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Tawfik MY, Soliman HH, Abdel-Fatah ZF. Accuracy of self-perceived cardiovascular disease risk and factors predicting risk underestimation in perimenopausal and postmenopausal women in Ismailia, Egypt. J Egypt Public Health Assoc 2024; 99:24. [PMID: 39349881 PMCID: PMC11442895 DOI: 10.1186/s42506-024-00170-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 08/26/2024] [Indexed: 10/04/2024]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death globally, with women at higher risk after menopause. This increased risk is attributed to both aging and hormonal changes. Prior research has established a link between CVD risk perception and adopting healthy behaviors to prevent CVD. This study aimed to assess the accuracy of self-perceived CVD risk in perimenopausal and postmenopausal women, and to identify factors that predict CVD risk underestimation among them. METHODS A cross-sectional study was conducted in the administrative sectors of Suez Canal University campus in Ismailia, Egypt, over a period of eight months starting in July 2022. A total of 390 eligible women (employees and workers) were randomly selected. Participants were interviewed to obtain data on demographics, medical history, self-perceived risk of CVD, self-perceived general health, awareness of factors that increase the risk of developing CVD, perceived stress, health literacy, numeracy, and self-perceived 10-year risk of developing major cardiovascular events. They also underwent measurements of blood pressure, weight, and height. The updated 2019 WHO/CVD risk non-laboratory-based prediction chart for the North Africa and Middle East Region was used to predict the 10-year risk of major cardiovascular events for the study participants. Risk accuracy was measured by comparing self-perceived CVD risk with predicted CVD risk. RESULTS The ratio of self-perceived to predicted moderate/high CVD risk was 27.7% to 44.3%, respectively. The accuracy of CVD risk perception was 68.2%. Kappa analysis results showed fair and significant agreement between self-perceived and predicted CVD risk (kappa ± SE = 35.9 ± 4.1%, p < 0 .001). The proportion of women who underestimated their risks was 24.1%. Of those in the high-risk group, 93.3% underestimated their CVD risk, compared to 50.6% in the moderate-risk group. Factors that significantly predicted CVD risk underestimation included being married (aOR 14.5; 95% CI 1.4-149.9), low income (aOR 2.321; 95% CI 1.09-4.909), high BMI (aOR 4.78; 95% CI 1.9-11.9), hypertension (aOR 3.5; 95% CI 2-6.2), and old age (aOR 1.46; 95% CI 1.3-1.6). CONCLUSIONS Approximately one-third of our study participants misperceived their CVD risk; of those who did, 75.8% underestimated it. Marital status, old age, low income, high BMI, and hypertension strongly predicted CVD risk underestimation. These findings identified the menopausal women subgroups that could benefit from targeted health interventions designed to reduce CVD risk underestimation and improve risk accuracy.
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Affiliation(s)
- Mirella Youssef Tawfik
- Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Hanan H Soliman
- Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Zeinab F Abdel-Fatah
- Department of Public Health, Occupational and Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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Ameri H, Poder TG. Comparison of four approaches in eliciting health state utilities with SF-6Dv2. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024:10.1007/s10198-024-01723-w. [PMID: 39340750 DOI: 10.1007/s10198-024-01723-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 09/05/2024] [Indexed: 09/30/2024]
Abstract
OBJECTIVE To empirically compare four preference elicitation approaches, the discrete choice experiment with time (DCETTO), the Best-Worst Scaling with time (BWSTTO), DCETTO with BWSTTO (DCEBWS), and the Standard Gamble (SG) method, in valuing health states using the SF-6Dv2. METHODS A representative sample of the general population in Quebec, Canada, completed 6 SG tasks or 13 DCEBWS (i.e., 10 DCETTO followed by 3 BWSTTO). Choice tasks were designed with the SF-6Dv2. Several models were used to estimate SG data, and the conditional logit model was used for the DCE or BWS data. The performance of SG models was assessed using prediction accuracy (mean absolute error [MAE]), goodness of fit using Bayesian information criterion (BIC), t-test, Jarque-Bera (JB) test, Ljung-Box (LB) test, the logical consistency of the parameters, and significance levels. Comparison between approaches was conducted using acceptability (self-reported difficulty and quality levels in answering, and completion time), consistency (monotonicity of model coefficients), accuracy (standard errors), dimensions coefficient magnitude, correlation between the value sets estimated, and the range of estimated values. The variance scale factor was computed to assess individuals' consistency in their choices for DCE and BWS approaches. RESULTS Out of 828 people who completed SG and 1208 for DCEBWS tasks, a total of 724 participants for SG and 1153 for DCE tasks were included for analysis. Although no significant difference was observed in self-reported difficulties and qualities in answers among approaches, the SG had the longest completion time and excluded participants in SG were more prone to report difficulties in answering. The range of standard errors of the SG was the narrowest (0.012 to 0.015), followed by BWSTTO (0.023 to 0.035), DCEBWS (0.028 to 0.050), and DCETTO (0.028 to 0.052). The highest number of insignificant and illogical parameters was for BWSTTO. Pain dimension was the most important across dimensions in all approaches. The correlation between SG and DCEBWS utility values was the strongest (0.928), followed by the SG and BWSTTO values (0.889), and the SG and DCETTO (0.849). The range of utility values generated by SG tended to be shorter (-0.143 to 1) than those generated by the other three methods, whereas BWSTTO (-0.505 to 1) range values were shorter than DCETTO (-1.063 to 1) and DCEBWS (-0.637 to 1). The variance scale factor suggests that respondents had almost similar level of certainty or confidence in both DCE and BWS responses. CONCLUSION The SG had the narrowest value set, the lowest completion rates, the longest completion time, the best prediction accuracy, and produced an unexpected sign for one level. The BWSTTO had a narrower value set, lower completion time, higher parameter inconsistency, and higher insignificant levels compared to DCETTO and DCEBWS. The results of DCEBWS were more similar to SG in number of insignificant and illogical parameters, and correlation.
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Affiliation(s)
- Hosein Ameri
- School of Public Health, University of Montreal, Montreal, QC, Canada
- Centre de Recherche de l'IUSMM, CIUSSS de l'Est de l'Île de Montréal, Montreal, QC, Canada
| | - Thomas G Poder
- School of Public Health, University of Montreal, Montreal, QC, Canada.
- Centre de Recherche de l'IUSMM, CIUSSS de l'Est de l'Île de Montréal, Montreal, QC, Canada.
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Whiting TL. Minimum Space When Transporting Pigs: Where Is the "Good" Law? Animals (Basel) 2024; 14:2732. [PMID: 39335321 PMCID: PMC11429333 DOI: 10.3390/ani14182732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Revised: 09/12/2024] [Accepted: 09/19/2024] [Indexed: 09/30/2024] Open
Abstract
This paper focuses on the problem of numeracy when writing regulations, specifically how to describe a threshold for crowding of pigs during transport, considering transported pigs range in body mass from 5 to 500 kg. When scientific findings provide the basis for regulation in the public interest, those findings must be communicated in a consistent way to regulators and policymaking bodies. Numeracy is the ability to understand, reason with, and apply appropriate numerical concepts to real-world questions. Scientific understanding is almost always based on rational understanding of numerical information, numeracy. The threshold of administrative offenses is often a numerical description. Commercial livestock transporters have an interest in loading livestock compartments to the maximum to achieve the largest payload allowed by axle weight laws, as is the case in all bulk commodity transport. Maximizing payload minimizes costs and environmental hazards of fuel exhaust and can benefit the public with lower pork prices, but has a serious animal welfare risk. Livestock production academics, veterinarians, and animal welfare activists have been working for decades to determine the level of livestock crowding in transport containers that would be appropriate for regulatory enforcement. The scientific discourse has been plagued by a lack of numerical standardization when describing results of trials and forming recommendations. Exceeding specific numerical thresholds is the core to implementing enforcement actions. This paper examines the communication and other barriers that have prevented emergence of a consensus on this question and provides a direction toward resolution. Further confirmation of effects of crowding livestock in transit is needed. This paper suggests that articulating an enforceable standard in pig transport is possible. In inspection for compliance, discovering the LP50 (lethal pressure-50) for slaughter-weight pigs is an initial global benchmark goal. The LP50 is the loading floor pressure in a commercial transport compartment, under field conditions, that would result in the death of at least one pig in the group 50% of the time.
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Kim S. Natural Frequencies Improve Public Understanding of Medical Test Results: An Experimental Study on Various Bayesian Inference Tasks with Multiple Scoring Methods and Non-Bayesian Reasoning Strategies. Med Decis Making 2024:272989X241275191. [PMID: 39291336 DOI: 10.1177/0272989x241275191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
BACKGROUND It is well established that the natural frequencies (NF) format is cognitively more beneficial for Bayesian inference than the conditional probabilities (CP) format. However, empirical studies have suggested that the NF facilitation effect might be limited to specific groups of individuals. Unlike previous studies that focused on a limited number of Bayesian inference problems evaluated by a single scoring method, it was essential to examine multiple Bayesian problems using various scoring metrics. This study also explored the impact of numeracy on Bayesian inference and assessed non-Bayesian cognitive strategies using the numerical information in problem solving. METHODS In a Web-based experimental survey, 175 South Korean adults were randomly assigned to 1 of 2 format groups (NF v. CP). After completing numeracy scales, participants were asked to estimate 4 Bayesian inference problems and document the numerical information used in their problem-solving process. Four scoring methods-strict rounding, loose rounding, absolute deviation, and 50-Split-were used to evaluate participants' estimations. RESULTS The NF format generally outperformed the CP format across all problems, except in a chorionic villus sampling test problem when evaluated using the 50-Split method. In addition, numeracy levels significantly influenced Bayesian inference; participants with higher numeracy demonstrated better performance. In addition, participants used various non-Bayesian strategies influenced by the format and the nature of the problems. CONCLUSIONS The NF facilitation effect was consistently observed across multiple Bayesian problems and scoring methods. Individuals with higher numeracy levels benefited more from the NF format. The use of various non-Bayesian strategies varied with the formats and nature of specific tasks. HIGHLIGHTS The natural frequencies (NF) format is known to foster understanding of medical test results compared with the conditional probabilities (CP) format, but some studies have reported that this benefit is either nonexistent or limited to specific groups.This study aims to replicate previous empirical studies using various Bayesian problems using multiple scoring methods.The NF format fosters understanding of medical test results across all Bayesian problems by all scoring methods, except in the CVS problem when using a 50-Split scoring method.Participants with high numeracy perform better Bayesian inference than those with lower numeracy. Particularly, higher numerates benefit more in the NF format than lower numerates do. In addition, the public tend to use various non-Bayesian reasoning strategies depending on the format and the nature of the tasks.
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Affiliation(s)
- Soyun Kim
- Institute of Health Policy and Management, Seoul National University Medical Research Center, Jongno-gu, Seoul, Republic of Korea
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Røislien J. Saving lives with statistics. Scand J Trauma Resusc Emerg Med 2024; 32:79. [PMID: 39223573 PMCID: PMC11370087 DOI: 10.1186/s13049-024-01256-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024] Open
Abstract
Healthcare is awash with numbers, and figuring out what knowledge these numbers might hold is worthwhile in order to improve patient care. Numbers allow for objective mathematical analysis of the information at hand, but while mathematics is objective by design, our choice of mathematical approach in a given situation is not. In prehospital and critical care, numbers stem from a wide range of different sources and situations, be it experimental setups, observational data or data registries, and what constitutes a "good" statistical analysis can be unclear. A well-crafted statistical analysis can help us see things our eyes cannot, and find patterns where our brains come short, ultimately contributing to changing clinical practice and improving patient outcome. With increasingly more advanced research questions and research designs, traditional statistical approaches are often inadequate, and being able to properly merge statistical competence with clinical knowhow is essential in order to arrive at not only correct, but also valuable and usable research results. By marrying clinical knowhow with rigorous statistical analysis we can accelerate the field of prehospital and critical care.
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Affiliation(s)
- Jo Røislien
- Department of Research, The Norwegian Air Ambulance Foundation, Oslo, Norway.
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
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Schultz EA, Eppler SL, Gardner M, Hu SS, Chou L, Safran M, Amanatullah DF, Abrams GD, Shapiro LM, Kamal RN. Health Numeracy Is Associated With a Patient's Ability to Interpret Patient-Reported Outcome Measures Data. Orthopedics 2024; 47:e255-e260. [PMID: 39073043 DOI: 10.3928/01477447-20240718-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) were originally developed as research tools; however, there is increasing interest in using PROMs to inform clinical care. Prior work has shown the benefits of implementing PROMs at the point of care, but a patient's health numeracy (their ability to understand and work with numbers) may affect their ability to interpret PROM results. MATERIALS AND METHODS We recruited patients presenting to an outpatient orthopedic clinic. Forty-nine patients completed a survey that included demographic information, the short-form General Health Numeracy Test, and accuracy questions about four PROM displays (bar graph, table, line graph, pictograph) that indicated the same PROM results. RESULTS Patients with higher health numeracy answered all display accuracy questions correctly (P=.016). Patients who preferred using the table were more likely to answer display accuracy questions incorrectly (odds ratio, 0.013, P=.024). The two most frequently preferred PROM formats were bar graphs and tables, and most patients preferred to learn about their PROM function scores via a combination of displays and verbal discussions. CONCLUSION Patient health numeracy is associated with the ability to correctly interpret visual displays of PROMs. Implementation of PROMs at point of care currently does not account for health numeracy. Efforts to account for health numeracy when using PROMs at point of care may improve the efficacy of using PROMs to improve outcomes in orthopedic surgery. [Orthopedics. 2024;47(5):e255-e260.].
