical, they don’t latch on to that. They simply focus on the content and not the context,” says Prof Shiv.

Prof Shiv stresses that because such behaviour is subconscious it is very insidious. The academics advise individuals to be cautious when in a situation involving hypothetical questions.

“Whether we know it or not, we’re being influenced by innocuous looking tactics,” says Prof Shiv.

● As resistance to antibiotics grows, doctors are being urged to limit their use, According to the World Health Organisation the problem is particularly acute in China and earlier this year it said that “Irrational and inappropriate use of antimicrobials is a major driver of antimicrobial resistance in China”.

Now research by a trio of academics has discovered that if patients appear to be more knowledgeable about antibiotics their doctor is less likely to prescribe them.

Wei Zhang, a professor of management at Ceibs in Shanghai, Janet Currie a professor of economics at Princeton University and Wanchuan Lin Eso, an associate professor of economics at Guanghua School of Management, Peking University sent patients to doctors with a variety of flu-like symptoms. However, whilst patient A was very knowledgeable about the type of antibiotics that might be necessary, patient B limited himself to a description of his illness.

The academics found that patient B was much more likely to be prescribed antibiotics than patient A which in turn meant a corresponding saving in drug expenditure. However the authors of the paper also said that patient A’s knowledge had a negative impact on doctor-patient relations as a result.

“Our results suggest that antibiotic abuse in China is not driven by patients actively demanding antibiotics, but is largely a supply-side phenomenon,” they said.

The article Patient knowledge and antibiotic abuse: evidence from an audit study in China, is published in the Journal of Health Economics.

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