ASSESSING QUALITY IN HIGH-UNCERTAINTY MARKETS: ONLINE REVIEWS OF CREDENCE SERVICES

In economics of information theory, credence products are those whose quality is difficult or impossible for consumers to assess, even after they have consumed the product (Darby & Karni, 1973). This dissertation is focused on the content, consumer perception, and power of online reviews for credence services. Economics of information theory has long assumed, without empirical confirmation, that consumers will discount the credibility of claims about credence quality attributes. The same theories predict that because credence services are by definition obscure to the consumer, reviews of credence services are incapable of signaling quality. Our research aims to question these assumptions. In the first essay we examine how the content and structure of online reviews of credence services systematically differ from the content and structure of reviews of experience services and how consumers judge these differences. We have found that online reviews of credence services have either less important or less credible content than reviews of experience services and that consumers do discount the credibility of credence claims. However, while consumers rationally discount the credibility of simple credence claims in a review, more complex argument structure and the inclusion of evidence attenuate this effect. In the second essay we ask, “Can online reviews predict the worst doctors?” We examine the power of online reviews to detect low quality, as measured by state medical board sanctions. We find that online reviews are somewhat predictive of a doctor’s suitability to practice medicine; however, not all the data are useful. Numerical or star ratings provide the strongest quality signal; user-submitted text provides some signal but is subsumed almost completely by ratings. Of the ratings variables in our dataset, we find that punctuality, rather than knowledge, is the strongest predictor of medical board sanctions. These results challenge the definition of credence products, which is a long-standing construct in economics of information theory. Our results also have implications for online review users, review platforms, and for the use of predictive modeling in the context of information systems research.

The Relation between Substance Use and Medication Adherence among HIV Positive Substance Users in Residential Treatment

Poor medication adherence is problematic among HIV positive, low-income African-American substance users. Substance use has been shown to be associated with poor medication adherence, though we do not know the mechanism that underlies this relationship. Lack of positive environmental rewards and the propensity to discount delayed rewards may be possible mechanisms to explain this relationship. Using baseline data from a randomized controlled trial, we examined the relationships between substance use and medication adherence, testing both environmental rewards and delay discounting as independent mediators. There was a main effect of substance use on adherence, such that high frequency of substance use predicted poor adherence. There was also a main effect of environmental rewards on adherence, such that a lack of environmental reinforcement predicted poor adherence. This study shed light on the processes that contribute to low adherence, namely substance use and lack of environmental contingencies, and suggests important targets for intervention.