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Doctors and Numbers

Author

Listed:
  • Tanner J. Caverly
  • Allan V. Prochazka
  • Brandon P. Combs
  • Brian P. Lucas
  • Shane R. Mueller
  • Jean S. Kutner
  • Ingrid Binswanger
  • Angela Fagerlin
  • Jacqueline McCormick
  • Shirley Pfister
  • Daniel D. Matlock

Abstract

Background . Risk interpretation affects decision making. Yet, there is no valid assessment of how clinicians interpret the risk data that they commonly encounter. Objective . To establish the reliability and validity of a 20-item test of clinicians’ risk interpretation. Methods . The Critical Risk Interpretation Test (CRIT) measures clinicians’ abilities to 1) modify the interpretation based on meaningful differences in the outcome (e.g., disease specific v. all-cause mortality) and time period (e.g., lifetime v. 10-year mortality), 2) maintain a stable interpretation for different risk framings (e.g., relative v. absolute risk), and 3) correctly interpret how diagnostic testing modifies risk. There were 658 clinicians and medical trainees who participated: 116 nurse practitioners (NPs) at a national conference, 273 medical students at 1 institution, 148 residents in internal medicine at 2 institutions, and 121 internists at 1 institution. Participants completed a self-administered paper test during educational conferences. Seventeen evidence-based medicine experts took the test online and formally assessed content validity. Eighteen second-year medical students were recruited to take the test and a retest 3 weeks later to explore test-retest correlation. Results . Expert review supported test clarity and content validity. Factor analysis supported that the CRIT identifies at least 3 separable areas of clinician knowledge. Test-retest correlation was fair (intraclass correlation coefficient = 0.65; standard error = 0.15). Scores on our test correlated with other tests of related abilities. Mean test scores varied among groups, with differences in prior evidence-based medicine training and experience (93 for NPs, 101 for medical students, 101 for residents, 103 for academic internists, and 110 for physician experts; P

Suggested Citation

  • Tanner J. Caverly & Allan V. Prochazka & Brandon P. Combs & Brian P. Lucas & Shane R. Mueller & Jean S. Kutner & Ingrid Binswanger & Angela Fagerlin & Jacqueline McCormick & Shirley Pfister & Daniel D, 2015. "Doctors and Numbers," Medical Decision Making, , vol. 35(4), pages 512-524, May.
    • Handle: RePEc:sae:medema:v:35:y:2015:i:4:p:512-524
    DOI: 10.1177/0272989X14558423
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    References listed on IDEAS

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    1. Edward T. Cokely & Mirta Galesic & Eric Schulz & Saima Ghazal & Rocio Garcia-Retamero, 2012. "Measuring risk literacy: The Berlin Numeracy Test," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 7(1), pages 25-47, January.
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