Trevena, LJ, Bonner, C, Okan, Y orcid.org/0000-0001-7963-1363 et al. (6 more authors) (2021) Current Challenges When Using Numbers in Patient Decision Aids: Advanced Concepts. Medical Decision Making, 41 (7). pp. 834-847. ISSN 0272-989X
Abstract
Background
Decision aid developers have to convey complex task-specific numeric information in a way that minimizes bias and promotes understanding of the options available within a particular decision. Whereas our companion paper summarizes fundamental issues, this article focuses on more complex, task-specific aspects of presenting numeric information in patient decision aids.
Methods
As part of the International Patient Decision Aids Standards third evidence update, we gathered an expert panel of 9 international experts who revised and expanded the topics covered in the 2013 review working in groups of 2 to 3 to update the evidence, based on their expertise and targeted searches of the literature. The full panel then reviewed and provided additional revisions, reaching consensus on the final version.
Results
Five of the 10 topics addressed more complex task-specific issues. We found strong evidence for using independent event rates and/or incremental absolute risk differences for the effect size of test and screening outcomes. Simple visual formats can help to reduce common judgment biases and enhance comprehension but can be misleading if not well designed. Graph literacy can moderate the effectiveness of visual formats and hence should be considered in tool design. There is less evidence supporting the inclusion of personalized and interactive risk estimates.
Discussion
More complex numeric information. such as the size of the benefits and harms for decision options, can be better understood by using incremental absolute risk differences alongside well-designed visual formats that consider the graph literacy of the intended audience. More research is needed into when and how to use personalized and/or interactive risk estimates because their complexity and accessibility may affect their feasibility in clinical practice.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 by Society for Medical Decision Making. This is an author produced version of an article published in Medical Decision Making. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | decision aids, risk communication, standards |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Business (Leeds) > Management Division (LUBS) (Leeds) > Management Division Decision Research (LUBS) |
Depositing User: | Symplectic Publications |
Date Deposited: | 01 Mar 2021 15:59 |
Last Modified: | 06 Jun 2024 10:40 |
Status: | Published |
Publisher: | SAGE Publications |
Identification Number: | 10.1177/0272989X21996342 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:171579 |