Strengths and limitations
To ensure we received a diverse range of opinions regarding the language of Choosing Wisely recommendations, we did not restrict participants based on their age, sex, clinical experience, or area of speciality, and we recruited physical therapists from all over the world (30 countries). The Best-Worst-Scaling design allowed us to identify which characteristics of language were likely to have the most influence on physical therapists’ willingness to follow Choosing Wisely recommendations. Best-Worst-Scaling surveys have been shown to have distinct advantages over traditional choice experiments (e.g., discrete choice experimentsOur study has some limitations. Because demographics were assessed after the choice tasks, we do not have demographic data on the 228/443 participants (51.5%) who opened the link but did not complete the survey and thus, we cannot determine whether our sample is representative of the physical therapists who were initially willing to complete the survey. Another limitation is that we could only create 12 positively framed recommendations (out of 60) due to the wording of the initial recommendations. As a result, our findings may have underestimated or overestimated the benefit of positive framing.