Effects of Patient Portal Message Framing on Treatment Preferences and Expectations for Degenerative Meniscus Tears: Randomized Exploratory Cross-Sectional Survey Study.

Authors

• Muzamil Ahmad, Oakland University William Beaumont School of Medicine Medical Student
• Annabella Jensen, Oakland University William Beaumont School of Medicine Medical Student
• Isabella Strickler, Oakland University William Beaumont School of Medicine Medical Student
• Ramon Arza, Corewell Health East Resident
• Matthew D. Ramey, Oakland University William Beaumont School of Medicine Medical Student
• Conor Dolson, Corewell Health East Resident
• Jeremy Policht, Corewell Health East Resident
• Yzen Al-Marrawi, Oakland University William Beaumont School of Medicine Medical Student
• Leonardo Cavinatto, Corewell Health East

Document Type

Article

Publication Date

5-12-2026

Publication Title

JMIR formative research

Abstract

BACKGROUND: Degenerative meniscus tears are common in middle-aged and older adults, and current guidelines favor nonoperative care. As patients increasingly turn to portal systems to view imaging results and communicate with their physicians, patient-facing wording may shape downstream treatment preferences and expectations.

OBJECTIVE: This study aimed to determine whether subtle differences in physician message framing about an identical degenerative meniscus tear influence preferred management, expectations for improvement with conservative therapy, and satisfaction when a physician recommends a different plan.

METHODS: A cross-sectional 37-question survey was developed de novo and distributed in January 2026 to lay adults in the United States (≥18 years) recruited via Amazon Mechanical Turk. Respondents were presented with a standardized vignette of an adult aged 60 years with knee pain due to a degenerative meniscus tear. Participants were randomized in a 1:1:1 fashion into 3 physician portal message framing groups: neutral, degenerative, and damage. Outcomes were the preferred next step in treatment, expected improvement with physical therapy, and retained satisfaction under physician-respondent disagreement. Chi-square and Fisher exact tests were used to compare categorical variables. Multivariable logistic regression analyses were used to assess associations between framing groups.

RESULTS: Of the 266 completed responses, 195 (73.3%) were included for analysis (neutral: n=67, 34.4%; degenerative: n=63, 32.3%; damage: n=65, 33.3%). Treatment preferences differed significantly across groups (χ

CONCLUSIONS: In this exploratory investigation, subtle differences in physician portal message framing regarding a magnetic resonance imaging impression of a degenerative meniscus tear were associated with shifts in treatment preferences and confidence in conservative care. These findings suggest that brief physician portal communications may be associated with shifts in hypothetical patient expectations and treatment preferences before clinical counseling occurs.

Volume

10

First Page

e92583

Recommended Citation

Ahmad M, Jensen A, Strickler I, Arza R, Ramey MD, Dolson C, et al [Policht J, Cavinatto L] Effects of patient portal message framing on treatment preferences and expectations for degenerative meniscus tears: randomized exploratory cross-sectional survey study. JMIR Form Res. 2026 May 12;10:e92583. doi: 10.2196/92583. PMID: 42118578.

DOI

10.2196/92583

ISSN

2561-326X

PubMed ID

42118578