IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v83y2013icp27-33.html
   My bibliography  Save this article

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

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953613000610
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2013.01.034?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    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. repec:cup:judgdm:v:4:y:2009:i:1:p:34-40 is not listed on IDEAS
    5. 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.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    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
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. 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.
    2. Alaina N. Talboy & Sandra L. Schneider, 2018. "Improving Understanding of Diagnostic Test Outcomes," Medical Decision Making, , vol. 38(5), pages 573-583, July.
    3. Dafina Petrova & Olga Kostopoulou & Brendan C. Delaney & Edward T. Cokely & Rocio Garcia-Retamero, 2018. "Strengths and Gaps in Physicians’ Risk Communication: A Scenario Study of the Influence of Numeracy on Cancer Screening Communication," Medical Decision Making, , vol. 38(3), pages 355-365, April.
    4. 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.
    5. 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.
    6. 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.
    7. Rocio Garcia-Retamero & Allen Andrade & Joseph Sharit & Jorge G. Ruiz, 2015. "Is Patients’ Numeracy Related to Physical and Mental Health?," Medical Decision Making, , vol. 35(4), pages 501-511, May.
    8. 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.
    9. 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.
    10. Zachary Breig & Paul Feldman, 2024. "Revealing risky mistakes through revisions," Journal of Risk and Uncertainty, Springer, vol. 68(3), pages 227-254, June.
    11. 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.
    12. Quiroga Gutierrez, Ana Cecilia, 2024. "Picture this: Making health insurance choices easier for those who need it," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 111(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Marie-Anne Durand & Renata W Yen & James O’Malley & Glyn Elwyn & Julien Mancini, 2020. "Graph literacy matters: Examining the association between graph literacy, health literacy, and numeracy in a Medicaid eligible population," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-14, November.
    2. 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.
    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.
    4. Christina Kreuzmair & Michael Siegrist & Carmen Keller, 2017. "Does Iconicity in Pictographs Matter? The Influence of Iconicity and Numeracy on Information Processing, Decision Making, and Liking in an Eye‐Tracking Study," Risk Analysis, John Wiley & Sons, vol. 37(3), pages 546-556, March.
    5. Schonlau Matthias & Peters Ellen, 2012. "Comprehension of Graphs and Tables Depend on the Task: Empirical Evidence from Two Web-Based Studies," Statistics, Politics and Policy, De Gruyter, vol. 3(2), pages 1-35, August.
    6. Christina Kreuzmair & Michael Siegrist & Carmen Keller, 2016. "High Numerates Count Icons and Low Numerates Process Large Areas in Pictographs: Results of an Eye‐Tracking Study," Risk Analysis, John Wiley & Sons, vol. 36(8), pages 1599-1614, August.
    7. repec:cup:judgdm:v:9:y:2014:i:5:p:420-432 is not listed on IDEAS
    8. Carmen Keller & Christina Kreuzmair & Rebecca Leins-Hess & Michael Siegrist, 2014. "Numeric and graphic risk information processing of high and low numerates in the intuitive and deliberative decision modes: An eye-tracker study," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 9(5), pages 420-432, September.
    9. Carmen Keller, 2011. "Using a Familiar Risk Comparison Within a Risk Ladder to Improve Risk Understanding by Low Numerates: A Study of Visual Attention," Risk Analysis, John Wiley & Sons, vol. 31(7), pages 1043-1054, July.
    10. Rebecca Hess & Vivianne H.M. Visschers & Michael Siegrist & Carmen Keller, 2011. "How do people perceive graphical risk communication? The role of subjective numeracy," Journal of Risk Research, Taylor & Francis Journals, vol. 14(1), pages 47-61, January.
    11. Yaniv Hanoch & Talya Miron-Shatz & Mary Himmelstein, 2010. "Genetic testing and risk interpretation: How do women understand lifetime risk results?," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 5(2), pages 116-123, April.
    12. Mehdi Mourali & Zhiyong Yang, 2023. "Misperception of Multiple Risks in Medical Decision-Making," Journal of Consumer Research, Journal of Consumer Research Inc., vol. 50(1), pages 25-47.
    13. Brandon Garrett & Gregory Mitchell, 2013. "How Jurors Evaluate Fingerprint Evidence: The Relative Importance of Match Language, Method Information, and Error Acknowledgment," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 10(3), pages 484-511, September.
    14. Yaniv Hanoch & Jonathan Rolison & Alexandra M. Freund, 2019. "Reaping the Benefits and Avoiding the Risks: Unrealistic Optimism in the Health Domain," Risk Analysis, John Wiley & Sons, vol. 39(4), pages 792-804, April.
    15. 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.
    16. Hannah A D Keage & Tobias Loetscher, 2018. "Estimating everyday risk: Subjective judgments are related to objective risk, mapping of numerical magnitudes and previous experience," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-17, December.
    17. Stephan Dickert & Janet Kleber & Ellen Peters & Paul Slovic, 2011. "Numeracy as a precursor to pro-social behavior: The impact of numeracy and presentation format on the cognitive mechanisms underlying donation decisions," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 6(7), pages 638-650, October.
    18. Ian G. J. Dawson & Johnnie E. V. Johnson & Michelle A. Luke, 2013. "Helping Individuals to Understand Synergistic Risks: An Assessment of Message Contents Depicting Mechanistic and Probabilistic Concepts," Risk Analysis, John Wiley & Sons, vol. 33(5), pages 851-865, May.
    19. Nicolas Eber & Patrick Roger & Tristan Roger, 2024. "Finance and intelligence: An overview of the literature," Journal of Economic Surveys, Wiley Blackwell, vol. 38(2), pages 503-554, April.
    20. repec:cup:judgdm:v:14:y:2019:i:4:p:412-422 is not listed on IDEAS
    21. Saima Ghazal & Edward T. Cokely & Rocio Garcia-Retamero, 2014. "Predicting biases in very highly educated samples: Numeracy and metacognition," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 9(1), pages 15-34, January.
    22. Becky L. Choma & David Sumantry & Yaniv Hanoch, 2019. "Right-wing ideology and numeracy: A perception of greater ability, but poorer performance," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 14(4), pages 412-422, July.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:83:y:2013:i:c:p:27-33. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.