DOCSLIB.ORG

Effect of Different Visual Presentations on the Comprehension of Prognostic

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Effect of Different Visual Presentations on the Comprehension of Prognostic Abukmail et al. BMC Med Inform Decis Mak (2021) 21:249 https://doi.org/10.1186/s12911-021-01612-9 RESEARCH Open Access Efect of diferent visual presentations on the comprehension of prognostic information: a systematic review Eman Abukmail*, Mina Bakhit, Chris Del Mar and Tammy Hofmann Abstract Background: Understanding prognostic information can help patients know what may happen to their health over time and make informed decisions. However, communicating prognostic information well can be challenging. Purpose: To conduct a systematic review to identify and synthesize research that has evaluated visual presentations that communicate quantitative prognostic information to patients or the public. Data sources: MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC and the Cochrane Central Register of Controlled Trials (CENTRAL) (from inception to December 2020), and forward and backward citation search. Study selection: Two authors independently screened search results and assessed eligibility. To be eligible, studies required a quantitative design and comparison of at least one visual presentation with another presentation of quan- titative prognostic information. The primary outcome was comprehension of the presented information. Secondary outcomes were preferences for or satisfaction with the presentations viewed, and behavioral intentions. Data extraction: Two authors independently assessed risk of bias and extracted data. Data synthesis: Eleven studies (all randomized trials) were identifed. We grouped studies according to the presenta- tion type evaluated. Bar graph versus pictograph (3 studies): no diference in comprehension between the groups. Survival vs mortality curves (2 studies): no diference in one study; higher comprehension in survival curve group in another study. Tabular format versus pictograph (4 studies): 2 studies reported similar comprehension between groups; 2 found higher comprehension in pictograph groups. Tabular versus free text (3 studies): 2 studies found no diference between groups; 1 found higher comprehension in a tabular group. Limitations: Heterogeneity in the visual presentations and outcome measures, precluding meta-analysis. Conclusions: No visual presentation appears to be consistently superior to communicate quantitative prognostic information. Keywords: Prognosis, Natural history, Health communication, Decision support techniques Introduction Shared decision making is a bidirectional communica- tion process in which clinicians and patients collaborate on making a health decision and discuss the available options (based on the best available evidence), the ben- *Correspondence: [email protected] efts and harms of each option, and the patient’s values, Faculty of Health Sciences and Medicine, Institute for Evidence-Based preferences, and circumstances [1, 2]. As part of making Healthcare, Bond University, 14 University Dr, Robina, QLD 4229, Australia © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/. The Creative Commons Public Domain Dedication waiver (http:// creat iveco mmons. org/ publi cdoma in/ zero/1. 0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Abukmail et al. BMC Med Inform Decis Mak (2021) 21:249 Page 2 of 10 decisions about the prevention or management of a Eligibility criteria health condition, patients need to know about more than Study types and participants just treatment options; they also need to know about the We included only studies with a quantitative design prognosis of the condition, with and without treatment. that looked at the prognosis of any health condition Communication of prognostic information is essential (real condition, hypothetical scenario, or fctitious as it helps patients to know what may happen to their condition). Te only participation restriction was the health over time, to make appropriate preparations, and exclusion of health professionals or health professional to make informed decisions about whether to intervene students. Studies of mixed populations (e.g. health and if so, how. If prognostic information is not communi- professionals and patients) were eligible if data were cated adequately, patients may have inaccurate expecta- reported separately for the eligible group. Tere was no tions about the likely course of their illness [3–5]. Poor limitation on study setting or publication language. communication of prognostic information can also make patients anxious, confused, and damage the relationship Interventions between clinician and patient [6, 7]. Studies were eligible if they compared a visual presen- Prognosis communication can be complex and chal- tation (e.g. a graph, words and numbers displayed in lenging for clinicians and patients. Clinicians sometimes tabular format) with at least one another type of pres- try to avoid or delay this kind of communication, while entation (e.g. another type of graph, or free text) to dis- patients often wait for their clinicians to initiate the pro- play quantitative prognostic information and included cess [8]. As with the communication of treatment infor- a specifed time frame (e.g. over the next 5 years) or mation, a contributor to the challenge of communicating time point (e.g. at 1 year). Prognostic information was prognostic information well is the difculty that clini- defned as information about the likelihood of any cians and patients can have understanding relevant quan- future outcome in patients with a given health condi- titative information [9–11]. tion including those who received no treatment (natu- To facilitate discussion about prognosis, clinicians may ral history) or those who did. use visual means (such as a graph) to present the quan- titative information. Although there is a large body of Outcomes synthesized evidence on how to communicate the quan- Our primary outcome was comprehension of the pre- titative benefts and harms of treatments, we are unaware sented information that was assessed using questions of any synthesis about the various visual presentations that required a quantitative answer (e.g. likelihood or that can be used to communicate quantitative prognostic duration of the outcome). For this reason, only some information. of the questions asked were eligible. Studies/data that assessed comprehension with questions requiring qual- Methods itative responses were ineligible. Secondary outcomes included: preferences for any of the presentations eval- Te protocol of this systematic review is registered at uated; satisfaction with the presentation; and behav- (CRD42020192564) and can be found in the Open Sci- ioral intentions relevant to the information presented ence Framework osf.io/ze26g. (e.g. intention to be screened). Objective Study selection Tis systematic review aimed to identify and synthesize Two authors (EA and MB) independently screened the research that has evaluated visual presentations that titles and abstracts, and then the full text of potentially communicate quantitative prognostic information to included studies. Discrepancies were resolved through patients or the public. consultation with the other two senior authors (CDM and TH). Information sources Data extraction and risk of bias assessment We searched for studies in six databases: MEDLINE, Data were extracted into a custom-designed spread- EMBASE, CINAHL, ERIC, PsycINFO, and the Cochrane sheet. Te studies’ characteristics (e.g., study settings, Central Register of Controlled Trials (CENTRAL), each sampling methods, study design) and participants’ from date of inception till December 2020. We used a tai- characteristics (e.g., age, sex, educational level, health lored search strategy for each database (see Additional literacy level, numeracy level, and the health condi- fle 1). Forward and backward citation analysis of the tion studied). Intervention details (including type of included studies was performed using Web of Science. Abukmail et al. BMC Med Inform Decis Mak (2021) 21:249 Page 3 of 10 presentation (e.g., bar graph), the presented informa- Results tion, who delivered the information, how, where and Study selection when the information was delivered), outcome details Our search identifed 5648 articles across the databases (including the eligible outcomes, how they were meas- and 614 articles identifed through forward and back- ured and at what timepoints) and result details (includ- ward citation analysis of the included studies (6262 in ing number of responses analysed, follow up rate, total), 5133 remained after duplicates were removed. results of eligible studies) are tabulated in the Addi- After the full-text screening, we identifed 9 articles: in tional fle 1 and show the data extracted. Two authors 2 of these,
Load more

Recommended publications
  • How New Fact Boxes Are Explaining Medical Risk to Millions
    BMJ 2017;357:j2460 doi: 10.1136/bmj.j2460 (Published 2017 May 24) Page 1 of 3 Feature FEATURE How new fact boxes are explaining medical risk to millions Smart ªfact boxesº that communicate evidence based information on the benefits and harms of drugs and health screening are being rolled out to millions of people in Europe. Gerd Gigerenzer and Kai Kolpatzik report Gerd Gigerenzer director 1, Kai Kolpatzik head 2 1Harding Center for Risk Literacy and Center for Adaptive Behavior and Cognition, Max Planck Institute for Human Development, Berlin, Germany; 2Department of Prevention, General Local Health Insurance Fund (AOK-Bundesverband), Berlin, Germany; Correspondence to: G Gigerenzer [email protected] An alien investigating healthcare on Earth would be quite ultrasonography or the blood test, and it gives the full reference puzzled. We spend billions on clinical studies but fail to ensure for the study. It also makes clear that the death rate was that patients and physicians are communicated the results measured after 12 to 13 years. 1 transparently. Instead they get persuasion, marketing, and, in The bottom section of the box presents information about harms, 2 3 some countries, misleading direct-to-consumer advertising. again beginning with a summary line. It shows that out of every One tool to bridge this gap is the fact box. Originally designed 100 women with a suspicious result, only six had ovarian cancer, for medication, it was introduced and tested by US researchers while 94 were falsely alarmed. Of these healthy women, 31 Lisa Schwartz and Steve Woloshin from Dartmouth College.
