Strengths and limitations
PRESSURE AREA
Methodological rigor was the guiding principle of this study, which improved on a previous onebasing patient vignettes on real patients;varying all seven STARWAVe factors systematically;testing the effects of two new risk-elicitation methods;ensuring a comprehensive and clinically plausible set of options for patient management; andtesting the effect of a non-clinical factor (parental concern).More broadly, the present study used a robust experimental approach that is under-represented in this area of research and predefined the hypotheses, procedure, and analyses in an approved protocol.Despite the authors’ attempts to improve ecological validity, patients appeared ‘on paper’ rather than in person. The authors therefore appreciate that some of the findings may fail to translate to clinical practice, where situational variables such as time pressure are known to play a role.The authors are also aware that analyses limited to the category-selection group (