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Sun X, Maidl E, Buchecker M. Dynamics of natural hazard risk awareness: Panel analysis insights from Switzerland. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2024; 368:122009. [PMID: 39151335 DOI: 10.1016/j.jenvman.2024.122009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 07/12/2024] [Accepted: 07/26/2024] [Indexed: 08/19/2024]
Abstract
The analysis of risk awareness should be the initial stage in integrated natural hazard risk management to promote appropriate and effective measures for mitigating risks and strengthening social resilience inside the multi-risk framework. Nevertheless, earlier studies focused on cross-sectional data and overlooked the changes in risk awareness levels and associated independent variables with time. This study analyzes for the first time a balanced nationwide panel dataset of 1612 respondent-year observations from Switzerland (period 2015-2021, including the epidemic of COVID-19) to examine and compare the effects of potential independent variables on the four dimensions of natural hazard risk awareness (NHRA), ranging from the broadest dimension of Relevance to higher dimensions of Perceived Probability of an event, Perceived Threat to life and valuables, and Perceived Situational Threat. The analysis in this study incorporates multiple methods of Random-Effect Model (RE), Generalized Linear Model (GLM), and mediation analysis. Results show that NHRA increased in Switzerland to different extents (up to 23.24%) depending on the dimension. Event memory, perceived information impact and reported individual informed level appeared to be the most consistent independent variables positively influencing panel NHRA. Among these, perceived information impact as an important indicator of risk communication, was also found to serve as a mediator from risk preparedness to risk awareness. By encouraging residents to engage in "Begin Doing Before Thinking" (BDBT) programs to leverage subliminal effects and self-reflection, this study proposes that behavior-cognition feedback loops may facilitate a virtuous cycle. Our promising observations provide recommendations for an effective awareness-rising strategy design and suggest extensive insights from potential short-interval panel analysis in the future.
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Affiliation(s)
- Xue Sun
- Swiss Federal Research Institute WSL, Birmensdorf, 8903, Switzerland; Department of Environmental Systems Science, ETH Zurich, Zurich, 8092, Switzerland.
| | - Elisabeth Maidl
- Swiss Federal Research Institute WSL, Birmensdorf, 8903, Switzerland
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Patel V, Grant LE, Shereefdeen H, MacKay M, Cheng L, Phypers M, Papadopoulos A, McWhirter JE. Evaluating Multi-Jurisdictional Enteric Illness Outbreak Messaging in Canada: A Content Analysis of Public Health Notices. HEALTH COMMUNICATION 2024:1-15. [PMID: 39169881 DOI: 10.1080/10410236.2024.2391207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Effective risk communication during enteric illness outbreaks requires the provision of clear and consistent information to diverse audiences to reduce risk of exposure, inform behavior changes, and prevent illness. Most enteric illnesses are caused by pathogens transmitted through consumption of contaminated food or water, contact with animals, or person-to-person contact. When multi-jurisdictional outbreaks occur, the Public Health Agency of Canada posts web-based Public Health Notices (PHNs) to inform Canadians. This study evaluated the comprehensibility of PHNs to optimize federal risk communication approaches. Publicly available web-based PHNs (n = 42) from 2014-2022 were obtained. A codebook was developed using the Centers for Disease Control and Prevention's (CDC) Clear Communication Index (CCI) and Health Belief Model (HBM) and systematically applied. A SMOG readability calculator was used to determine reading grade level. Descriptive statistics were calculated to summarize coded data. The average reading grade level was above Grade 12 (13.9 ± 1.1). PHNs communicated the nature of the risk (100%) and behavioral recommendations (96.5%) clearly. An active voice was sometimes used (61.9%), but numerical information was less commonly presented using best practices (38.1%). The HBM was fully incorporated in seven PHNs, with most PHNs using five of six constructs (66.7%). PHNs shared similar information in a consistent order (75.0%). Aligning PHNs to best practices in risk communication is recommended, including writing content at a reading grade level that supports comprehension by diverse audiences, following the CCI to increase clarity, including all HBM constructs to promote behavior change, and maintaining message consistency.
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Affiliation(s)
- Vayshali Patel
- Department of Population Medicine, University of Guelph
- Outbreak Management Division, Centre for Food-borne, Environmental, and Zoonotic Infectious Diseases, Public Health Agency of Canada
| | | | - Hisba Shereefdeen
- Department of Population Medicine, University of Guelph
- Outbreak Management Division, Centre for Food-borne, Environmental, and Zoonotic Infectious Diseases, Public Health Agency of Canada
| | | | - Leslie Cheng
- Outbreak Management Division, Centre for Food-borne, Environmental, and Zoonotic Infectious Diseases, Public Health Agency of Canada
| | - Melissa Phypers
- Outbreak Management Division, Centre for Food-borne, Environmental, and Zoonotic Infectious Diseases, Public Health Agency of Canada
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Koning M, Lok C, Ubbink DT, Aarts JWM. Exploring the MAPPING application to facilitate risk communication and shared decision-making between physicians and patients with gynaecological cancer. BMJ Open Qual 2024; 13:e002776. [PMID: 39160112 PMCID: PMC11337712 DOI: 10.1136/bmjoq-2024-002776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 07/26/2024] [Indexed: 08/21/2024] Open
Abstract
This is an observational study in which we evaluated current levels of risk communication (RC) among gynaecological oncologists and their view on the Mapping All Patient Probabilities in Numerical Graphs (MAPPING) application as a possible tool to facilitate RC and shared decision-making (SDM). In part A, we audio-recorded 29 conversations between gynaecological oncologists and patients when discussing treatment options. In part B, interviews were performed with eight gynaecological oncologists.RC and SDM were measured using two observer-based measures, that is, the RC content (RCC) tool (scale 0-2) and the OPTION-5 instrument (scale 0-100). We used CollaboRATE questionnaire (scale 0-10) and a self-developed survey to assess patient-reported RC and SDM. In part B, we evaluated physicians' attitudes regarding the use of the MAPPING application to support RC. Patients were minimally involved in the decision-making process (OPTION-5 25.9%±13.4 RCC 0.21±0.18). Patient-reported SDM was high (mean collaboRATE score 9.19±1.79) and patients preferred receiving numeric information, whereas most physicians used qualitative risk terms rather than exact numbers. In part B, gynaecologists had a positive attitude towards the MAPPING application. However, they stated that the app was difficult to use improvement of layout and better implementations are needed.
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Affiliation(s)
- Mijra Koning
- Amsterdam UMC Locatie AMC, Amsterdam, Noord-Holland, The Netherlands
| | - Christianne Lok
- Centre for Gynecological Oncology Amsterdam (CGOA), Amsterdam, The Netherlands
- NKI, Amsterdam, Noord-Holland, The Netherlands
| | - Dirk T Ubbink
- Amsterdam UMC Locatie AMC, Amsterdam, Noord-Holland, The Netherlands
| | - Johanna Wilhelmina Maria Aarts
- Centre for Gynecological Oncology Amsterdam (CGOA), Amsterdam, The Netherlands
- Department of Obstetrics & Gynaecology, Amsterdam UMC Location VUmc, Amsterdam, Noord-Holland, The Netherlands
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Szczygieł M, Sarı MH. The relationship between numerical magnitude processing and math anxiety, and their joint effect on adult math performance, varied by indicators of numerical tasks. Cogn Process 2024; 25:421-442. [PMID: 38644404 PMCID: PMC11269442 DOI: 10.1007/s10339-024-01186-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 03/21/2024] [Indexed: 04/23/2024]
Abstract
According to the hypothesis of Maloney et al. (Cognition 114(2):293-297, 2010. https://doi.org/10.1016/j.cognition.2009.09.013), math anxiety is related to deficits in numerical magnitude processing, which in turn compromises the development of advanced math skills. Because previous studies on this topic are contradictory, which may be due to methodological differences in the measurement of numerical magnitude processing, we tested Maloney et al.'s hypothesis using different tasks and their indicators: numerical magnitude processing (symbolic and non-symbolic comparison tasks: accuracy, reaction time, numerical ratio, distance and size effects, and Weber fraction; number line estimation task: estimation error), math anxiety (combined scores of learning, testing, math problem solving, and general math anxiety), and math performance. The results of our study conducted on 119 young adults mostly support the hypothesis proposed by Maloney et al. that deficiency in symbolic magnitude processing is related to math anxiety, but the relationship between non-symbolic processes and math anxiety was opposite to the assumptions. Moreover, the results indicate that estimation processes (but not comparison processes) and math anxiety are related to math performance in adults. Finally, high math anxiety moderated the relationship between reaction time in the symbolic comparison task, reaction time in the non-symbolic comparison task, numerical ratio effect in the symbolic comparison task, and math performance. Because the results of the joint effect of numerical magnitude processing and math anxiety on math performance were inconsistent, this part of the hypothesis is called into question.
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Affiliation(s)
- Monika Szczygieł
- Institute of Psychology, Jagiellonian University in Kraków, Kraków, Poland.
| | - Mehmet Hayri Sarı
- Faculty of Education, Nevşehir Hacı Bektaş Veli University, Nevşehir, Türkiye
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Blase R, Meis-Harris J, Weltermann B, Dohle S. Icon Arrays for Medical Risk Communication: Do Icon Type and Color Influence Cardiovascular Risk Perception and Recall? Med Decis Making 2024; 44:661-673. [PMID: 39056311 DOI: 10.1177/0272989x241263040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
BACKGROUND Icon arrays have been shown to be an effective method for communicating medical risk information. However, in practice, icon arrays used to visualize personal risks often differ in the type and color of the icons. The aim of this study was to examine the influence of icon type and color on the perception and recall of cardiovascular risk, as little is known about how color affects the perception of icon arrays. METHODS A total of 866 participants aged 40 to 90 years representative of the German population in terms of gender and age completed an online experiment. Using a 2 × 2 between-subjects design, participants were randomly assigned to 1 of 4 experimental groups. They received their hypothetical 10-year cardiovascular risk using an icon array that varied by icon type (smiley v. person) and color (black/white v. red/yellow). We measured risk perception, emotional response, intentions of taking action to reduce the risk (e.g., increasing one's physical activity), risk recall, and graph evaluation/trustworthiness, as well as numeracy and graphical literacy. RESULTS Icon arrays using person icons were evaluated more positively. There was no effect of icons or color on risk perception, emotional response, intentions of taking action to reduce the risk, or trustworthiness of the graph. While more numerate/graphical literate participants were more likely to correctly recall the presented risk estimate, icon type and color did not influence the probability of correct recall. CONCLUSIONS Differences in the perception of the tested icon arrays were rather small, suggesting that they may be equally suitable for communicating medical risks. Further research on the robustness of these results across other colors, icons, and risk domains could add to guidelines on the design of visual aids. HIGHLIGHTS The use of different icons and colors did not influence the perception and the probability of recalling the 10-year cardiovascular risk, the emotional response, or the intentions to reduce the presented risk.Icon arrays with person icons were evaluated more positively.There was no evidence to suggest that the effectiveness of the studied icon arrays varied based on individuals' levels of numerical or graphical literacy, nor did it differ between people with or without a history of CVD or on medication for an increased CVD risk.
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Affiliation(s)
- Rebecca Blase
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| | - Julia Meis-Harris
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| | - Birgitta Weltermann
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
| | - Simone Dohle
- Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany
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Genie MG, Poudel N, Paolucci F, Ngorsuraches S. Choice Consistency in Discrete Choice Experiments: Does Numeracy Skill Matter? VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024:S1098-3015(24)02782-7. [PMID: 39094694 DOI: 10.1016/j.jval.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/05/2024] [Accepted: 07/17/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVES This study investigated the relationship between numeracy skills (NS) and choice consistency in discrete choice experiments (DCEs). METHODS A DCE was conducted to explore patients' preferences for kidney transplantation in Italy. Patients completed the DCE and answered 3-item numeracy questions. A heteroskedastic multinomial logit model was used to investigate the effect of numeracy on choice consistency. RESULTS Higher NS were associated with greater choice consistency, increasing the scale to 1.63 (P < .001), 1.39 (P < .001), and 1.18 (P < .001) for patients answering 3 of 3, 2 of 3, and 1 of 3 questions correctly, respectively, compared with those with no correct answers. This corresponded to 63%, 39%, and 18% more consistent choices, respectively. Accounting for choice consistency resulted in varying willingness-to-wait (WTW) estimates for kidney transplant attributes. Patients with the lowest numeracy (0/3) were willing to wait approximately 42 months [95% CI: 29.37, 54.68] for standard infectious risk, compared with 33 months [95% CI: 28.48, 38.09] for 1 of 3, 28 months [95% CI: 25.13, 30.32] for 2 of 3, and 24 months [95% CI: 20.51, 27.25] for 3 of 3 correct answers. However, WTW differences for an additional year of graft survival and neoplastic risk were not statistically significant across numeracy levels. Supplementary analyses of 2 additional DCEs on COVID-19 vaccinations and rheumatoid arthritis, conducted online, supported these findings: higher NS were associated with more consistent choices across different disease contexts and survey formats. CONCLUSIONS The findings suggested that combining patients with varying NS could bias WTW estimates, highlighting the need to consider numeracy in DCE data analysis and interpretation.