    [Show full text]
  • Breast Cancer Screening in 2018: Time for Shared Decision Making
    Supplementary Online Content Keating NL, Pace LE. Breast cancer screening in 2018: time for shared decision making. JAMA. doi:10.1001/jama.2018.3388 eBox. Selected Tools to Facilitate Shared Decisions About Breast Cancer Screening eReferences. Sources From Which Estimates for Mammogram Benefits and Harms Were Based (in-print Table) This supplementary material has been provided by the authors to give readers additional information about their work. © 2018 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/30/2021 eBox. Selected Tools to Facilitate Shared Decisions about Breast Cancer Screening Women of All Ages Healthdecision.org/University of Wisconsin Decision Tool Detailed tool that allows risk calculation for an individual patient that includes breast density, and shows estimates of benefits and harms for no, biennial, or annual mammograms. https://www.healthdecision.org/tool.html#/tool/mammo Harding Center for Risk Literacy Fact Box: Early Detection of Breast Cancer by Mammography Screening See link to download a brief mammography fact box summarizing benefits and harms of screening for women aged ≥50 years. https://www.harding-center.mpg.de/en/fact-boxes/early-detection-of- cancer/breast-cancer-early-detection Women Aged 40-49 Years Australian Decision Aid for Women Aged 40 Thinking about Starting Mammography Screening Includes link to personal worksheet to summarize risk factors (though without numeric risk estimates) and assess preferences. In randomized controlled trial, decision aid increased knowledge and reduced indecision about starting mammography screening, with fewer starting, without increasing anxiety.1 http://www.mammogram.med.usyd.edu.au/ Weill Cornell Medical College Breast Cancer Screening Decisions: A Mammogram Decision Aid for Women ages 40-49 Provides risk assessment and discussion of benefits and harms (although numbers for benefits/harms do not include overdiagnosis), has opportunity to express preferences and values.
    [Show full text]
  • Critical Appraisal of Meta-Analyses: an Introductory Guide for the Practicing Surgeon Nathan Lawrentschuk1,4, Jonathan Mccall2,4 and Ulrich Güller*3
    Patient Safety in Surgery BioMed Central Review Open Access Critical appraisal of meta-analyses: an introductory guide for the practicing surgeon Nathan Lawrentschuk1,4, Jonathan McCall2,4 and Ulrich Güller*3 Address: 1Department of Urology, University of Toronto, University Health Network, Toronto, Canada, 2DCRI Communications Group, Duke Clinical Research Institute, Durham, NC, USA, 3European Board Certified Colo-Proctology (EBSQ), Department of Surgery, Division of Visceral Surgery and Transplantation, Inselspital, University of Bern, CH-3010 Bern, Switzerland and 4Department of Surgery, University of Toronto, Toronto, Canada Email: Nathan Lawrentschuk - [email protected]; Jonathan McCall - [email protected]; Ulrich Güller* - [email protected] * Corresponding author Published: 22 July 2009 Received: 12 May 2009 Accepted: 22 July 2009 Patient Safety in Surgery 2009, 3:16 doi:10.1186/1754-9493-3-16 This article is available from: http://www.pssjournal.com/content/3/1/16 © 2009 Lawrentschuk et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Meta-analyses are an essential tool of clinical research. Meta-analyses of individual randomized controlled trials frequently constitute the highest possible level of scientific evidence for a given research question and allow surgeons to rapidly gain a comprehensive understanding of an important clinical issue. Moreover, meta-analyses often serve as cornerstones for evidence-based surgery, treatment guidelines, and knowledge transfer. Given the importance of meta-analyses to the medical (and surgical) knowledge base, it is of cardinal importance that surgeons have a basic grasp of the principles that guide a high-quality meta-analysis, and be able to weigh objectively the advantages and potential pitfalls of this clinical research tool.
