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The 1-in-X Effect on the Subjective Assessment of Medical Probabilities

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Listed:
  • Stefania Pighin
  • Lucia Savadori
  • Elisa Barilli
  • Laura Cremonesi
  • Maurizio Ferrari
  • Jean-François Bonnefon

Abstract

Among numerical formats available to express probability, ratios are extensively used in risk communication, perhaps because of the health professional’s intuitive sense of their clarity and simplicity. Moreover, health professionals, in the attempt to make the data more meaningful, tend to prefer proportions with a numerator of 1 and shifting denominators (e.g., 1 in 200) rather than equivalent rates of disease per unit of population exposed to the threat (e.g., 5 in 1000). However, in a series of 7 experiments, it is shown that individual subjective assessments of the same probability presented through proportions rather than rates vary significantly. A 1-in- X format (e.g., 1 in 200) is subjectively perceived as bigger and more alarming than an N -in- X * N format (e.g., 5 in 1000). The 1-in- X effect generalizes to different populations, probabilities, and medical conditions. Further-more, the effect is not attenuated by a communicative intervention (verbal analogy), but it disappears with an icon array visual aid.

Suggested Citation

  • Stefania Pighin & Lucia Savadori & Elisa Barilli & Laura Cremonesi & Maurizio Ferrari & Jean-François Bonnefon, 2011. "The 1-in-X Effect on the Subjective Assessment of Medical Probabilities," Medical Decision Making, , vol. 31(5), pages 721-729, September.
  • Handle: RePEc:sae:medema:v:31:y:2011:i:5:p:721-729
    DOI: 10.1177/0272989X11403490
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    References listed on IDEAS

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    1. Cass R. Sunstein & Richard H. Thaler, 2003. "Libertarian paternalism is not an oxymoron," Conference Series ; [Proceedings], Federal Reserve Bank of Boston, vol. 48(Jun).
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    3. Garcia-Retamero, Rocio & Galesic, Mirta, 2010. "Who proficts from visual aids: Overcoming challenges in people's understanding of risks," Social Science & Medicine, Elsevier, vol. 70(7), pages 1019-1025, April.
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    Cited by:

    1. Suk, Kwanho & Hwang, Sanyoung & Jeong, Yunjoo, 2022. "The 1-in-X effect in perceptions of risk likelihood differences," Organizational Behavior and Human Decision Processes, Elsevier, vol. 170(C).
    2. Miroslav Sirota & Marie Juanchich, 2019. "Ratio Format Shapes Health Decisions: The Practical Significance of the “1-in-X†Effect," Medical Decision Making, , vol. 39(1), pages 32-40, January.
    3. Stefania Pighin & Lucia Savadori & Elisa Barilli & Rino Rumiati & Sara Bonalumi & Maurizio Ferrari & Laura Cremonesi, 2013. "Using Comparison Scenarios to Improve Prenatal Risk Communication," Medical Decision Making, , vol. 33(1), pages 48-58, January.
    4. Brian J. Zikmund-Fisher, 2011. "Time to Retire the 1-in-X Risk Format," Medical Decision Making, , vol. 31(5), pages 703-704, September.
    5. Miroslav Sirota & Marie Juanchich & Olga Kostopoulou & Robert Hanak, 2014. "Decisive Evidence on a Smaller-Than-You-Think Phenomenon," Medical Decision Making, , vol. 34(4), pages 419-429, May.
    6. Jurriaan P. Oudhoff & Daniëlle R. M. Timmermans, 2015. "The Effect of Different Graphical and Numerical Likelihood Formats on Perception of Likelihood and Choice," Medical Decision Making, , vol. 35(4), pages 487-500, May.
    7. Miroslav Sirota & Marie Juanchich & Dafina Petrova & Rocio Garcia-Retamero & Lukasz Walasek & Sudeep Bhatia, 2018. "Health Professionals Prefer to Communicate Risk-Related Numerical Information Using “1-in-X†Ratios," Medical Decision Making, , vol. 38(3), pages 366-376, April.
    8. Brian J. Zikmund-Fisher, 2014. "Continued Use of 1-in-X Risk Communications Is a Systemic Problem," Medical Decision Making, , vol. 34(4), pages 412-413, May.

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