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Affiliation(s)
- Mesfin G Genie
- Newcastle Business School, College of Human and Social Futures, The University of Newcastle, Australia; Department of Population Health Sciences, Duke University, Durham, NC, USA; Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, UK.
| | - Nabin Poudel
- Department of Health Outcomes Research and Policy, Auburn University, Auburn, AL, USA; Department of Practice, Sciences, and Health Outcomes Research, University of Maryland, School of Pharmacy, Baltimore, MD, USA
| | - Francesco Paolucci
- Newcastle Business School, College of Human and Social Futures, The University of Newcastle, Australia
| | - Surachat Ngorsuraches
- Department of Health Outcomes Research and Policy, Auburn University, Auburn, AL, USA
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Austin JD, James E, Perez RL, Mazza GL, Kling JM, Fraker J, Mina L, Banerjee I, Sharpe R, Patel BK. Factors influencing U.S. women's interest and preferences for breast cancer risk communication: a cross-sectional study from a large tertiary care breast imaging center. BMC Womens Health 2024; 24:359. [PMID: 38907193 PMCID: PMC11191185 DOI: 10.1186/s12905-024-03197-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Breast imaging clinics in the United States (U.S.) are increasingly implementing breast cancer risk assessment (BCRA) to align with evolving guideline recommendations but with limited uptake of risk-reduction care. Effectively communicating risk information to women is central to implementation efforts, but remains understudied in the U.S. This study aims to characterize, and identify factors associated with women's interest in and preferences for breast cancer risk communication. METHODS This is a cross-sectional survey study of U.S. women presenting for a mammogram between January and March of 2021 at a large, tertiary breast imaging clinic. Survey items assessed women's interest in knowing their risk and preferences for risk communication if considered to be at high risk in hypothetical situations. Multivariable logistic regression modeling assessed factors associated with women's interest in knowing their personal risk and preferences for details around exact risk estimates. RESULTS Among 1119 women, 72.7% were interested in knowing their breast cancer risk. If at high risk, 77% preferred to receive their exact risk estimate and preferred verbal (52.9% phone/47% in-person) vs. written (26.5% online/19.5% letter) communications. Adjusted regression analyses found that those with a primary family history of breast cancer were significantly more interested in knowing their risk (OR 1.5, 95% CI 1.0, 2.1, p = 0.04), while those categorized as "more than one race or other" were significantly less interested in knowing their risk (OR 0.4, 95% CI 0.2, 0.9, p = 0.02). Women 60 + years of age were significantly less likely to prefer exact estimates of their risk (OR 0.6, 95% CI 0.5, 0.98, p < 0.01), while women with greater than a high school education were significantly more likely to prefer exact risk estimates (OR 2.5, 95% CI 1.5, 4.2, p < 0.001). CONCLUSION U.S. women in this study expressed strong interest in knowing their risk and preferred to receive exact risk estimates verbally if found to be at high risk. Sociodemographic and family history influenced women's interest and preferences for risk communication. Breast imaging centers implementing risk assessment should consider strategies tailored to women's preferences to increase interest in risk estimates and improve risk communication.
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Affiliation(s)
- Jessica D Austin
- Department of Quantitative Health Sciences, Division of Epidemiology, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA.
| | - Emily James
- Mayo Clinic College of Medicine of Medicine and Science, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Rachel L Perez
- Mayo Clinic College of Medicine of Medicine and Science, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Gina L Mazza
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Juliana M Kling
- Women's Health Internal Medicine, Department of Internal Medicine, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Jessica Fraker
- Women's Health Internal Medicine, Department of Internal Medicine, Mayo Clinic, 13400 E. Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Lida Mina
- Department of Internal Medicine, Division of Medical Oncology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Imon Banerjee
- Department of Diagnostic Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Richard Sharpe
- Department of Diagnostic Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Bhavika K Patel
- Department of Diagnostic Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
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14
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Hwang Y, Jeong SH. Gist Knowledge and Misinformation Acceptance: An Application of Fuzzy Trace Theory. HEALTH COMMUNICATION 2024; 39:937-944. [PMID: 37038244 DOI: 10.1080/10410236.2023.2197306] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Applying fuzzy trace theory to misinformation related to COVID-19, the present study (a) examines the roles of gist knowledge in predicting misinformation acceptance, and (b) further examines whether a gist cue in fact checking scales affects the level of gist knowledge. Study 1 (a survey) showed that categorical gist knowledge was negatively related to misinformation acceptance, whereas ordinal gist knowledge was not, when both types of knowledge were included in the model. In addition, Study 2 (an experiment) showed that fact checking scales containing a categorical gist cue resulted in greater categorical gist knowledge.
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Affiliation(s)
- Yoori Hwang
- Department of Digital Media, Myongji University
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15
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Fox DS, Elliott L, Bachman HJ, Votruba-Drzal E, Libertus ME. Diversity of spatial activities and parents' spatial talk complexity predict preschoolers' gains in spatial skills. Child Dev 2024; 95:734-749. [PMID: 37861229 PMCID: PMC11023785 DOI: 10.1111/cdev.14024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Children's spatial activities and parental spatial talk were measured to examine their associations with variability in preschoolers' spatial skills (N = 113, Mage = 4 years, 4 months; 51% female; 80% White, 11% Black, and 9% other). Parents who reported more diversity in daily spatial activities and used longer spatial talk utterances during a spatial activity had children with greater gains in spatial skills from ages 4 to 5 (β = .17 and β = .40, respectively). Importantly, this study is the first to move beyond frequency counts of spatial input and investigate the links among the diversity of children's daily spatial activities, as well as the complexity of parents' spatial language across different contexts, and preschoolers' gains in spatial skills, an important predictor of later STEM success.
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Affiliation(s)
- Danielle S Fox
- Learning Research and Development Center, Pittsburgh, Pennsylvania, USA
- Department of Psychology, Dietrich School of Arts and Sciences, Pittsburgh, Pennsylvania, USA
| | - Leanne Elliott
- Learning Research and Development Center, Pittsburgh, Pennsylvania, USA
- Department of Psychology, Dietrich School of Arts and Sciences, Pittsburgh, Pennsylvania, USA
| | - Heather J Bachman
- Learning Research and Development Center, Pittsburgh, Pennsylvania, USA
- Department of Health and Human Development, School of Education, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Votruba-Drzal
- Learning Research and Development Center, Pittsburgh, Pennsylvania, USA
- Department of Psychology, Dietrich School of Arts and Sciences, Pittsburgh, Pennsylvania, USA
| | - Melissa E Libertus
- Learning Research and Development Center, Pittsburgh, Pennsylvania, USA
- Department of Psychology, Dietrich School of Arts and Sciences, Pittsburgh, Pennsylvania, USA
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16
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Vromans RD, Bol N, van Wezel MMC, Krahmer EJ. "R" you getting this? Factors contributing to the public's understanding, evaluation, and use of basic reproduction numbers for infectious diseases. BMC Public Health 2024; 24:1209. [PMID: 38693508 PMCID: PMC11064422 DOI: 10.1186/s12889-024-18669-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 04/19/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND We (1) examined the effects of evaluative labels and visual aids on people's understanding, evaluation, and use of the COVID-19 reproduction number (or "r-number"), (2) examined whether people's perceived susceptibility and (intended) adherence to preventive measures changed after being exposed to the r-number, and (3) explored whether these effects and changes depended on people's numeracy skills. METHODS In an online experiment, participants from a large Dutch representative sample (N = 1,168) received information about the COVID-19 r-number displayed on the corona dashboard of the Dutch Ministry of Health, Welfare and Sport. The r-number was either presented with or without a categorical line display (i.e., evaluative label) and with or without an icon-based tree diagram (i.e., visual aid) explaining how the number works. Regarding people's use of the statistic, we measured perceived susceptibility to COVID-19 and adherence (intention) to five preventive measures before and after exposure to the r-number. After exposure, we also measured participants' understanding, perceived usefulness, affective and cognitive evaluation, and objective numeracy. RESULTS About 56% of participants correctly interpreted the r-number, with highly numerate people having better understanding than less numerate people. Information about the r-number was perceived as more useful when presented with a visual aid. There were no differences across experimental conditions in people's understanding, affective, and cognitive evaluations. Finally, independent of experimental conditions, intention to adhere to preventive measures was higher after seeing the r-number, but only among highly numerate people. CONCLUSIONS Although evaluative labels and visual aids did not facilitate people's understanding and evaluation of the r-number, our results show that the statistic is perceived as useful and may be used to stimulate adherence to preventive measures. Policy makers and public health communicators are advised to clearly explain why they are giving these numbers to - especially - the less numerate people, but also how people could use them for behavior change to combat the spread of virus during a pandemic.
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Affiliation(s)
- Ruben D Vromans
- Department of Communication and Cognition, Tilburg center for Cognition and Communication, Tilburg School of Humanities and Digital Sciences, Tilburg University, P.O. Box 90153, Tilburg, 5037 LE, The Netherlands.
| | - Nadine Bol
- Department of Communication and Cognition, Tilburg center for Cognition and Communication, Tilburg School of Humanities and Digital Sciences, Tilburg University, P.O. Box 90153, Tilburg, 5037 LE, The Netherlands
| | - Marloes M C van Wezel
- Department of Communication and Cognition, Tilburg center for Cognition and Communication, Tilburg School of Humanities and Digital Sciences, Tilburg University, P.O. Box 90153, Tilburg, 5037 LE, The Netherlands
| | - Emiel J Krahmer
- Department of Communication and Cognition, Tilburg center for Cognition and Communication, Tilburg School of Humanities and Digital Sciences, Tilburg University, P.O. Box 90153, Tilburg, 5037 LE, The Netherlands
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17
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Benda N, Woode S, Niño de Rivera S, Kalish RB, Riley LE, Hermann A, Masterson Creber R, Costa Pimentel E, Ancker JS. Understanding Symptom Self-Monitoring Needs Among Postpartum Black Patients: Qualitative Interview Study. J Med Internet Res 2024; 26:e47484. [PMID: 38669066 PMCID: PMC11087860 DOI: 10.2196/47484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 02/20/2024] [Accepted: 03/08/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Pregnancy-related death is on the rise in the United States, and there are significant disparities in outcomes for Black patients. Most solutions that address pregnancy-related death are hospital based, which rely on patients recognizing symptoms and seeking care from a health system, an area where many Black patients have reported experiencing bias. There is a need for patient-centered solutions that support and encourage postpartum people to seek care for severe symptoms. OBJECTIVE We aimed to determine the design needs for a mobile health (mHealth) patient-reported outcomes and decision-support system to assist Black patients in assessing when to seek medical care for severe postpartum symptoms. These findings may also support different perinatal populations and minoritized groups in other clinical settings. METHODS We conducted semistructured interviews with 36 participants-15 (42%) obstetric health professionals, 10 (28%) mental health professionals, and 11 (31%) postpartum Black patients. The interview questions included the following: current practices for symptom monitoring, barriers to and facilitators of effective monitoring, and design requirements for an mHealth system that supports monitoring for severe symptoms. Interviews were audio recorded and transcribed. We analyzed transcripts using directed content analysis and the constant comparative process. We adopted a thematic analysis approach, eliciting themes deductively using conceptual frameworks from health behavior and human information processing, while also allowing new themes to inductively arise from the data. Our team involved multiple coders to promote reliability through a consensus process. RESULTS Our findings revealed considerations related to relevant symptom inputs for postpartum support, the drivers that may affect symptom processing, and the design needs for symptom self-monitoring and patient decision-support interventions. First, participants viewed both somatic and psychological symptom inputs as important to capture. Second, self-perception; previous experience; sociocultural, financial, environmental, and health systems-level factors were all perceived to impact how patients processed, made decisions about, and acted upon their symptoms. Third, participants provided recommendations for system design that involved allowing for user control and freedom. They also stressed the importance of careful wording of decision-support messages, such that messages that recommend them to seek care convey urgency but do not provoke anxiety. Alternatively, messages that recommend they may not need care should make the patient feel heard and reassured. CONCLUSIONS Future solutions for postpartum symptom monitoring should include both somatic and psychological symptoms, which may require combining existing measures to elicit symptoms in a nuanced manner. Solutions should allow for varied, safe interactions to suit individual needs. While mHealth or other apps may not be able to address all the social or financial needs of a person, they may at least provide information, so that patients can easily access other supportive resources.
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Affiliation(s)
- Natalie Benda
- School of Nursing, Columbia University, New York, NY, United States
| | - Sydney Woode
- Department of Radiology, Early Lung and Cardiac Action Program, The Mount Sinai Health System, New York, NY, United States
| | | | - Robin B Kalish
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States
| | - Laura E Riley
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States
| | - Alison Hermann
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, United States
| | | | - Eric Costa Pimentel
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States
| | - Jessica S Ancker
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
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18
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Chamorro Y, Mendizabal-Ruiz AP, Abreu-Mendoza RA, Morales JA, de Lourdes Ramírez-Dueñas M, Matute E. Preliminary Evidence for a Positive Relation Between the COMT rs4680 Met/Met Genotype and Math Achievement. Dev Neuropsychol 2024; 49:138-151. [PMID: 38461456 DOI: 10.1080/87565641.2024.2326879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 03/01/2024] [Indexed: 03/12/2024]
Abstract
To identify if COMT polymorphisms interact with executive functions as predictors of math skills, we assessed 38 adolescents (mean age = 16.4 ± 0.80 years, IQ > 80) from a larger study of high-school students screened for their mathematical abilities. Adolescents were genotyped for the COMT Val158Met polymorphism (grouped as Met/Met or Val-carriers) and completed the WRAT math achievement test, working-memory, inhibitory-control, and shifting tasks. Met/Met-carriers achieved higher WRAT scores than the Val-carriers (W = 229, p = .009). Genotype group was a moderate-to-strong predictor of WRAT scores (β = 0.56 to 0.74). No genotype/executive-function interaction was detected. Our findings suggest that the rs4680 Met/Met genotype is positively associated with math achievement.
