When discussing risks and benefits with cancer patients, physicians could focus on losses such as mortality rates and cancer recurrence or, alternatively, gains such as survival rates and curing cancer. Previous research has shown that the way health information is framed influences individuals’ preferences and choices. We operationalized gain–loss framing as physicians’ choice of words related to gains (cancer survival), or losses (cancer mortality). In an exploratory analysis, we investigated (a) whether physicians used gain or loss words as a function of their recommendation, (b) whether physicians’ choice of words was associated with patients’ treatment choices. We analyzed transcribed consultations with male patients who had intermediate-risk prostate cancer. Using an iterative process of gathering and evaluating words, we created gain- and loss-dictionaries. The loss-dictionary included words related to cancer death and cancer progression. The gain-dictionary included words related to survival and cure. Using Linguistic Inquiry and Word Count software, we calculated the number of words related to gains and losses in each transcript. We found that physicians who recommended immediate cancer treatment for prostate cancer (vs. active surveillance) used slightly fewer words related to losses and significantly fewer words related specifically to death from cancer. Further analysis showed that loss words were associated with the patient’s choice of immediate cancer treatment. A novel method of automated text analysis showed that physicians’ use of loss words was correlated with physicians’ recommendations for cancer treatment versus active surveillance. Additionally, loss words in consultations were associated with patients’ choice of cancer treatment.

在与癌症患者讨论风险和收益时，医生可以专注于诸如死亡率和癌症复发之类的损失，或者诸如生存率和治愈癌症之类的收益。先前的研究表明，健康信息的构建方式会影响个人的偏好和选择。我们将损益定格化作为医生选择与获益（癌症生存期）或损失（癌症死亡率）相关的词语进行操作。在一项探索性分析中，我们调查了（a）医生是否根据自己的建议使用了增减词，（b）医师的词语选择是否与患者的治疗选择相关。我们分析了患有中危前列腺癌的男性患者的转录咨询。通过收集和评估单词的迭代过程，我们创建了收益和损失字典。损失字典包括与癌症死亡和癌症进展有关的词。增益字典包括与生存和治愈有关的词。使用语言查询和单词计数软件，我们计算了每个成绩单中与得失相关的单词数。我们发现，建议立即对前列腺癌进行癌症治疗（相对于主动监测）的医生使用的与遗失有关的词要少一些，而与癌症死亡相关的用词要少得多。进一步的分析表明，失语与患者选择立即癌症治疗有关。一种新颖的自动文本分析方法表明，医师对遗失词的使用与医师对癌症治疗和主动监测的建议相关。另外，