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Visual representation of statistical information improves diagnostic inferences in doctors and their patients

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  • Garcia-Retamero, Rocio
  • Hoffrage, Ulrich

Abstract

Doctors and patients have difficulty inferring the predictive value of a medical test from information about the prevalence of a disease and the sensitivity and false-positive rate of the test. Previous research has established that communicating such information in a format the human mind is adapted to—namely natural frequencies—as compared to probabilities, boosts accuracy of diagnostic inferences. In a study, we investigated to what extent these inferences can be improved—beyond the effect of natural frequencies—by providing visual aids. Participants were 81 doctors and 81 patients who made diagnostic inferences about three medical tests on the basis of information about prevalence of a disease, and the sensitivity and false-positive rate of the tests. Half of the participants received the information in natural frequencies, while the other half received the information in probabilities. Half of the participants only received numerical information, while the other half additionally received a visual aid representing the numerical information. In addition, participants completed a numeracy scale. Our study showed three important findings: (1) doctors and patients made more accurate inferences when information was communicated in natural frequencies as compared to probabilities; (2) visual aids boosted accuracy even when the information was provided in natural frequencies; and (3) doctors were more accurate in their diagnostic inferences than patients, though differences in accuracy disappeared when differences in numerical skills were controlled for. Our findings have important implications for medical practice as they suggest suitable ways to communicate quantitative medical data.

Suggested Citation

  • Garcia-Retamero, Rocio & Hoffrage, Ulrich, 2013. "Visual representation of statistical information improves diagnostic inferences in doctors and their patients," Social Science & Medicine, Elsevier, vol. 83(C), pages 27-33.
    • Handle: RePEc:eee:socmed:v:83:y:2013:i:c:p:27-33
    DOI: 10.1016/j.socscimed.2013.01.034
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    1. Carmen Keller & Michael Siegrist, 2009. "Effect of Risk Communication Formats on Risk Perception Depending on Numeracy," Medical Decision Making, , vol. 29(4), pages 483-490, July.
    2. Rocio Garcia-Retamero & Mirta Galesic & Gerd Gigerenzer, 2010. "Do Icon Arrays Help Reduce Denominator Neglect?," Medical Decision Making, , vol. 30(6), pages 672-684, November.
    3. Judith Covey, 2007. "A Meta-analysis of the Effects of Presenting Treatment Benefits in Different Formats," Medical Decision Making, , vol. 27(5), pages 638-654, September.
    4. Garcia-Retamero, R. & Galesic, M., 2009. "Communicating treatment risk reduction to people with low numeracy skills: A cross-cultural comparison," American Journal of Public Health, American Public Health Association, vol. 99(12), pages 2196-2202.
    5. repec:cup:judgdm:v:4:y:2009:i:1:p:34-40 is not listed on IDEAS
    6. Stone, Eric R. & Sieck, Winston R. & Bull, Benita E. & Frank Yates, J. & Parks, Stephanie C. & Rush, Carolyn J., 2003. "Foreground:background salience: Explaining the effects of graphical displays on risk avoidance," Organizational Behavior and Human Decision Processes, Elsevier, vol. 90(1), pages 19-36, January.
    7. Jessica S. Ancker & Elke U. Weber & Rita Kukafka, 2011. "Effect of Arrangement of Stick Figures on Estimates of Proportion in Risk Graphics," Medical Decision Making, , vol. 31(1), pages 143-150, January.
    8. Isaac M. Lipkus & Greg Samsa & Barbara K. Rimer, 2001. "General Performance on a Numeracy Scale among Highly Educated Samples," Medical Decision Making, , vol. 21(1), pages 37-44, February.
    9. Brian J. Zikmund-Fisher & Dylan M. Smith & Peter A. Ubel & Angela Fagerlin, 2007. "Validation of the Subjective Numeracy Scale: Effects of Low Numeracy on Comprehension of Risk Communications and Utility Elicitations," Medical Decision Making, , vol. 27(5), pages 663-671, September.
    10. Deb Feldman-Stewart & Michael D. Brundage & Vladimir Zotov, 2007. "Further Insight into the Perception of Quantitative Information: Judgments of Gist in Treatment Decisions," Medical Decision Making, , vol. 27(1), pages 34-43, January.
    11. Isaac M. Lipkus, 2007. "Numeric, Verbal, and Visual Formats of Conveying Health Risks: Suggested Best Practices and Future Recommendations," Medical Decision Making, , vol. 27(5), pages 696-713, September.
    12. Angela Fagerlin & Catharine Wang & Peter A. Ubel, 2005. "Reducing the Influence of Anecdotal Reasoning on People’s Health Care Decisions: Is a Picture Worth a Thousand Statistics?," Medical Decision Making, , vol. 25(4), pages 398-405, July.
    13. repec:cup:judgdm:v:7:y:2012:i:1:p:25-47 is not listed on IDEAS
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    Cited by:

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    2. James Alm & Lilith Burgstaller & Arrita Domi & Amanda März & Matthias Kasper, 2023. "Nudges, Boosts, and Sludge: Using New Behavioral Approaches to Improve Tax Compliance," Economies, MDPI, vol. 11(9), pages 1-22, September.
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    4. Jessica K. Witt, 2020. "The Precision-Bias Distinction for Evaluating Visual Decision Aids for Risk Perception," Medical Decision Making, , vol. 40(6), pages 846-853, August.
    5. Alaina N. Talboy & Sandra L. Schneider, 2018. "Improving Understanding of Diagnostic Test Outcomes," Medical Decision Making, , vol. 38(5), pages 573-583, July.
    6. Lyndal J. Trevena & Carissa Bonner & Yasmina Okan & Ellen Peters & Wolfgang Gaissmaier & Paul K. J. Han & Elissa Ozanne & Danielle Timmermans & Brian J. Zikmund-Fisher, 2021. "Current Challenges When Using Numbers in Patient Decision Aids: Advanced Concepts," Medical Decision Making, , vol. 41(7), pages 834-847, October.
    7. Michelle McDowell & Mirta Galesic & Gerd Gigerenzer, 2018. "Natural Frequencies Do Foster Public Understanding of Medical Tests: Comment on Pighin, Gonzalez, Savadori, and Girotto (2016)," Medical Decision Making, , vol. 38(3), pages 390-399, April.
    8. Aysegul Kanay & Denis Hilton & Laetitia Charalambides & Jean-Baptiste Corrégé & Eva Inaudi & Laurent Waroquier & Stéphane Cézéra, 2021. "Making the carbon basket count: Goal setting promotes sustainable consumption in a simulated online supermarket," Post-Print hal-03403040, HAL.
    9. Stefania Pighin & Michel Gonzalez & Lucia Savadori & Vittorio Girotto, 2016. "Natural Frequencies Do Not Foster Public Understanding of Medical Test Results," Medical Decision Making, , vol. 36(6), pages 686-691, August.
    10. Eric R. Stone & Wändi Bruine de Bruin & Abigail M. Wilkins & Emily M. Boker & Jacqueline MacDonald Gibson, 2017. "Designing Graphs to Communicate Risks: Understanding How the Choice of Graphical Format Influences Decision Making," Risk Analysis, John Wiley & Sons, vol. 37(4), pages 612-628, April.

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