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Affiliation(s)
- Yaira Chamorro
- Instituto de Neurociencias, Centro Universitario de Ciencias Biológicas y Agropecuarias, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Adriana P Mendizabal-Ruiz
- Departamento de Farmacobiología, Centro Universitario de Ciencias Exactas e Ingenierías, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | | | - J Alejandro Morales
- Departamento de Ciencias Computacionales, Centro Universitario de Ciencias Exactas e Ingenierías, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - María de Lourdes Ramírez-Dueñas
- Instituto de Neurociencias, Centro Universitario de Ciencias Biológicas y Agropecuarias, Universidad de Guadalajara, Guadalajara, Jalisco, México
| | - Esmeralda Matute
- Instituto de Neurociencias, Centro Universitario de Ciencias Biológicas y Agropecuarias, Universidad de Guadalajara, Guadalajara, Jalisco, México
- Departamento de Estudios en Educación, Centro Universitario de Ciencias Sociales y Humanidades, Universidad de Guadalajara, Guadalajara, Jalisco, México
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Hutmacher F, Reichardt R, Appel M. Motivated reasoning about climate change and the influence of Numeracy, Need for Cognition, and the Dark Factor of Personality. Sci Rep 2024; 14:5615. [PMID: 38454097 PMCID: PMC10920913 DOI: 10.1038/s41598-024-55930-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/29/2024] [Indexed: 03/09/2024] Open
Abstract
Human information processing is not always rational but influenced by prior attitudes, a phenomenon commonly known as motivated reasoning. We conducted two studies (N1 = 556, N2 = 1198; UK samples) investigating motivated reasoning in the context of climate change with a focus on individual differences as potential moderating factors. While previous research investigated motivated reasoning regarding the debate whether climate change is anthropogenic, we focused on current discourses about the effectiveness of different countermeasures. To this end, participants evaluated fictitious scientific data on the effectiveness of regulations to reduce CO2 emissions. In both studies, participants exhibited motivated reasoning as indicated by the observation that prior attitudes about CO2 reduction policies predicted evaluation of the scientific data. The degree of motivated reasoning was not related to individual difference variables, namely the ability to understand and reason with numbers (Numeracy), the willingness to show this ability (Need for Cognition), and the tendency to maximize one's individual utility (Dark Factor of Personality). However, numeracy was associated with a less biased interpretation of the presented information. Our research demonstrates that motivated reasoning is a general phenomenon, and points to numerical training as one way to improve reasoning.
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Affiliation(s)
- Fabian Hutmacher
- Human-Computer-Media Institute, Julius-Maximilians-University Würzburg, Oswald-Külpe-Weg 82, 97074, Würzburg, Germany.
| | - Regina Reichardt
- Department of Psychology, University of Regensburg, Regensburg, Germany
| | - Markus Appel
- Human-Computer-Media Institute, Julius-Maximilians-University Würzburg, Oswald-Külpe-Weg 82, 97074, Würzburg, Germany
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20
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Felgendreff L, Siegers R, Otten L, Betsch C. Infographics on risks associated with COVID-19 and the willingness to get the AstraZeneca vaccine: two randomized online experiments. BMC Public Health 2024; 24:529. [PMID: 38378506 PMCID: PMC10880230 DOI: 10.1186/s12889-024-18057-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 02/09/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Germans hesitated to get vaccinated with AstraZeneca in the COVID-19 pandemic after reports of blood clots. METHODS In two preregistered online experiments with stratified randomization (Study 1 N = 824, Study 2: N = 1,056), we tested whether providing evidence-based benefit-risk information reduces the perceived risk of the AstraZeneca vaccine and the perceived probability of blood clots due to the AstraZeneca vaccine and increases the vaccination intention. In Study 1, participants saw no infographic (control) or one of two infographics (low vs. high exposure risk varied by the underlying incidence rates). Study 2 additionally varied the infographic design displaying the risk information (presented as table, circle icons, or manikin-like icons). RESULTS The infographic decreased the risk perception of the vaccine compared to no infographic (Study 1: Cohens d = 0.31, 95% CI [0.14, 0.48]; Study 2: Cohens d = 0.34, 95% CI [0.06, 0.62]), but it did not influence the perceived probability of blood clots due to the AstraZeneca vaccine (Study 2: Cohens d = 0.05, 95% CI [-0.23, 0.33]). Also, the infographic design did not affect the perceived probability of blood clots (Study 2). The vaccination intention was not affected by viewing the infographic (Study 1: Cohens d = 0.04, 95% CI [-0.13, 0.21]; Study 2: Cohens d = 0.04, 95% CI [-0.24, 0.32]) nor the presented infection rate (Study 1: Cohens d = 0.07, 95% CI [-0.09, 0.24], Study 2: Cohens d = 0.01, 95% CI [-0.12, 0.15]) but by risk perceptions, sociodemographic characteristics, confidence in the AstraZeneca vaccine, and preference for alternative vaccines. CONCLUSIONS The evidence-based benefit-risk information helped putting the risk of vaccinations into perspective. Nevertheless, objective risk information alone did not affect vaccination intention that was low due to the preexisting lacking vaccine confidence.
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Affiliation(s)
- Lisa Felgendreff
- Institute for Planetary Health Behaviour, University of Erfurt, Nordhäuser Str. 63, Erfurt, 99089, Germany.
- Health Communication, BNITM Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
| | - Regina Siegers
- Data Literacy Project, Leibniz Institute for Educational Trajectories, Bamberg, Germany
| | - Leonie Otten
- Institute for Planetary Health Behaviour, University of Erfurt, Nordhäuser Str. 63, Erfurt, 99089, Germany
- Health Communication, BNITM Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Cornelia Betsch
- Institute for Planetary Health Behaviour, University of Erfurt, Nordhäuser Str. 63, Erfurt, 99089, Germany
- Health Communication, BNITM Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
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Sasanguie D, Larmuseau C, Depaepe F, Jansen BRJ. Anxiety about Mathematics and Reading in Preadolescents Is Domain-Specific. J Intell 2024; 12:14. [PMID: 38392170 PMCID: PMC10890043 DOI: 10.3390/jintelligence12020014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/10/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
It was investigated whether test anxiety (TA), mathematics anxiety (MA), and reading anxiety (RA) can be traced back to some type of general academic anxiety or whether these are separable. A total of 776 fifth graders (Mage = 10.9 years) completed questionnaires on TA, MA, and RA, as well as a mathematics test. Also, mathematics and reading performance results from the National Tracking System were requested. The sample was randomly split into two halves. Confirmatory factor analyses showed that a three-factor model (factors: TA, MA, RA) had superior model fit compared with a one-factor model (factor: "Academic anxiety"), in both halves. The resulting anxiety factors were related to math performance measures using structural equation models. A scarcity of data on reading performance prevented the analysis of links between anxiety and reading performance. Anxiety-math performance relations were stronger for MA than for TA and MA. We concluded that TA, MA, and RA are separable constructs.
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Affiliation(s)
- Delphine Sasanguie
- Research Centre for Learning in Diversity, HOGENT, 9000 Ghent, Belgium
- Faculty of Psychology and Educational Sciences@Kulak, KU Leuven, 8500 Kortrijk, Belgium
| | - Charlotte Larmuseau
- Faculty of Psychology and Educational Sciences@Kulak, KU Leuven, 8500 Kortrijk, Belgium
- ITEC, IMEC Research Group, KU Leuven, 8500 Kortrijk, Belgium
| | - Fien Depaepe
- Faculty of Psychology and Educational Sciences@Kulak, KU Leuven, 8500 Kortrijk, Belgium
- ITEC, IMEC Research Group, KU Leuven, 8500 Kortrijk, Belgium
| | - Brenda R J Jansen
- Department of Psychology, Faculty of Social and Behavioural Sciences, University of Amsterdam, 1018 WS Amsterdam, The Netherlands
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Friederichs H, Friederichs WJ, März M. ChatGPT in medical school: how successful is AI in progress testing? MEDICAL EDUCATION ONLINE 2023; 28:2220920. [PMID: 37307503 PMCID: PMC10262795 DOI: 10.1080/10872981.2023.2220920] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/16/2023] [Accepted: 05/30/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND As generative artificial intelligence (AI), ChatGPT provides easy access to a wide range of information, including factual knowledge in the field of medicine. Given that knowledge acquisition is a basic determinant of physicians' performance, teaching and testing different levels of medical knowledge is a central task of medical schools. To measure the factual knowledge level of the ChatGPT responses, we compared the performance of ChatGPT with that of medical students in a progress test. METHODS A total of 400 multiple-choice questions (MCQs) from the progress test in German-speaking countries were entered into ChatGPT's user interface to obtain the percentage of correctly answered questions. We calculated the correlations of the correctness of ChatGPT responses with behavior in terms of response time, word count, and difficulty of a progress test question. RESULTS Of the 395 responses evaluated, 65.5% of the progress test questions answered by ChatGPT were correct. On average, ChatGPT required 22.8 s (SD 17.5) for a complete response, containing 36.2 (SD 28.1) words. There was no correlation between the time used and word count with the accuracy of the ChatGPT response (correlation coefficient for time rho = -0.08, 95% CI [-0.18, 0.02], t(393) = -1.55, p = 0.121; for word count rho = -0.03, 95% CI [-0.13, 0.07], t(393) = -0.54, p = 0.592). There was a significant correlation between the difficulty index of the MCQs and the accuracy of the ChatGPT response (correlation coefficient for difficulty: rho = 0.16, 95% CI [0.06, 0.25], t(393) = 3.19, p = 0.002). CONCLUSION ChatGPT was able to correctly answer two-thirds of all MCQs at the German state licensing exam level in Progress Test Medicine and outperformed almost all medical students in years 1-3. The ChatGPT answers can be compared with the performance of medical students in the second half of their studies.
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Affiliation(s)
| | | | - Maren März
- Charité– Universitätsmedizin Berlin, Kooperationspartner der Freien Universität Berlin, Humboldt-Universität Zu Berlin, Progress Test Medizin, Charitéplatz 1, Berlin, Germany
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Whitehead HL, Hawes Z. Cognitive Foundations of Early Mathematics: Investigating the Unique Contributions of Numerical, Executive Function, and Spatial Skills. J Intell 2023; 11:221. [PMID: 38132839 PMCID: PMC10744352 DOI: 10.3390/jintelligence11120221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/01/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
There is an emerging consensus that numerical, executive function (EF), and spatial skills are foundational to children's mathematical learning and development. Moreover, each skill has been theorized to relate to mathematics for different reasons. Thus, it is possible that each cognitive construct is related to mathematics through distinct pathways. The present study tests this hypothesis. One-hundred and eighty 4- to 9-year-olds (Mage = 6.21) completed a battery of numerical, EF, spatial, and mathematics measures. Factor analyses revealed strong, but separable, relations between children's numerical, EF, and spatial skills. Moreover, the three-factor model (i.e., modelling numerical, EF, and spatial skills as separate latent variables) fit the data better than a general intelligence (g-factor) model. While EF skills were the only unique predictor of number line performance, spatial skills were the only unique predictor of arithmetic (addition) performance. Additionally, spatial skills were related to the use of more advanced addition strategies (e.g., composition/decomposition and retrieval), which in turn were related to children's overall arithmetic performance. That is, children's strategy use fully mediated the relation between spatial skills and arithmetic performance. Taken together, these findings provide new insights into the cognitive foundations of early mathematics, with implications for assessment and instruction moving forward.
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Affiliation(s)
| | - Zachary Hawes
- Department of Applied Psychology & Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON M5S 1V6, Canada;
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Olschewski S, Rieskamp J, Hertwig R. The link between cognitive abilities and risk preference depends on measurement. Sci Rep 2023; 13:21151. [PMID: 38036599 PMCID: PMC10689477 DOI: 10.1038/s41598-023-47844-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023] Open
Abstract
Risk preference is an important construct for understanding individual differences in risk taking throughout the behavioral sciences. An active stream of research has focused on better understanding risk preference through its connection to other psychological constructs, in particular, cognitive abilities. Here, we examine two large-scale multimethod data sets and demonstrate that the method used to measure risk preference is an important moderator. In self-report measures, we found small but consistent positive correlations between working memory capacity/numeracy, facets of cognitive abilities, and risk tolerance. In behavioral measures, we found, on average, no correlation and large intermethod heterogeneity. This heterogeneity can be explained by the choice architecture that is created in behavioral methods-in particular, the relation between risk and reward and the impact of decision error in a task. Consequently, investigating how risk preference relates to psychological constructs such as cognitive abilities require a profound understanding of the choice architecture in measurements of risk preference and in the real world.
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Affiliation(s)
- Sebastian Olschewski
- Department of Psychology, Center for Economic Psychology, University of Basel, Missionsstrasse 62A, 4056, Basel, Switzerland.