    [Show full text]
  • Habilitationsschrift
    Aus dem CharitéCentrum für Human- und Gesundheitswissenschaften Institut für Medizinische Soziologie und Rehabilitationswissenschaften Direktorin: Prof. Dr. Adelheid Kuhlmey Habilitationsschrift “Statistical literacy in medicine: Physicians’ and patients’ understanding of health statistics in cancer screening and prevention” zur Erlangung der Lehrbefähigung für das Fach Medizinische Soziologie und Rehabilitationswissenschaften vorgelegt dem Fakultätsrat der Medizinischen Fakultät Charité-Universitätsmedizin Berlin von Dr. rer. nat. Odette Wegwarth geboren in Salzwedel Eingereicht: 11/2014 Dekanin: Prof. Dr. med. Annette Grüters-Kieslich 1. Gutachter: Prof. Dr. Ulrich Mansmann, Ludwig-Maximilians-Universität München 2. Gutachter: Prof. Dr. Karl Wegscheider, Universitätsklinikum Hamburg-Eppendorf To all the fabulous, open-minded, and inquiring physicians who believed in the importance of my research and were willing to divulge their weak spot, health statistics. Content table 1. Introduction: What is statistical literacy in medicine and why does it matter? …………………p. 1 1.1. Benefit and harms can be express in different statistical formats …………………p. 2 1.2. Not all health statistic formats are appropriate for all setting …………………p. 5 1.3. Statistical literacy and transparency: The fundament of informed decisions ………p. 9 2. Five studies on physicians’ and patients’ understanding of health statistics and facts in cancer screening and prevention …………………p. 12 2.1. "There is nothing to worry about": Gynecologists' counseling on mammography …………………p. 12 2.2. Deceiving numbers: Survival rates and their impact on doctors' risk communication …………………p. 20 2.3. Do physicians understand cancer screening statistics? A national survey of primary care physicians in the United States …………………p. 31 2.4. Overdiagnosis and overtreatment: Evaluation of what physicians tell patients about screening harms …………………p.
    [Show full text]
  • A Registered Report Randomised Trial on 'Fact Boxes'
    Risk communication in tables vs. text: a Registered Report randomised trial on 'fact boxes' Cameron Brick1,2, Michelle McDowell3, & Alexandra L. J. Freeman1 1 Winton Centre for Risk and Evidence Communication, Centre for Mathematical Sciences, University of Cambridge, Wilberforce Road, Cambridge CB3 0WA, United Kingdom 2 Department of Psychology, University of Amsterdam, 1012 WX Amsterdam, Netherlands 3 Harding Center for Risk Literacy, Max Planck Institute for Human Development, 14195 Berlin, Germany Corresponding author: Cameron Brick, [email protected] Accepted 19 July 2019 as a Stage 1 Registered Report at Royal Society Open Science. Pre-print v1 19 July 2019 Funding was provided by the David and Claudia Harding Foundation and the Winton Charitable Foundation. Keywords: risk communication, fact box, decision aid, decision making, risk literacy Abstract Objectives Identifying effective summary formats is fundamental to multiple fields including science communication, systematic reviews, evidence-based policy, and medical decision making. This study will test whether table or text-only formats lead to better comprehension of the potential harms and benefits of different options, here in a medical context. Design Pre-registered, longitudinal experiment: between-subjects factorial 2 (message format) x 2 topic (topic: therapeutic or preventative intervention) on comprehension and later recall (CONSORT- SPI 2018). Setting Longitudinal online survey experiment. Participants [[ N ]] census-matched UK residents recruited through the survey panel firm YouGov. Primary outcome measure Comprehension of harms and benefits and knowledge recall after one month. Results Fact boxes—simple tabular messages—led to [[ less, equal, more ]] comprehension than text- only formats and [[ greater, equal, lower ]] knowledge recall after one month.
