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Breast Cancer Patients’ Treatment Expectations after Exposure to the Decision Aid Program Adjuvant Online: The Influence of Numeracy

Author

Listed:
  • Isaac M. Lipkus

    (Duke University School of Nursing, Durham, NC, isaac.lipkus@duke.edu)

  • Ellen Peters

    (Decision Research, Eugene, OR)

  • Gretchen Kimmick

    (Duke University Medical Center, Durham, NC)

  • Vlayka Liotcheva

    (Duke University Medical Center, Durham, NC)

  • Paul Marcom

    (Duke University Medical Center, Durham, NC)

Abstract

The decision aid called ‘‘Adjuvant Online’’ (Adjuvant! for short) helps breast cancer patients make treatment decisions by providing numerical estimates of treatment efficacy (e.g., 10-y relapse or survival). Studies exploring how patients’ numeracy interacts with the estimates provided by Adjuvant! are lacking. Pooling across 2 studies totaling 105 women with estrogen receptor—positive, early-stage breast cancer, the authors explored patients’ treatment expectations, perceived benefit from treatments, and confidence of personal benefit from treatments. Patients who were more numerate were more likely to provide estimates of cancer-free survival that matched the estimates provided by Adjuvant! for each treatment option compared with patients with lower numeracy (odds ratios of 1.6 to 2.4). As estimates of treatment efficacy provided by Adjuvant! increased, so did patients’ estimates of cancer-free survival (0.37 > r s > 0.48) and their perceptions of treatment benefit from hormonal therapy (r s = 0.28) and combined therapy (r s = 0.27). These relationships were significantly more pronounced for those with higher numeracy, especially for perceived benefit of combined therapy. Results suggest that numeracy influences a patient’s ability to interpret numerical estimates of treatment efficacy from decision aids such as Adjuvant!.

Suggested Citation

  • Isaac M. Lipkus & Ellen Peters & Gretchen Kimmick & Vlayka Liotcheva & Paul Marcom, 2010. "Breast Cancer Patients’ Treatment Expectations after Exposure to the Decision Aid Program Adjuvant Online: The Influence of Numeracy," Medical Decision Making, , vol. 30(4), pages 464-473, July.
    • Handle: RePEc:sae:medema:v:30:y:2010:i:4:p:464-473
    DOI: 10.1177/0272989X09360371
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    References listed on IDEAS

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    1. Nathan F. Dieckmann & Paul Slovic & Ellen M. Peters, 2009. "The Use of Narrative Evidence and Explicit Likelihood by Decisionmakers Varying in Numeracy," Risk Analysis, John Wiley & Sons, vol. 29(10), pages 1473-1488, October.
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    Cited by:

    1. Talya Miron-Shatz & Yaniv Hanoch & Benjamin A. Katz & Glen M. Doniger & Elissa M. Ozanne, 2015. "Willingness to test for BRCA1/2 in high risk women: Influenced by risk perception and family experience, rather than by objective or subjective numeracy?," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 10(4), pages 386-399, July.
    2. E. Peters & H. Kunreuther & N. Sagara & P. Slovic & D. R. Schley, 2012. "Protective Measures, Personal Experience, and the Affective Psychology of Time," Risk Analysis, John Wiley & Sons, vol. 32(12), pages 2084-2097, December.
    3. Ye, Jun & Zhou, Kun & Chen, Rui, 2021. "Numerical or verbal Information: The effect of comparative information in social comparison on prosocial behavior," Journal of Business Research, Elsevier, vol. 124(C), pages 198-211.
    4. Michael R. Eber & Cass R. Sunstein & James K. Hammitt & Jennifer M. Yeh, 2021. "The modest effects of fact boxes on cancer screening," Journal of Risk and Uncertainty, Springer, vol. 62(1), pages 29-54, February.
    5. repec:cup:judgdm:v:10:y:2015:i:4:p:386-399 is not listed on IDEAS
    6. William J. Burns & Ellen Peters & Paul Slovic, 2012. "Risk Perception and the Economic Crisis: A Longitudinal Study of the Trajectory of Perceived Risk," Risk Analysis, John Wiley & Sons, vol. 32(4), pages 659-677, April.
    7. Yasmina Okan & Eric R. Stone & Wändi Bruine de Bruin, 2018. "Designing Graphs that Promote Both Risk Understanding and Behavior Change," Risk Analysis, John Wiley & Sons, vol. 38(5), pages 929-946, May.

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