- Warwick Business School, University of Warwick, Coventry, UK.
| | - Jörg Rieskamp
- Department of Psychology, Center for Economic Psychology, University of Basel, Missionsstrasse 62A, 4056, Basel, Switzerland
| | - Ralph Hertwig
- Max Planck Institute for Human Development, Berlin, Germany
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25
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Vilaro MJ, Bryan E, Palani T, Cooks EJ, Mertens G, Zalake M, Lok BC, Krieger JL. Rural adults' perceptions of nutrition recommendations for cancer prevention: Contradictory and conflicting messages. PREVENTIVE ONCOLOGY & EPIDEMIOLOGY 2023; 1:2237680. [PMID: 38390218 PMCID: PMC10883477 DOI: 10.1080/28322134.2023.2237680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Despite robust evidence linking alcohol, processed meat, and red meat to colorectal cancer (CRC), public awareness of nutrition recommendations for CRC prevention is low. Marginalized populations, including those in rural areas, experience high CRC burden and may benefit from culturally tailored health information technologies. This study explored perceptions of web-based health messages iteratively in focus groups and interviews with 48 adults as part of a CRC prevention intervention. We analyzed transcripts for message perceptions and identified three main themes with subthemes: (1) Contradictory recommendations, between the intervention's nutrition risk messages and recommendations for other health conditions, from other sources, or based on cultural or personal diets; (2) reactions to nutrition risk messages, ranging from aversion (e.g., "avoid alcohol" considered "preachy") to appreciation, with suggestions for improving messages; and (3) information gaps. We discuss these themes, translational impact, and considerations for future research and communication strategies for delivering web-based cancer prevention messages.
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Affiliation(s)
| | - Emma Bryan
- STEM Translational Communication Center, University of Florida
| | - Te Palani
- STEM Translational Communication Center, University of Florida
| | - Eric J Cooks
- STEM Translational Communication Center, University of Florida
| | - Gillian Mertens
- STEM Translational Communication Center, University of Florida
- Literacy Department, SUNY Cortland
| | - Mohan Zalake
- Computer and Information Sciences and Engineering, University of Florida
| | - Benjamin C Lok
- Computer and Information Sciences and Engineering, University of Florida
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Buelow MT, Moore S, Kowalsky JM, Okdie BM. Cognitive chicken or the emotional egg? How reconceptualizing decision-making by integrating cognition and emotion can improve task psychometrics and clinical utility. Front Psychol 2023; 14:1254179. [PMID: 38034301 PMCID: PMC10687164 DOI: 10.3389/fpsyg.2023.1254179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
Decision-making is an executive function, tapping into cognitive, emotional, and personality-based components. This complexity, and the varying operational definitions of the construct, is reflected in the rich array of behavioral decision-making tasks available for use in research and clinical settings. In many cases, these tasks are "subfield-specific," with tasks developed by cognitive psychologists focusing on cognitive aspects of decision-making and tasks developed by clinical psychologists focusing on interactions between emotional and cognitive aspects. Critically, performance across different tasks does not consistently correlate, obfuscating the ability to compare scores between measures and detect changes over time. Differing theories as to what cognitive and/or emotional aspects affect decision-making likely contribute to this lack of consistency across measures. The low criterion-related validity among decision-making tasks and lack of consistent measurement of the construct presents challenges for emotion and decision-making scholars. In this perspective, we provide several recommendations for the field: (a) assess decision-making as a specific cognitive ability versus a taxonomy of cognitive abilities; (b) a renewed focus on convergent validity across tasks; (c) further assessment of test-retest reliability versus practice effects on tasks; and (d) reimagine future decision-making research to consider the research versus clinical implications. We discuss one example of decision-making research applied to clinical settings, acquired brain injury recovery, to demonstrate how some of these concerns and recommendations can affect the ability to track changes in decision-making across time.
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Affiliation(s)
- Melissa T. Buelow
- Department of Psychology, The Ohio State University, Newark, OH, United States
| | - Sammy Moore
- School of Psychological Sciences, The University of Western Australia, Perth, WA, Australia
| | | | - Bradley M. Okdie
- Department of Psychology, The Ohio State University, Newark, OH, United States
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Kerr J, van der Bles AM, Dryhurst S, Schneider CR, Chopurian V, Freeman ALJ, van der Linden S. The effects of communicating uncertainty around statistics, on public trust. ROYAL SOCIETY OPEN SCIENCE 2023; 10:230604. [PMID: 38026007 PMCID: PMC10663791 DOI: 10.1098/rsos.230604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
Uncertainty around statistics is inevitable. However, communicators of uncertain statistics, particularly in high-stakes and potentially political circumstances, may be concerned that presenting uncertainties could undermine the perceived trustworthiness of the information or its source. In a large survey experiment (Study 1; N = 10 519), we report that communicating uncertainty around present COVID-19 statistics in the form of a numeric range (versus no uncertainty) may lead to slightly lower perceived trustworthiness of the number presented but has no impact on perceived trustworthiness of the source of the information. We also show that this minimal impact of numeric uncertainty on trustworthiness is also present when communicating future, projected COVID-19 statistics (Study 2; N = 2,309). Conversely, we find statements about the mere existence of uncertainty, without quantification, can reduce both perceived trustworthiness of the numbers and of their source. Our findings add to others suggesting that communicators can be transparent about statistical uncertainty without undermining their credibility as a source but should endeavour to provide a quantification, such as a numeric range, where possible.
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Affiliation(s)
- John Kerr
- Winton Centre for Risk & Evidence Communication, University of Cambridge, Cambridge CB2 1TN, UK
- Department of Public Health, University of Otago, Wellington, New Zealand
| | | | - Sarah Dryhurst
- Winton Centre for Risk & Evidence Communication, University of Cambridge, Cambridge CB2 1TN, UK
- Department of Psychology, University of Cambridge, Cambridge CB2 1TN, UK
| | - Claudia R. Schneider
- Winton Centre for Risk & Evidence Communication, University of Cambridge, Cambridge CB2 1TN, UK
- Department of Psychology, University of Cambridge, Cambridge CB2 1TN, UK
| | - Vivien Chopurian
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin 10099, Germany
| | - Alexandra L. J. Freeman
- Winton Centre for Risk & Evidence Communication, University of Cambridge, Cambridge CB2 1TN, UK
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Ünal ZE, Kartal G, Ulusoy S, Ala AM, Yilmaz MZ, Geary DC. Relative Contributions of g and Basic Domain-Specific Mathematics Skills to Complex Mathematics Competencies. INTELLIGENCE 2023; 101:101797. [PMID: 38053742 PMCID: PMC10695353 DOI: 10.1016/j.intell.2023.101797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Meta-analytic structural equation modeling was used to estimate the relative contributions of general cognitive ability or g (defined by executive functions, short-term memory, and intelligence) and basic domain-specific mathematical abilities to performance in more complex mathematics domains. The domain-specific abilities included mathematics fluency (e.g., speed of retrieving basic facts), computational skills (i.e., accuracy at solving multi-step arithmetic, algebra, or geometry problems), and word problems (i.e., mathematics problems presented in narrative form). The core analysis included 448 independent samples and 431,344 participants and revealed that g predicted performance in all three mathematics domains. Mathematics fluency contributed to the prediction of computational skills, and both mathematics fluency and computational skills predicted word problem performance, controlling g. The relative contribution of g was consistently larger than basic domain-specific abilities, although the latter may be underestimated. The patterns were similar across younger and older individuals, individuals with and without a disability (e.g., learning disability), concurrent and longitudinal assessments, and family socioeconomic status, and have implications for fostering mathematical development.
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Affiliation(s)
- Zehra E. Ünal
- Department of Psychological Sciences, University of Missouri
| | - Gamze Kartal
- Department of Educational Psychology, University of Illinois-Urbana Champaign
| | - Serra Ulusoy
- Department of Mathematics and Science Education, Bogazici University
| | - Asli M. Ala
- Department of Mathematics Education, Erzincan University
| | - Münibe Z. Yilmaz
- Department of Counseling, Leadership, Adult Education, and School Psychology, Texas State University
| | - David C. Geary
- Department of Psychological Sciences, University of Missouri
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Manzar S, El Koussaify J, Garcia VC, Ozdag Y, Akoon A, Dwyer CL, Klena JC, Grandizio LC. Statistical Literacy in Hand and Upper-Extremity Patients. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2023; 5:793-798. [PMID: 38106924 PMCID: PMC10721529 DOI: 10.1016/j.jhsg.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/15/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose Statistical literacy is the ability of a patient to apply basic statistical concepts to their health care. Understanding statistics is a critical component of shared decision making. The purpose of this investigation was to define levels of statistical literacy in an upper-extremity (UE) patient population. We aimed to determine if patient demographics would be associated with statistical literacy. Methods An electronic survey was administered to a consecutive series of UE patients at a single institution. We recorded baseline demographics, Single Assessment Numeric Evaluation scores, the Berlin Numeracy Test (BNT), and General Health Numeracy Test. We also included a surgical risk question, which asked: "Approximately 3% of patients who get carpal tunnel surgery develop an infection. If 100 patients get this surgery, how many would you expect to develop an infection?" A covariate-controlled adjusted odds ratio reflecting the association between each statistical literacy outcome measure and patient characteristics was reported. Results A total 254 surveys were administered, 148 of which were completed and included. Fifty percent of respondents had a high-school education or less. For the BNT, 78% scored in the bottom quartile, and 52% incorrectly answered all questions. For the General Health Numeracy Test, 34% answered 0 or 1/6 questions correctly. For the surgical risk question, 24% of respondents answered incorrectly. Respondents who had a college or graduate degree had 2.62 times greater odds (95% confidence interval, 1.09-6.32) of achieving a BNT score in a higher quartile than patients who did not have a college or graduate degree. Conclusions Overall levels of statistical literacy are low for UE patients. Clinical relevance When engaging in management discussions and shared decision making, UE surgeons should assume low levels of statistical literacy. Consideration of alternative formats, such as frequencies, video-based materials, and pictographs, may be warranted when discussing outcomes and risks of surgical procedures.
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Affiliation(s)
- Shahid Manzar
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA
| | - Jad El Koussaify
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA
| | - Victoria C. Garcia
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA
| | - Yagiz Ozdag
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA
| | - Anil Akoon
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA
| | - C. Liam Dwyer
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA
| | - Joel C. Klena
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA
| | - Louis C. Grandizio
- Department of Orthopaedic Surgery, Geisinger Musculoskeletal Institute, Geisinger Commonwealth School of Medicine, Danville, PA
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Tiede KE, Gaissmaier W. How Do People Process Different Representations of Statistical Information? Insights into Cognitive Effort, Representational Inconsistencies, and Individual Differences. Med Decis Making 2023; 43:803-820. [PMID: 37842816 PMCID: PMC10625726 DOI: 10.1177/0272989x231202505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/23/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Graphical representation formats (e.g., icon arrays) have been shown to lead to better understanding of the benefits and risks of treatments compared to numbers. We investigate the cognitive processes underlying the effects of format on understanding: how much cognitive effort is required to process numerical and graphical representations, how people process inconsistent representations, and how numeracy and graph literacy affect information processing. METHODS In a preregistered between-participants experiment, 665 participants answered questions about the relative frequencies of benefits and side effects of 6 medications. First, we manipulated whether the medical information was represented numerically, graphically (as icon arrays), or inconsistently (numerically for 3 medications and graphically for the other 3). Second, to examine cognitive effort, we manipulated whether there was time pressure or not. In an additional intervention condition, participants translated graphical information into numerical information before answering questions. We also assessed numeracy and graph literacy. RESULTS Processing icon arrays was more strongly affected by time pressure than processing numbers, suggesting that graphical formats required more cognitive effort. Understanding was lower when information was represented inconsistently (v. consistently) but not if there was a preceding intervention. Decisions based on inconsistent representations were biased toward graphically represented options. People with higher numeracy processed quantitative information more efficiently than people with lower numeracy did. Graph literacy was not related to processing efficiency. LIMITATIONS Our study was conducted with a nonpatient sample, and the medical information was hypothetical. CONCLUSIONS Although graphical (v. numerical) formats have previously been found to lead to better understanding, they may require more cognitive effort. Therefore, the goal of risk communication may play an important role when choosing how to communicate medical information. HIGHLIGHTS This article investigates the cognitive processes underlying the effects of representation format on the understanding of statistical information and individual differences therein.Processing icon arrays required more cognitive effort than processing numbers did.When information was represented inconsistently (i.e., partly numerically and partly graphically), understanding was lower than with consistent representation, and decisions were biased toward the graphically represented options.People with higher numeracy processed quantitative information more efficiently than people with lower numeracy did.
