PDF(Pubmed)
Abstract：
We hypothesized that people at the borderline of being labeled as \"prediabetic\" based on A1c blood test results, who initially face equivalent risks of developing diabetes but who are labeled differently, would be more likely to develop diabetes when labeled as \"prediabetic\" as a result of the label. Study 1 served to establish the psychological effect of the prediabetes label: we surveyed 260 participants on Amazon Mechanical Turk to test whether risk perception significantly increased when comparing A1c test results that differed by 0.1% and led to different diagnostic labels (5.6 and 5.7%) but did not significantly increase when comparing those that differed by 0.1% but received the same label (5.5%/5.6 and 5.7%/5.8%). Study 2 explored whether labels are associated with different rates of developing diabetes when the initial difference in A1c results suggests equivalent risk. Using data from 8,096 patients, we compared patients whose initial A1c results differed by 0.1% and found those who received results labeled as prediabetic (A1c of 5.7%) were significantly more likely to develop diabetes than patients whose initial results were labeled as normal (5.6%). In contrast, patients whose initial results differed by 0.1% but who received the same \"normal\" label (5.5 and 5.6%) were equally likely to develop diabetes. These preliminary results suggest that diagnostic labels may become self-fulfilling, especially when the underlying pathology of patients receiving different labels does not meaningfully differ.
摘要：
根据A1c血液检测结果，我们假设人们处于被标记为“糖尿病前期”的边缘，他们最初面临同等的患糖尿病风险，但被贴上不同的标签，当标记为“糖尿病前期”时，更有可能发展为糖尿病。研究1用于建立糖尿病前期标签的心理影响：我们对AmazonMechanicalTurk上的260名参与者进行了调查，以测试在比较A1c测试结果差异0.1％并导致不同的诊断标签（5.6和5.7％）时，风险感知是否显着增加，但在比较差异0.1％但接受相同标签（5.5％/5.6和5.7％/5.8％）时，风险感知没有显着增加。研究2探讨了当A1c结果的初始差异表明同等风险时，标签是否与不同的糖尿病发病率相关。使用8096名患者的数据，我们比较了初始A1c结果相差0.1%的患者,发现接受结果标记为糖尿病前期(A1c为5.7%)的患者比初始结果标记为正常(5.6%)的患者更容易患糖尿病.相比之下,初始结果相差0.1%,但接受相同"正常"标签(5.5%和5.6%)的患者同样可能发生糖尿病.这些初步结果表明，诊断标签可能会自我实现，特别是当接受不同标签的患者的潜在病理没有明显差异时。
