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Puzzle: Surgery or Radiation

Several decades ago, the dominant therapies for lung cancer were radiation, which offered better short-term survival rates, and surgery, which offered better long-term rates. A thought experiment was conducted in which surgeons were randomly assigned to one of two groups and asked whether they would choose surgery. Group 1 was told: The one-month survival rate is 90%. Group 2 was told: There is 10% mortality in the first month. Yes, the two statements say the same thing. What did the two physician groups choose?

Several decades ago, the dominant therapies for lung cancer were radiation, which offered better short-term survival rates, and surgery, which offered better long-term rates. A thought experiment was conducted in which surgeons were randomly assigned to one of two groups and asked whether they would choose surgery.

  • Group 1 was told: The one-month survival rate is 90%.
  • Group 2 was told: There is 10% mortality in the first month.

Yes, the two statements say the same thing. What did the two physician groups choose?

  • Group 1: opted overwhelmingly for surgery – 84% chose it.
  • Group 2: only 50% chose surgery.

This is an example of how the emotional framing of a problem governs what one chooses.

  • Group 1 saw the choice framed as “survival,” and this positive framing dominated the decision.
  • Group 2 saw the choice framed as “mortality,” a negative framing that dominated the decision.

This experiment was conducted by Amos Tversky, the noted Israeli expert in cognition and bias, and was recounted in Thinking Fast and Slow, the book by Tversky’s colleague, Daniel Kahneman.