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Affiliation(s)
- Kevin E. Tiede
- Center for Adaptive Rationality, Max Planck Institute for Human Development, Germany
- Department of Psychology, University of Konstanz, Germany
- Graduate School of Decision Sciences, University of Konstanz, Germany
| | - Wolfgang Gaissmaier
- Department of Psychology, University of Konstanz, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Germany
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31
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de Veer MR, Hermus M, van der Zijden CJ, van der Wilk BJ, Wijnhoven BPL, Stiggelbout AM, Dekker JWT, Coene PPLO, Busschbach JJ, van Lanschot JJB, Lagarde SM, Kranenburg LW. Surgeon's steering behaviour towards patients to participate in a cluster randomised trial on active surveillance for oesophageal cancer: A qualitative study. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:106935. [PMID: 37210275 DOI: 10.1016/j.ejso.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 04/20/2023] [Accepted: 05/15/2023] [Indexed: 05/22/2023]
Abstract
INTRODUCTION Few studies have been conducted into how physicians use steering behaviour that may persuade patients to choose for a particular treatment, let alone to participate in a randomised trial. The aim of this study is to assess if and how surgeons use steering behaviour in their information provision to patients in their choice to participate in a stepped-wedge cluster randomised trial investigating an organ sparing treatment in (curable) oesophageal cancer (SANO trial). MATERIALS AND METHODS A qualitative study was performed. Thematic content analysis was applied to audiotaped and transcribed consultations of twenty patients with eight different oncological surgeons in three Dutch hospitals. Patients could choose to participate in a clinical trial in which an experimental treatment of 'active surveillance' (AS) was offered. Patients who did not want to participate underwent standard treatment: neoadjuvant chemoradiotherapy followed by oesophagectomy. RESULTS Surgeons used various techniques to steer patients towards one of the two options, mostly towards AS. The presentation of pros and cons of treatment options was imbalanced: positive framing of AS was used to steer patients towards the choice for AS, and negative framing of AS to make the choice for surgery more attractive. Further, steering language, i.e. suggestive language, was used, and surgeons seemed to use the timing of the introduction of the different treatment options, to put more focus on one of the treatment options. CONCLUSION Awareness of steering behaviour can help to guide physicians in more objectively informing patients on participation in future clinical trials.
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Affiliation(s)
- Mathijs R de Veer
- Department of Psychiatry, Section Medical Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands.
| | - Merel Hermus
- Department of Psychiatry, Section Medical Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | | | - Berend J van der Wilk
- Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Bas P L Wijnhoven
- Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Anne M Stiggelbout
- Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands
| | | | | | - Jan J Busschbach
- Department of Psychiatry, Section Medical Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Jan J B van Lanschot
- Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Sjoerd M Lagarde
- Department of Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Leonieke W Kranenburg
- Department of Psychiatry, Section Medical Psychology, Erasmus University Medical Centre, Rotterdam, the Netherlands
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Gaissmaier W, Tiede KE, Garcia-Retamero R. The Lure of Beauty: People Select Representations of Statistical Information Largely Based on Attractiveness, Not Comprehensibility. Med Decis Making 2023; 43:774-788. [PMID: 37872798 PMCID: PMC10625725 DOI: 10.1177/0272989x231201579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/28/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVE People differ in whether they understand graphical or numerical representations of statistical information better. However, assessing these skills is often not feasible when deciding which representation to select or use. This study investigates whether people choose the representation they understand better, whether this choice can improve risk comprehension, and whether results are influenced by participants' skills (graph literacy and numeracy). METHODS In an experiment, 160 participants received information about the benefits and side effects of painkillers using either a numerical or a graphical representation. In the "no choice" condition, the representation was randomly assigned to each participant. In the "choice" condition, participants could select the representation they would like to receive. The study assessed gist and verbatim knowledge (immediate comprehension and recall), accessibility of the information, attractiveness of the representation, as well as graph literacy and numeracy. RESULTS In the "choice" condition, most (62.5%) chose the graphical format, yet there was no difference in graph literacy or numeracy (nor age or gender) between people who chose the graphical or the numerical format. Whereas choice slightly increased verbatim knowledge, it did not improve gist or overall knowledge compared with random assignment. However, participants who chose a representation rated the representation as more attractive, and those who chose graphs rated them as more accessible than those without a choice. LIMITATIONS The sample consisted of highly educated undergraduate students with higher graph literacy than the general population. The task was inconsequential for participants in terms of their health. CONCLUSIONS When people can choose between representations, they fail to identify what they comprehend better but largely base that choice on how attractive the representation is for them. HIGHLIGHTS People differ systematically in whether they understand graphical or numerical representations of statistical information better. However, assessing these underlying skills to get the right representation to the right people is not feasible in practice. A simple and efficient method to achieve this could be to let people choose among representations themselves.However, our study showed that allowing participants to choose a representation (numerical v. graphical) did not improve overall or gist knowledge compared with determining the representation randomly, even though it did slightly improve verbatim knowledge.Rather, participants largely chose the representation they found more attractive. Most preferred the graphical representation, including those with low graph literacy.It would therefore be important to develop graphical representations that are not only attractive but also comprehensible even for people with low graph literacy.
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Affiliation(s)
- Wolfgang Gaissmaier
- Department of Psychology, University of Konstanz, Konstanz, Germany
- Centre for the Advanced Study of Collective Behaviour, University of Konstanz, Germany
| | - Kevin E. Tiede
- Department of Psychology, University of Konstanz, Konstanz, Germany
- Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany
- Graduate School of Decision Sciences, University of Konstanz, Germany
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Proto R, Recchia G, Dryhurst S, Freeman ALJ. Do colored cells in risk matrices affect decision-making and risk perception? Insights from randomized controlled studies. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2023; 43:2114-2128. [PMID: 36627812 DOI: 10.1111/risa.14091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/04/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Risk matrices communicate the likelihood and potential impact of risks and are often used to inform decision-making around risk mitigations. The merits and demerits of risk matrices in general have been discussed extensively, yet little attention has been paid to the potential influence of color in risk matrices on their users. We draw from fuzzy-trace theory and hypothesize that when color is present, individuals are likely to place greater value on reducing risks that cross color boundaries (i.e., the boundary-crossing effect), leading to sub-optimal decision making. In two randomized controlled studies, employing forced-choice and willingness-to-pay measures to investigate the boundary-crossing effect in two different color formats for risk matrices, we find preliminary evidence to support our hypotheses that color can influence decision making. The evidence also suggests that the boundary-crossing effect is only present in, or is stronger for, higher numeracy individuals. We therefore recommend that designers should consider avoiding color in risk matrices, particularly in situations where these are likely to be used by highly numerate individuals, if the communication goal is to inform in an unbiased way.
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Affiliation(s)
- Ruri Proto
- Winton Centre for Risk and Evidence Communication, Department of Pure Mathematics and Mathematical Statistics, University of Cambridge, Cambridge, UK
| | - Gabriel Recchia
- Winton Centre for Risk and Evidence Communication, Department of Pure Mathematics and Mathematical Statistics, University of Cambridge, Cambridge, UK
| | - Sarah Dryhurst
- Winton Centre for Risk and Evidence Communication, Department of Pure Mathematics and Mathematical Statistics, University of Cambridge, Cambridge, UK
- Institute for Risk and Disaster Reduction, University College London, London, UK
| | - Alexandra L J Freeman
- Winton Centre for Risk and Evidence Communication, Department of Pure Mathematics and Mathematical Statistics, University of Cambridge, Cambridge, UK
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Lehmann RJB, Schäfer T, Helmus LM, Henniges J, Fleischhauer M. Same Score, Different Audience, Different Message: Perceptions of Sex Offense Risk Depend on Static-99R Risk Level and Personality Factors of the Recipient. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2023; 35:863-895. [PMID: 36720719 DOI: 10.1177/10790632221148667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
There are multiple ways to report risk scale results. Varela et al. (2014) found that Static-99R results were interpreted differently by prospective jurors based on risk level (high vs low) and an interaction between risk level and risk communication format (categorical, absolute estimate, and risk ratio). We adapted and extended Varela et al.'s (2014) study using updated Static-99R norms, recruiting a population-wide sample (n = 166), and adding variables assessing the personality factors 'cognitive motivation' (i.e., need for cognition) and 'attitudinal affect' (i.e., attitudes toward sex offenders, authoritarianism). We found a main effect of risk level and no effect of either communication format or the interaction between the two. Adding the personality variables increased explained variance from 9% to 34%, suggesting risk perception may be more about the personality of the person receiving the information than the information itself. We also found an interaction between attitudes toward sex offenders and risk level. Our results suggest risk perception might be better understood if personality factors are considered, particularly attitudes toward sex offenders. Because biases/personality of the person receiving the information are unknown in real world settings we argue that sharing multiple methods for communicating risk might be best and more inclusive.
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Affiliation(s)
| | - Thomas Schäfer
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - L Maaike Helmus
- Department of Criminology, Simon Fraser University, Vancouver, BC, Canada
| | - Julia Henniges
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
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Zaleskiewicz T, Traczyk J, Sobkow A, Fulawka K, Megías-Robles A. Visualizing risky situations induces a stronger neural response in brain areas associated with mental imagery and emotions than visualizing non-risky situations. Front Hum Neurosci 2023; 17:1207364. [PMID: 37795209 PMCID: PMC10546025 DOI: 10.3389/fnhum.2023.1207364] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/31/2023] [Indexed: 10/06/2023] Open
Abstract
In an fMRI study, we tested the prediction that visualizing risky situations induces a stronger neural response in brain areas associated with mental imagery and emotions than visualizing non-risky and more positive situations. We assumed that processing mental images that allow for "trying-out" the future has greater adaptive importance for risky than non-risky situations, because the former can generate severe negative outcomes. We identified several brain regions that were activated when participants produced images of risky situations and these regions overlap with brain areas engaged in visual, speech, and movement imagery. We also found that producing images of risky situations, in contrast to non-risky situations, was associated with increased neural activation in the insular cortex and cerebellum-the regions involved, among other functions, in emotional processing. Finally, we observed an increased BOLD signal in the cingulate gyrus associated with reward-based decision making and monitoring of decision outcomes. In summary, risky situations increased neural activation in brain areas involved in mental imagery, emotional processing, and decision making. These findings imply that the evaluation of everyday risky situations may be driven by emotional responses that result from mental imagery.
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Affiliation(s)
- Tomasz Zaleskiewicz
- Faculty of Psychology in Wrocław, SWPS University of Social Sciences and Humanities, Wrocław, Poland
| | - Jakub Traczyk
- Faculty of Psychology in Wrocław, SWPS University of Social Sciences and Humanities, Wrocław, Poland
| | - Agata Sobkow
- Faculty of Psychology in Wrocław, SWPS University of Social Sciences and Humanities, Wrocław, Poland
| | - Kamil Fulawka
- Faculty of Psychology in Wrocław, SWPS University of Social Sciences and Humanities, Wrocław, Poland
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Frame ME, Acker-Mills B, Maresca A, Patterson RE, Curtis E, Buccello-Stout R, Nelson J. Evaluation of a decision support system using Bayesian network modeling in an applied Multi-INT surveillance environment. MILITARY PSYCHOLOGY 2023:1-13. [PMID: 37699140 DOI: 10.1080/08995605.2023.2250243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/02/2023] [Indexed: 09/14/2023]
Abstract
Sensemaking and decision-making are fundamental components of applied Intelligence, Surveillance, and Reconnaissance (ISR). Analysts acquire information from multiple sources over a period of hours, days, or even over the scale of months or years, that must be interpreted and integrated to predict future adversarial events. Sensemaking is essential for developing an appropriate mental model that will lead to accurate predictions sooner. Decision Support Systems (DSS) are one proposed solution to improve analyst decision-making outcomes by leveraging computers to conduct calculations that may be difficult for human operators and provide recommendations. In this study, we tested two simulated DSS that were informed by a Bayesian Network Model as a potential prediction-assistive tool. Participants completed a simulated multi-day, multi-source intelligence task and were asked to make predictions regarding five potential outcomes on each day. Participants in both DSS conditions were able to converge on the correct solution significantly faster than the control group, and between 36-44% more of the sample was able to reach the correct conclusion. Furthermore, we found that a DSS representing projected outcome probabilities as numerical, rather than using verbal ordinal labels, were better able to differentiate which outcomes were extremely unlikely than the control group or verbal-probability DSS.
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Affiliation(s)
- Mary E Frame
- Research and Development Department, Parallax Advanced Research, Beavercreek, Ohio
| | - Barbara Acker-Mills
- Research and Development Department, Parallax Advanced Research, Beavercreek, Ohio
| | - Anna Maresca
- Research and Development Department, Parallax Advanced Research, Beavercreek, Ohio
| | | | - Erica Curtis
- Research and Development Department, Parallax Advanced Research, Beavercreek, Ohio
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Keval A, Titi M, Saleh HO, Young S, Gomez JD, Atanasov V, Black B, Meurer J. Community focus groups about a COVID-19 individual risk assessment tool: access, understanding and usefulness. BMC Public Health 2023; 23:1761. [PMID: 37697247 PMCID: PMC10494421 DOI: 10.1186/s12889-023-16696-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/04/2023] [Indexed: 09/13/2023] Open
Abstract
To make informed COVID-19 related decisions, individuals need information about their personal risks and how those risks may vary with specific demographic and health characteristics. The Fight COVID Milwaukee web-based risk assessment tool allows for assessment of COVID-19 mortality risk as a function of personal and neighborhood characteristics. The purpose of this study is to explore public understanding of this risk assessment tool and risk perception through community focus groups. Individuals were recruited from the general adult population in Milwaukee County, Wisconsin, USA, to participate in nine online focus groups where the risk assessment tool was presented for feedback. Three main themes were identified in the focus groups regarding the web-based risk assessment tool: some challenges in accessibility, variable ease of understanding, and personal usefulness but uncertain value for others. This paper explores how members of the community interpret individual risk assessments and life expectancy estimations, and how these vary with age, gender, race/ethnicity, socioeconomic status, and pre-existing comorbidities.
