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Communication of Uncertainty Regarding Individualized Cancer Risk Estimates

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  • Paul K. J. Han
  • William M. P. Klein
  • Tom Lehman
  • Bill Killam
  • Holly Massett
  • Andrew N. Freedman

Abstract

Objective . To examine the effects of communicating uncertainty regarding individualized colorectal cancer risk estimates and to identify factors that influence these effects. Methods . Two Web-based experiments were conducted, in which adults aged 40 years and older were provided with hypothetical individualized colorectal cancer risk estimates differing in the extent and representation of expressed uncertainty. The uncertainty consisted of imprecision (otherwise known as “ambiguity†) of the risk estimates and was communicated using different representations of confidence intervals. Experiment 1 ( n = 240) tested the effects of ambiguity (confidence interval v. point estimate) and representational format (textual v. visual) on cancer risk perceptions and worry. Potential effect modifiers, including personality type (optimism), numeracy, and the information’s perceived credibility, were examined, along with the influence of communicating uncertainty on responses to comparative risk information. Experiment 2 ( n = 135) tested enhanced representations of ambiguity that incorporated supplemental textual and visual depictions. Results . Communicating uncertainty led to heightened cancer-related worry in participants, exemplifying the phenomenon of “ambiguity aversion.†This effect was moderated by representational format and dispositional optimism; textual (v. visual) format and low (v. high) optimism were associated with greater ambiguity aversion. However, when enhanced representations were used to communicate uncertainty, textual and visual formats showed similar effects. Both the communication of uncertainty and use of the visual format diminished the influence of comparative risk information on risk perceptions. Conclusions . The communication of uncertainty regarding cancer risk estimates has complex effects, which include heightening cancer-related worry—consistent with ambiguity aversion—and diminishing the influence of comparative risk information on risk perceptions. These responses are influenced by representational format and personality type, and the influence of format appears to be modifiable and content dependent.

Suggested Citation

  • Paul K. J. Han & William M. P. Klein & Tom Lehman & Bill Killam & Holly Massett & Andrew N. Freedman, 2011. "Communication of Uncertainty Regarding Individualized Cancer Risk Estimates," Medical Decision Making, , vol. 31(2), pages 354-366, March.
    • Handle: RePEc:sae:medema:v:31:y:2011:i:2:p:354-366
    DOI: 10.1177/0272989X10371830
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    1. Berger, Loïc & Bleichrodt, Han & Eeckhoudt, Louis, 2013. "Treatment decisions under ambiguity," Journal of Health Economics, Elsevier, vol. 32(3), pages 559-569.
    2. Dean, Marleah, 2016. "“It’s not if I get cancer, it’s when I get cancer”: BRCA-positive patients’ (un)certain health experiences regarding hereditary breast and ovarian cancer risk," Social Science & Medicine, Elsevier, vol. 163(C), pages 21-27.
    3. van der Bles, Anne Marthe & van der Liden, Sander & Freeman, Alessandra L. J. & Mitchell, James & Galvao, Ana Beatriz & Spiegelhalter, David J., 2019. "Communicating uncertainty about facts, numbers, and science," EMF Research Papers 22, Economic Modelling and Forecasting Group.
    4. Toshio Fujimi & Masahide Watanabe & Hirokazu Tatano, 2021. "Public trust, perceived accuracy, perceived likelihood, and concern on multi-model climate projections communicated with different formats," Mitigation and Adaptation Strategies for Global Change, Springer, vol. 26(5), pages 1-20, June.
    5. Jakob D. Jensen & Manusheela Pokharel & Courtney L. Scherr & Andy J. King & Natasha Brown & Christina Jones, 2017. "Communicating Uncertain Science to the Public: How Amount and Source of Uncertainty Impact Fatalism, Backlash, and Overload," Risk Analysis, John Wiley & Sons, vol. 37(1), pages 40-51, January.

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