    [Show full text]
  • US Gynecologists' Estimates and Beliefs Regarding Ovarian Cancer
    www.nature.com/scientificreports OPEN US gynecologists’ estimates and beliefs regarding ovarian cancer screening’s efectiveness 5 years Received: 18 June 2018 Accepted: 8 November 2018 after release of the PLCO evidence Published: xx xx xxxx Odette Wegwarth 1,2 & Gerd Gigerenzer2 Efcient patient care requires the conscientious use of current best evidence. Such evidence on ovarian cancer screening showed that the screening has no survival beneft but considerable harms; currently no medical organization recommends it. In a cross-sectional online survey study with 401 US outpatient gynecologists we investigated whether they follow the recommendation of their medical organizations in daily practice and report estimates of ovarian cancer screening’s efectiveness that approximate current best evidence (within a ± 10 percent margin of error), and if not, whether a fact box intervention summarizing current best evidence improves judgments. Depending on question, 44.6% to 96.8% reported estimates and beliefs regarding screening’s efectiveness that diverged from evidence, and 57.6% reported regularly recommending the screening. Gynecologists who recommend screening overestimated the beneft and underestimated the harms more frequently. After seeing the fact box, 51.6% revised initial estimates and beliefs, and the proportion of responses approximating best evidence increased on all measures (e.g., mortality reduction: 32.9% [95% CI, 26.5 to 39.7] before intervention, 77.3% [71.0 to 82.8] after intervention). Overall, results highlight the need for intensifed training programs on the interpretation of medical evidence. The provision of fact box summaries in medical journals may additionally improve the practice of evidence-based medicine. Te practice of evidence-based medicine (EbM) requires physicians to conscientiously and judiciously use the currently best scientifc evidence in making sound decisions about patients’ care.
    [Show full text]
  • Communicating Relative Risk Changes with Baseline Risk: Presentation Format and Numeracy Matter
    ORIGINAL ARTICLE Communicating Relative Risk Changes with Baseline Risk: Presentation Format and Numeracy Matter Nicolai Bodemer, PhD, Bjo¨rn Meder, PhD, and Gerd Gigerenzer, PhD Background. Treatment benefits and harms are often and harms, whereas a percentage format often impeded communicated as relative risk reductions and increases, understanding. For example, many participants misinter- which are frequently misunderstood by doctors and patients. preted a relative risk reduction as referring to an absolute One suggestion for improving understanding of such risk risk reduction. Participants with higher numeracy generally information is to also communicate the baseline risk. We performed better than those with lower numeracy, but all investigated 1) whether the presentation format of the base- participants benefitted from a frequency format. Limitations line risk influences understanding of relative risk changes are that we used a hypothetical medical scenario and a non- and 2) the mediating role of people’s numeracy skills. representative sample. Conclusions. Presenting baseline risk Method. We presented laypeople (N =1234)withahypothet- in a frequency format improves understanding of relative ical scenario about a treatment that decreased (Experiments risk information, whereas a percentage format is likely to 1a, 2a) or increased (Experiments 1b, 2b) the risk of heart lead to misunderstandings. People’s numeracy skills play disease. Baseline risk was provided as a percentage or a fre- an important role in correctly understanding medical infor- quency. In a forced-choice paradigm, the participants’ task mation. Overall, communicating treatment benefits and was to judge the risk in the treatment group given the rela- harms in the form of relative risk changes remains problem- tive risk reduction (or increase) and the baseline risk.
    [Show full text]
  • Risk Communication in Tables Versus Text
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Apollo Risk communication in tables versus text: a registered royalsocietypublishing.org/journal/rsos report randomized trial on ‘fact boxes’ Registered report Cite this article: Brick C, McDowell M, Freeman Cameron Brick1,2, Michelle McDowell3,4 and Alexandra ALJ. 2020 Risk communication in tables versus 1 text: a registered report randomized trial on ‘fact L. J. Freeman ’ boxes . R. Soc. open sci. 7: 190876. 1Winton Centre for Risk and Evidence Communication, Centre for Mathematical Sciences, http://dx.doi.org/10.1098/rsos.190876 University of Cambridge, Wilberforce Road, Cambridge, CB3 0WA, UK 2Department of Psychology, University of Amsterdam, 1012 WX Amsterdam, The Netherlands 3Harding Center for Risk Literacy, University of Potsdam, 14469 Potsdam, Germany 4Max Planck Institute for Human Development, 14195 Berlin, Germany Received: 13 May 2019 CB, 0000-0002-7174-8193; MM, 0000-0002-1522-757X; Accepted: 27 February 2020 ALJF, 0000-0002-4115-161X Objectives: identifying effective summary formats is fundamental to multiple fields including science communication, systematic reviews, evidence-based policy and medical decision-making. Subject Category: This study tested whether table or text-only formats lead to Psychology and cognitive neuroscience better comprehension of the potential harms and benefits of different options, here in a medical context. Design: pre- Subject Areas: registered, longitudinal experiment: between-subjects factorial 2 psychology (message format) × 2 topic (therapeutic or preventative intervention) on comprehension and later recall (CONSORT-SPI Keywords: 2018). Setting: longitudinal online survey experiment. Participants: 2305 census-matched UK residents recruited risk communication, fact box, decision aid, through the survey panel firm YouGov.