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Affiliation(s)
- Aliyah Keval
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA.
| | - Mohammad Titi
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA
| | - Hadi Omar Saleh
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA
| | - Staci Young
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA
| | - Julia Dickson Gomez
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA
| | | | - Bernard Black
- Northwestern University, 633 Clark St, Evanston, IL, 60208, USA
| | - John Meurer
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA
- Institute for Health and Equity, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA
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Jung M. Bridging the ICT Revolution and Communication Inequality: Lessons for Cancer Survivors. Asian Pac J Cancer Prev 2023; 24:2923-2928. [PMID: 37774042 PMCID: PMC10762738 DOI: 10.31557/apjcp.2023.24.9.2923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/10/2023] [Indexed: 10/01/2023] Open
Abstract
The rapid development of information and communication technologies (ICTs) offers new opportunities for providing health information to patients. In this study, we examined the contrasting effects that communication innovation through ICTs can bring in the care of patients with chronic diseases and the health promotion of medical consumers. We also discussed how disparities in information technology usage, based on socioeconomic status, affect the information gap and health inequalities among medical consumers. ICTs have democratized health information, but the information gap persists and can deepen health inequality. Communication inequality manifests in access to technology, information processing, attention to health information, information seeking, and health outcomes. Significant differences in health communication behaviors exist according to social class. Social disparities in technology access and usage contribute to the information gap, which ultimately leads to different health levels. Communication innovation through ICT has both positive and negative effects on managing chronic diseases. Positively, it democratizes information generation and consumption, enabling patients to interact with healthcare providers and peers for support and advice. Negatively, an abundance of medical information can cause cognitive overload. To maximize benefits and minimize adverse effects, efforts should focus on promoting ICTs in healthcare, enhancing patients' decision-making abilities, and addressing communication inequality. Healthcare institutions must provide consistent, high-quality information, and governments should support underserved populations' access to information, ensuring that ICTs contribute to improved health outcomes.
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Affiliation(s)
- Minsoo Jung
- Department of Health Science, Dongduk Women’s University, Seoul, South Korea.
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.
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Gilmore C. Understanding the complexities of mathematical cognition: A multi-level framework. Q J Exp Psychol (Hove) 2023; 76:1953-1972. [PMID: 37129432 PMCID: PMC10466984 DOI: 10.1177/17470218231175325] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 05/03/2023]
Abstract
Mathematics skills are associated with future employment, well-being, and quality of life. However, many adults and children fail to learn the mathematics skills they require. To improve this situation, we need to have a better understanding of the processes of learning and performing mathematics. Over the past two decades, there has been a substantial growth in psychological research focusing on mathematics. However, to make further progress, we need to pay greater attention to the nature of, and multiple elements involved in, mathematical cognition. Mathematics is not a single construct; rather, overall mathematics achievement is comprised of proficiency with specific components of mathematics (e.g., number fact knowledge, algebraic thinking), which in turn recruit basic mathematical processes (e.g., magnitude comparison, pattern recognition). General cognitive skills and different learning experiences influence the development of each component of mathematics as well as the links between them. Here, I propose and provide evidence for a framework that structures how these components of mathematics fit together. This framework allows us to make sense of the proliferation of empirical findings concerning influences on mathematical cognition and can guide the questions we ask, identifying where we are missing both research evidence and models of specific mechanisms.
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Affiliation(s)
- Camilla Gilmore
- Centre for Mathematical Cognition, Loughborough University, Loughborough, UK
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Tiwari RR, Pandey B, Chaudhari KS. Image-Based Communication for Strengthening Patient Health Education in Rural and Underserved Settings. Cureus 2023; 15:e41279. [PMID: 37533623 PMCID: PMC10391694 DOI: 10.7759/cureus.41279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 08/04/2023] Open
Abstract
Effective communication is the cornerstone of efficient patient care. It is vital to obtain a thorough history, build the patient's trust, and ensure compliance to treatment. Image-based communication (IBC) using comic-like strips is better than the conventional verbal and written modes, as it is inexpensive, less human resource dependent, and diversity agnostic. Strips based on local and socioculturally relevant issues and characters grab readers' attention, are relatable and entertaining, and utilize a storyline that invigorates thinking. The medical advice delivered by an ideal IBC strip is easy to comprehend, has a better recall, and promotes patient adherence. With an idea that IBC strips can serve as a vital supportive tool in underserved and overburdened clinics, we have described the nuances of adapting them into the existing physician-patient experience. We utilize a prototype IBC of an elderly woman helping a family whose child developed acute fever, possibly malaria. Various elements of an IBC strip, namely, panels, gutters, background, characters, bubbles, captions, and visual effects, are illustrated, and their variations are described later. Once designed, an IBC strip must be critically evaluated for the accuracy of the educational message, and errors, if any, must be corrected. The images are then subjected to a series of local field tests to ensure that they serve their purpose and have the desired cultural competence. Once ready, IBC strips can be posted in public spaces and outside clinics or distributed to healthcare workers or patients. Here, they serve as educational and health literacy tools. The strips can significantly reduce caregiver-patient interaction time and improve the quality of communication, especially when patients are illiterate or understand a different language. It is easier to develop rapport and partnership with a patient when the communication is presented through a pictorial tool. An IBC strip can be used to train grassroot workers, who subsequently train patients, thereby serving a dual purpose. To obtain tangible clinical and epidemiologic benefits from IBC strips, rigorous evidence building and standardization are a crucial long-term goal.
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Affiliation(s)
- Rakesh R Tiwari
- Department of Ayurved Basic Principles (Department of Ayurveda Samhita Siddhanta), Dr. D.Y. Patil College of Ayurved & Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
- Department of Ayurved Basic Principles (Department of Ayurveda Samhita Siddhanta), K.G. Mittal Ayurved College, Mumbai, IND
| | - Bhrigupati Pandey
- Department of Ayurved Basic Principles (Department of Ayurveda Samhita Siddhanta), Dr. D.Y. Patil College of Ayurved & Research Centre, Dr. D.Y. Patil Vidyapeeth (Deemed to be University), Pune, IND
| | - Kaustubh S Chaudhari
- Department of Internal Medicine, Dr. Vaishampayan Memorial Government Medical College, Solapur, IND
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Laventhal N. Negative Studies and the Future of Prenatal Counseling at the Margin of Gestational Viability. J Pediatr 2023; 258:113440. [PMID: 37088184 DOI: 10.1016/j.jpeds.2023.113440] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 04/10/2023] [Indexed: 04/25/2023]
Affiliation(s)
- Naomi Laventhal
- Department of Pediatrics, University of Michigan, Ann Arbor, MI.
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Haward MF, Lorenz JM, Janvier A, Fischhoff B. Antenatal consultation and deliberation: adapting to parental preferences. J Perinatol 2023; 43:895-902. [PMID: 36725985 DOI: 10.1038/s41372-023-01605-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 12/28/2022] [Accepted: 01/10/2023] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To analyze and compare perspectives on antenatal consultation and decision-making from participants with varying degrees of prematurity experience and clinician-experts. STUDY DESIGN Open-ended interviews structured around topics previously identified by recognized clinician-experts were conducted with participants having different levels of prematurity experience. Analysis used mixed methods (thematic and mental models analysis). Secondary sub-group comparisons were performed, based on degree of experience. RESULTS Non-clinician participants' (n = 80) perspectives differed regarding: amount and content of information desired, decision-making strategies, and who - parent or clinician - should direct consultations. Most wanted to retain decisional authority, all recognized their emotional limitations and many advocated for deliberation support. Participants worried parents' would regret choosing palliative care contrary to clinicians. Bereaved parents often saw issues differently. CONCLUSIONS Parents approach risk and decision-making for extremely premature infants in a personal fashion. They need personalized support tailored to their unique circumstances, decision-making preferences, and emotions.
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Affiliation(s)
- Marlyse F Haward
- Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - John M Lorenz
- Department of Pediatrics, Morgan Stanley Children Hospital of New York and Columbia University, Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Annie Janvier
- Department of Pediatrics, Bureau de l'Éthique Clinique, Université de Montréal and Division of Neonatology, Research Center, Clinical Ethics Unit, Palliative Care Unit, Unité de recherche en éthique clinique et partenariat famille, CHU Sainte-Justine, Montréal, QC, Canada
| | - Baruch Fischhoff
- Institute for Politics and Strategy, and Department of Engineering and Public Policy, Carnegie Mellon University, Pittsburgh, PA, USA
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Spiazzi BF, Duarte AC, Zingano CP, Teixeira PP, Amazarray CR, Merello EN, Wayerbacher LF, Farenzena LP, Correia PE, Bertoluci MC, Gerchman F, Colpani V. Coconut oil: an overview of cardiometabolic effects and the public health burden of misinformation. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:e000641. [PMID: 37364144 PMCID: PMC10660992 DOI: 10.20945/2359-3997000000641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Recent data from meta-analyses of randomized clinical trials (RCTs) suggest that dietary intake of coconut oil, rich in saturated fatty acids, does not result in cardiometabolic benefits, nor in improvements in anthropometric, lipid, glycemic, and subclinical inflammation parameters. Nevertheless, its consumption has surged in recent years all over the world, a phenomenon which can possibly be explained by an increasing belief among health professionals that this oil is as healthy as, or perhaps even healthier than, other oils, in addition to social network misinformation spread. The objective of this review is to present nutritional and epidemiological aspects related to coconut oil, its relationship with metabolic and cardiovascular health, as well as possible hypotheses to explain its high rate of consumption, in spite of the most recent data regarding its actual effects.
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Affiliation(s)
- Bernardo Frison Spiazzi
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Ana Cláudia Duarte
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Carolina Pires Zingano
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Divisão de Endocrinologia e Metabologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
| | - Paula Portal Teixeira
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Carmen Raya Amazarray
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Eduarda Nunes Merello
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Laura Fink Wayerbacher
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Laura Penso Farenzena
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Poliana Espíndola Correia
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Marcello Casaccia Bertoluci
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Divisão de Endocrinologia e Metabologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
| | - Fernando Gerchman
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Departamento de Medicina Interna, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
- Divisão de Endocrinologia e Metabologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
| | - Verônica Colpani
- Programa de Pós-graduação em Ciências Médicas: Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil,
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McDonnell SM, Basir MA, Yan K, Liegl MN, Windschitl PD. Effect of Presenting Survival Information as Text or Pictograph During Periviable Birth Counseling: A Randomized, Controlled Trial. J Pediatr 2023; 257:113382. [PMID: 36894129 DOI: 10.1016/j.jpeds.2023.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 01/23/2023] [Accepted: 02/28/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVES To examine whether presenting a 30% or a 60% chance of survival in different survival information formats would influence hypothetical periviable birth treatment choice and whether treatment choice would be associated with participants' recall or their intuitive beliefs about the chances of survival. STUDY DESIGN An internet sample of women (n = 1052) were randomized to view a vignette with either a 30% or 60% chance of survival with intensive care during the periviable period. Participants were randomized to survival information presented as text-only, in a static pictograph, or in an iterative pictograph. Participants chose intensive care or palliative care and reported their recall of the chance of survival and their intuitive beliefs about their infant's chance of survival. RESULTS There was no difference in treatment choice by presentation with a 30% vs 60% chance of survival (P = .48), by survival information format (P = .80), or their interaction (P = .18). However, participants' intuitive beliefs about chance of survival significantly predicted treatment choice (P < .001) and had the most explanatory power of any participant characteristic. Intuitive beliefs were optimistic and did not differ by presentation of a 30% or 60% chance of survival (P = .65), even among those with accurate recall of the chance of survival (P = .09). CONCLUSIONS Physicians should recognize that parents may use more than outcome data to make treatment choices and in forming their own, often-optimistic, intuitive beliefs about their infant's chance of survival. TRIAL REGISTRATION ClinicalTrials.gov: NCT04859114.
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Affiliation(s)
| | - Mir A Basir
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
| | - Ke Yan
- Department of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI
| | - Melodee Nugent Liegl
- Department of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI
| | - Paul D Windschitl
- Department of Psychological & Brain Sciences, University of Iowa, Iowa City, IA
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Gutwein A, Han YY, Colón-Semidey A, Alvarez M, Acosta-Pérez E, Forno E, Canino G, Apter A, Celedón JC. Low parental numeracy and severe asthma exacerbations in a prospective study of Puerto Rican youth. Ann Allergy Asthma Immunol 2023; 130:791-796.e2. [PMID: 36893909 PMCID: PMC10247399 DOI: 10.1016/j.anai.2023.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/20/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND Numeracy is the mathematical knowledge required to understand and act on instructions from health care providers. Whether persistently low parental numeracy is linked to childhood asthma exacerbations is unknown. OBJECTIVE To evaluate whether low parental numeracy at 2 time points is associated with asthma exacerbations and worse lung function in Puerto Rican youth. METHODS Prospective study of 225 youth with asthma in San Juan (PR) who participated in 2 visits approximately 5.3 years apart, with the first at ages 6 to 14 years and the second at ages 9 to 20 years. Parental numeracy was assessed with a modified version of the Asthma Numeracy Questionnaire (score range = 0-3 points), and persistently low parental numeracy was defined as a score less than or equal to 1 point at both visits. Asthma exacerbation outcomes included more than or equal to 1 emergency department (ED) visit, more than or equal to 1 hospitalization, and more than or equal to 1 severe exacerbation (≥1 ED visit or ≥1 hospitalization) for asthma in the year before the second visit. Spirometry was conducted using an EasyOne spirometer (NDD Medical Technologies, Andover, Massachusetts). RESULTS In an analysis adjusting for age, sex, parental education, use of inhaled corticosteroids, and the time between study visits, persistently low parental numeracy was associated with more than or equal to 1 ED visit for asthma (odds ratio [ORs], 2.17; 95% confidence interval [CI], 1.10-4.26), more than or equal to 1 hospitalization for asthma (OR, 3.92; 95% CI, 1.42-10.84), and more than or equal to 1 severe asthma exacerbation (OR, 1.99; 95% CI, 1.01-3.87) in the year before the follow-up visit. Persistently low parental numeracy was not significantly associated with change in lung function measures. CONCLUSION Persistently low parental numeracy is associated with asthma exacerbation outcomes in Puerto Rican youth.