    [Show full text]
  • Personalized Early Detection and Prevention of Breast Cancer: ENVISION Consensus Statement
    CONSENSUS STATEMENT Personalized early detection and prevention of breast cancer: ENVISION consensus statement Nora Pashayan 1, Antonis C. Antoniou2, Urska Ivanus 3, Laura J. Esserman4, Douglas F. Easton 2, David French 5, Gaby Sroczynski6,7, Per Hall8,9, Jack Cuzick10, D. Gareth Evans11, Jacques Simard 12, Montserrat Garcia-Closas13, Rita Schmutzler14, Odette Wegwarth15, Paul Pharoah 2,16, Sowmiya Moorthie17, Sandrine De Montgolfier 18, Camille Baron19, Zdenko Herceg 20, Clare Turnbull21, Corinne Balleyguier22, Paolo Giorgi Rossi23, Jelle Wesseling24, David Ritchie 25, Marc Tischkowitz26, Mireille Broeders27, Dan Reisel28, Andres Metspalu 29, Thomas Callender 1, Harry de Koning 30, Peter Devilee31, Suzette Delaloge 32, Marjanka K. Schmidt 24 and Martin Widschwendter 28,33,34 ✉ Abstract | The European Collaborative on Personalized Early Detection and Prevention of Breast Cancer (ENVISION) brings together several international research consortia working on different aspects of the personalized early detection and prevention of breast cancer. In a consensus conference held in 2019, the members of this network identified research areas requiring development to enable evidence-based personalized interventions that might improve the benefits and reduce the harms of existing breast cancer screening and prevention programmes. The priority areas identified were: 1) breast cancer subtype-specific risk assessment tools applicable to women of all ancestries; 2) intermediate surrogate markers of response to preventive measures; 3) novel non-surgical preventive measures to reduce the incidence of breast cancer of poor prognosis; and 4) hybrid effectiveness–implementation research combined with modelling studies to evaluate the long-term population outcomes of risk-based early detection strategies. The implementation of such programmes would require health-care systems to be open to learning and adapting, the engagement of a diverse range of stakeholders and tailoring to societal norms and values, while also addressing the ethical and legal issues.
    [Show full text]
  • How Skeptics Could Be Convinced (Not Persuaded) to Get Vaccinated
    1 How skeptics could be convinced (not persuaded) to get 2 vaccinated against COVID-19 3 4 PREPRINT – NOT PEER REVIEWED 5 6 Felix G. Rebitscheka,b,1 7 Christin Ellermanna 8 Mirjam Jennya,b,c 9 Nico A. Siegeld 10 Christian Spinnerd 11 Gert G. Wagnera,b,e 12 13 aHarding Center for Risk Literacy, Faculty of Health Sciences Brandenburg, University of 14 Potsdam, Potsdam 15 bMax Planck Institute for Human Development, Berlin 16 cRobert Koch Institute, Berlin 17 dinfratest dimap, Berlin 18 eGerman Socio-Economic Panel Study (SOEP), Berlin 19 20 1Felix G. Rebitschek, Email: [email protected] 21 22 Competing Interest Statement: The German Standing Committee on Vaccination 23 (STIKO) at the Robert Koch Institute officially recommends COVID-19 vaccinations. The 24 activities of the STIKO are coordinated and supported by the Robert Koch Institute 25 (author M.J.). The other authors declare no competing interest. 26 27 Data availability 28 Data and analysis code for these studies are available upon request. 29 30 Classification: Social Sciences: Psychological and Cognitive Sciences; 31 Keywords: COVID-19 vaccination uptake, vaccination skeptics, informed decision- 32 making, fact boxes 33 34 35 36 37 38 39 Abstract 40 Central to the SARS-CoV-2 pandemic strategy, COVID-19 vaccination depends on the 41 population’s uptake decisions. Because at least 60% of the population needs to be vaccinated, 42 but fewer, for example, in Germany are expected to do so, it is important to know how to convince 43 those who are undecided or skeptical. According to the health care standard of enabling citizens 44 to make informed decisions based on balanced information (boosting) – instead of persuasion or 45 seduction (nudging) – a comparison of benefits and harms of having or not having the vaccination 46 would be required to inform these groups.