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Affiliation(s)
- Amanda Gutwein
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Yueh-Ying Han
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Angel Colón-Semidey
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Maria Alvarez
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Edna Acosta-Pérez
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Erick Forno
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico
| | - Andrea Apter
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Juan C Celedón
- Division of Pulmonary Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania.
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Pillai D, Narayan J, Gentry-Maharaj A, Deo S, Vijaykumar DK, Mukherjee P, Wadhwa N, Bhasin A, Mishra A, Rajanbabu A, Kannan R, Husain Z, Kumar A, Antoniou AC, Manchanda R, Menon U. Co-Creation of Breast Cancer Risk Communication Tools and an Assessment of Risk Factor Awareness: A Qualitative Study of Patients and the Public in India. Cancers (Basel) 2023; 15:2973. [PMID: 37296935 PMCID: PMC10252022 DOI: 10.3390/cancers15112973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Low awareness of BC and its associated risk factors causes delays in diagnosis and impacts survival. It is critical to communicate BC risk to patients in a format that they are easily able to understand. Our study aim was to develop easy-to-follow transmedia prototypes to communicate BC risk and evaluate user preferences, alongside exploring awareness of BC and its risk factors. METHODS Prototypes of transmedia tools for risk communication were developed with multidisciplinary input. A qualitative in-depth online interview study was undertaken using a pre-defined topic guide of BC patients (7), their relatives (6), the general public (6), and health professionals (6). Interviews were analyzed using a thematic approach. FINDINGS Most participants preferred pictographic representations (frequency format) of lifetime risk and risk factors and storytelling using short animations and comic strips (infographics) for communicating genetic risk and testing: "In a short time, they explained it very well, and I liked it". Suggestions included minimizing technical terminology, decreasing the delivery speed, "two-way dialogue", and using local "language for different locations". There was low awareness of BC, with some understanding of age and hereditary risk factors but limited knowledge of reproductive factors. INTERPRETATION Our findings support use of multiple context-specific multimedia tools in communicating cancer risk in an easy-to-understand way. The preference for storytelling using animations and infographics is a novel finding and should be more widely explored.
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Affiliation(s)
- Divya Pillai
- Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad—Gurgaon Expressway, Faridabad 121001, India
| | | | - Aleksandra Gentry-Maharaj
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Faculty of Population Health Sciences, University College London, London WC1V 6LJ, UK
| | | | | | - Poulome Mukherjee
- Cachar Cancer Hospital & Research Centre, Meherpur, Silchar 788015, India
| | - Nitya Wadhwa
- Translational Health Science & Technology Institute, NCR Biotech Science Cluster, Faridabad—Gurgaon Expressway, Faridabad 121001, India
| | | | - Ashutosh Mishra
- All India Institute of Medical Sciences, New Delhi 110029, India
| | - Anupama Rajanbabu
- Amrita Institute of Medical Sciences & Research Centre, Kochi 682041, India
| | - Ravi Kannan
- Cachar Cancer Hospital & Research Centre, Meherpur, Silchar 788015, India
| | - Zakir Husain
- 86/1 College Street, Economics Department, Presidency University Kolkata, Kolkata 700073, India
| | | | - Antonis C. Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Ranjit Manchanda
- Wolfson Institute of Population Health, Barts CRUK Cancer Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Department of Gynaecological Oncology, Barts Health NH Trust, London EC1A 7BE, UK
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
| | - Usha Menon
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, Faculty of Population Health Sciences, University College London, London WC1V 6LJ, UK
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Reyna VF, Brainerd CJ. Numeracy, gist, literal thinking and the value of nothing in decision making. NATURE REVIEWS PSYCHOLOGY 2023; 2:1-19. [PMID: 37361389 PMCID: PMC10196318 DOI: 10.1038/s44159-023-00188-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 06/28/2023]
Abstract
The onus on the average person is greater than ever before to make sense of large amounts of readily accessible quantitative information, but the ability and confidence to do so are frequently lacking. Many people lack practical mathematical skills that are essential for evaluating risks, probabilities and numerical outcomes such as survival rates for medical treatments, income from retirement savings plans or monetary damages in civil trials. In this Review, we integrate research on objective and subjective numeracy, focusing on cognitive and metacognitive factors that distort human perceptions and foment systematic biases in judgement and decision making. Paradoxically, an important implication of this research is that a literal focus on objective numbers and mechanical number crunching is misguided. Numbers can be a matter of life and death but a person who uses rote strategies (verbatim representations) cannot take advantage of the information contained in the numbers because 'rote' strategies are, by definition, processing without meaning. Verbatim representations (verbatim is only surface form, not meaning) treat numbers as data as opposed to information. We highlight a contrasting approach of gist extraction: organizing numbers meaningfully, interpreting them qualitatively and making meaningful inferences about them. Efforts to improve numerical cognition and its practical applications can benefit from emphasizing the qualitative meaning of numbers in context - the gist - building on the strengths of humans as intuitive mathematicians. Thus, we conclude by reviewing evidence that gist training facilitates transfer to new contexts and, because it is more durable, longer-lasting improvements in decision making.
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Affiliation(s)
- Valerie F. Reyna
- Cornell University, Department of Psychology, Human Neuroscience Institute, Ithaca, NY USA
| | - Charles J. Brainerd
- Cornell University, Department of Psychology, Human Neuroscience Institute, Ithaca, NY USA
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Guo Z, Yuan Y, Fu Y, Cui N, Yu Q, Guo E, Ding C, Zhang Y, Jin J. Cardiovascular disease risk perception among community adults in South China: a latent profile analysis. Front Public Health 2023; 11:1073121. [PMID: 37228713 PMCID: PMC10203385 DOI: 10.3389/fpubh.2023.1073121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
Objective Risk perception, a critical psychological construct, influences health behavior modification and maintenance of individuals with cardiovascular disease (CVD) risk. Little is known about CVD risk perception among Chinese adults. This research examined the profiles of CVD risk perception of community adults in South China, and explored the characteristics and factors that influence their perception of CVD risk. Method This cross-sectional study was conducted in Hangzhou, Zhejiang Province, in South China from March to July 2022 and included 692 participants. Risk perception was assessed using the Chinese version of the Attitude and Beliefs about Cardiovascular Disease Risk Questionnaire. Latent profile analysis (LPA) was performed to extract latent classes of CVD risk perception. These classes of CVD risk perception were compared with 10-year CVD risk categories to define correctness of estimation. Chi-square tests and multinomial regression analyses were used to identify differences between these categories. Results Three CVD risk perception classes were identified by LPA: low risk perception (14.2% of participants), moderate risk perception (46.8%), high risk perception (39.0%). Individuals who were aged with 40-60 year (OR = 6.94, 95% CI = 1.86-25.84), diabetes (OR = 6.26, 95% CI = 1.34-29.17), married (OR = 4.52, 95% CI = 2.30-8.90), better subjective health status (OR = 3.23, 95% CI = 1.15-9.10) and perceived benefits and intention to change physical activity (OR = 1.16, 95% CI = 1.05-1.27) were more likely to be in the high-risk perception class. Compared to absolute 10-year CVD risk based on China-PAR, a third of participants (30.1%) correctly estimated their CVD risk, 63.3% overestimated it and 6.6% underestimated it. CVD risk underestimation was associated with hypertension (OR = 3.91, 95% CI = 1.79-8.54), drinking (OR = 3.05, 95% CI = 1.22-7.64), better subjective health status (OR = 2.67, 95% CI = 1.18-6.03). Conclusions Most adults in South China possess a moderate level of CVD risk perception. Advanced age, higher monthly income, diabetes and better health status were significantly related to higher perceived CVD risk. Individuals with hypertension, drinking and better subjective health status were associated with CVD risk underestimation. Healthcare professionals should pay attention to the indicators for different classes and identify underestimation group as early as possible.
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Affiliation(s)
- Zhiting Guo
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yong Yuan
- China Mobile (Hangzhou) Information Technology Co., Ltd., Hangzhou, Zhejiang, China
| | - Yujia Fu
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Nianqi Cui
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qunfei Yu
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Erling Guo
- School of Public Health, Hebei Medical University, Shijiangzhuang, Hebei, China
| | - Chuanqi Ding
- Emergency Department, Changxing County People's Hospital, Huzhou, Zhejiang, China
| | - Yuping Zhang
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jingfen Jin
- Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Key Laboratory of the Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, Zhejiang, China
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Lacey HP, Lacey SC, Dayal P, Forest C, Blasi D. Context Matters: Emotional Sensitivity to Probabilities and the Bias for Action in Cancer Treatment Decisions. Med Decis Making 2023; 43:417-429. [PMID: 36951184 PMCID: PMC10595072 DOI: 10.1177/0272989x231161341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND Past studies have shown a commission bias for cancer treatment, a tendency to choose active treatment even when watchful waiting is less risky. This bias suggests motivations for action beyond mortality statistics, but recent evidence suggests that individuals differ in their emotional sensitivity to probabilities (ESP), the tendency to calibrate emotional reactions to probability. The current study aims to examine the role of ESP in the commission bias, specifically whether those higher in ESP are more likely to choose watchful waiting when risk probabilities align with that choice. METHODS Participants (N = 1,055) read a scenario describing a hypothetical cancer diagnosis and chose between surgery and watchful waiting, with random assignment between versions where the mortality rate was either lower for surgery or for watchful waiting. We modeled choice using the Possibility Probability Questionnaire (PPQ), a measure of ESP, and several other individual differences in a logistic regression. RESULTS We observed a commission bias as in past studies with most participants choosing surgery both when surgery was optimal (71%) and when watchful waiting was optimal (58%). An ESP × Condition interaction indicated that the predictive role of ESP depended on condition. Those higher in ESP were more likely to choose surgery when probabilities favored surgery, β = 0.57, P < 0.001, but when probabilities favored watchful waiting, ESP had a near-zero relationship with choice, β = 0.05, P < 0.99. CONCLUSIONS The role of ESP in decision making is context specific. Higher levels of ESP predict choosing action when that action is warranted but do not predict a shift away from surgery when watchful waiting offers better chances of survival. ESP does not overcome the commission bias. HIGHLIGHTS Past studies have identified a "commission bias," a tendency to choose active treatment over watchful waiting, even when mortality rate is lower for waiting.Evaluation of risk probabilities is related to individual differences in emotional sensitivity to probabilities (ESP) and has been shown to predict reactions to and decisions about health risk situations.ESP appears to be selectively factored into decision making. ESP was a robust predictor of choosing surgery when probability information supported surgery but did not predict decisions when probability information supported watchful waiting.Those who are most emotionally attuned to probabilities are just as susceptible to the commission bias as those who are less attuned.
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Affiliation(s)
- Heather P Lacey
- Department of Psychology, Center for Health and Behavioral Sciences, Bryant University, Smithfield, RI, USA
| | - Steven C Lacey
- Carroll School of Management, Boston University, Chestnut Hill, MA, USA
| | - Prerna Dayal
- Department of Psychology, Center for Health and Behavioral Sciences, Bryant University, Smithfield, RI, USA
| | - Caroline Forest
- Department of Psychology, Center for Health and Behavioral Sciences, Bryant University, Smithfield, RI, USA
| | - Dana Blasi
- Department of Psychology, Center for Health and Behavioral Sciences, Bryant University, Smithfield, RI, USA
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Irwin D, Mandel DR. Communicating uncertainty in national security intelligence: Expert and nonexpert interpretations of and preferences for verbal and numeric formats. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2023; 43:943-957. [PMID: 35994518 DOI: 10.1111/risa.14009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/19/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
Organizations in several domains including national security intelligence communicate judgments under uncertainty using verbal probabilities (e.g., likely) instead of numeric probabilities (e.g., 75% chance), despite research indicating that the former have variable meanings across individuals. In the intelligence domain, uncertainty is also communicated using terms such as low, moderate, or high to describe the analyst's confidence level. However, little research has examined how intelligence professionals interpret these terms and whether they prefer them to numeric uncertainty quantifiers. In two experiments (N = 481 and 624, respectively), uncertainty communication preferences of expert (n = 41 intelligence analysts in Experiment 1) and nonexpert intelligence consumers were elicited. We examined which format participants judged to be more informative and simpler to process. We further tested whether participants treated verbal probability and confidence terms as independent constructs and whether participants provided coherent numeric probability translations of verbal probabilities. Results showed that although most nonexperts favored the numeric format, experts were about equally split, and most participants in both samples regarded the numeric format as more informative. Experts and nonexperts consistently conflated probability and confidence. For instance, confidence intervals inferred from verbal confidence terms had a greater effect on the location of the estimate than the width of the estimate, contrary to normative expectation. Approximately one-fourth of experts and over one-half of nonexperts provided incoherent numeric probability translations for the terms likely and unlikely when the elicitation of best estimates and lower and upper bounds were briefly spaced by intervening tasks.
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Affiliation(s)
| | - David R Mandel
- Intelligence, Influence and Collaboration Section, Defence Research and Development Canada, Toronto, ON, Canada
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