    [Show full text]
  • A Simple Tool for Communicating the Benefits and Harms of Health Interventions: a Guide for Creating a Fact Box
    TUTORIAL A Simple Tool for Communicating the Benefits and Harms of Health Interventions: A Guide for Creating a Fact Box Michelle McDowell, PhD, Felix G. Rebitschek, PhD, Gerd Gigerenzer, PhD, Odette Wegwarth, PhD One of the major hurdles to promoting informed decision and provides alternatives for addressing issues related to making in health is the continued use of poor risk presen- missing, insufficient, imprecise, or conflicting evidence tation formats. This article offers a guide to develop a and for dealing with issues related to statistical and clini- Fact Box, a simple decision tool to present data about the cal significance. The guide concludes with details on benefits and harms of treatments that has been demon- how to document the development of the Fact Box for the strated to improve understanding of health risks, an purpose of transparency and reproducibility. Fact Boxes important part of risk literacy. The article offers guidance are an efficient tool to promote risk literacy and should about how to determine the evidence basis for a health be available in every physician’s office. Key words: risk topic, select outcomes to report, extract and present num- communication; informed decision making; evidence- bers or outcomes, and design the layout. The guide also based medicine. (MDM Policy & Practice 2016;1: addresses potential challenges for summarizing evidence 1–10) o make informed health decisions, individuals not adequately informed about the benefits and Tneed balanced and transparent information harms of treatments or preventive health behaviors, about health risks. Unfortunately, many people are in part a result of poor statistical literacy and the use of confusing and misleading risk presentation formats.1 While there is an extensive literature on Received 9 May 2016 from the Harding Center for Risk Literacy, Max evidence-based risk communication strategies for Planck Institute for Human Development, Berlin, Germany (MM, FGR, improving risk comprehension,2 there is a need for GG, OW).
    [Show full text]
  • Michelle Mcdowell, Phd –
    Michelle McDowell, PhD Harding Center for Risk Literacy Faculty of Health Sciences Brandenburg Joint Faculty of the University of Potsdam, BTU and MHB University of Potsdam, Virchowstrasse 2 | 14482 Potsdam +49 (0)331 7044 5652 / [email protected] Professional Experience 2020–present Research Program Leader, Harding Center for Risk Literacy, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany. 2016–2019 Research Scientist, Harding Center for Risk Literacy, Max Planck Institute for Human Development, Berlin, Germany. 2013–2015 Postdoctoral Research Fellow, Harding Center for Risk Literacy, Max Planck Institute for Human Development, Berlin, Germany. 2011–2012 Research Fellow, Grififth Health Institute, Area of Strategic Investment, Griffith University, Brisbane, Australia. 2011 PhD, Doctor of Philosophy, Department of Psychology, Griffith University, Brisbane, Australia. 2010 Graduate Certificate in Research Management, Southern Cross University, Tweed Heads, Australia. 2005 Bachelor of Psychology, Department of Psychology, Griffith University, Brisbane, Australia. Grants and Awards 2018 Vontobel Prize for Research on Age(ing) awarded to Andrea Loizeau and Florian Riese for the paper: Loizeau, AJ, Theill, N, Cohen, SM, Eicher, S, Mitchell, SL, Meier, S, McDowell, M., Martin, M & Riese, F. (2019), Fact Box Decision Support Tools Reduce Decisional Conflict about Artificial Hydration and Antibiotics for Pneumonia in Advanced Dementia: a Randomized Controlled Trial. Age and Ageing, 48 (1), 67-74. (25,000CHF) 2017 “VisRisk”: Visualising and communicating complex evidence in risk assessments – Federal Institute for Risk Assessment (111,900e) 2016 Best Poster Prize. Rauwolf, G, McDowell, M, Okan, Y & Ziegler, M. Grün=gesund? Über die Farbwirkung bei der Benutzung von Icon Arrays [Green=healthy? The effect of colour in Icon Arrays.] EbM Kongress, Cologne.
    [Show full text]