MDM Policy and PracticePub Date : 2025-02-24eCollection Date: 2025-01-01DOI: 10.1177/23814683241255333
Jessica S Ancker, Natalie C Benda, Mohit M Sharma, Stephen B Johnson, Michelle Demetres, Diana Delgado, Brian J Zikmund-Fisher
{"title":"How Point (Single-Probability) Tasks Are Affected by Probability Format, Part 1: A Making Numbers Meaningful Systematic Review.","authors":"Jessica S Ancker, Natalie C Benda, Mohit M Sharma, Stephen B Johnson, Michelle Demetres, Diana Delgado, Brian J Zikmund-Fisher","doi":"10.1177/23814683241255333","DOIUrl":"10.1177/23814683241255333","url":null,"abstract":"<p><p><b>Background.</b> To create guidance on the effect of data presentation format on communication of health numbers, the Making Numbers Meaningful project undertook a systematic review. <b>Purpose.</b> This article (one of a series) covers research studying so-called \"point tasks,\" in which a reader examines stimuli to obtain information about single probabilities. The current article presents the evidence on the effects of data presentation format on multiple outcomes: identification and recall, contrast, categorization, and computation. <b>Data Sources.</b> MEDLINE, Embase, CINAHL, the Cochrane Library, PsycINFO, ERIC, ACM Digital Library; hand search of 4 journals. <b>Finding Selection.</b> Manual pairwise screening to identify experimental and quasi-experimental research comparing 2 or more formats for quantitative health information for patients or other lay audiences. This article reports on 218 findings from 99 articles on single probability communication. <b>Data Extraction.</b> Pairwise extraction of data on stimulus (data in a data presentation format), task, and perceptual/affective/cognitive/behavioral outcomes. <b>Data Synthesis.</b> Most evidence on these outcomes was weak or insufficient. There was moderate to strong evidence that 1) recall was better with icon arrays with human figures than icon arrays with blocks, 2) survival curves make it easier to identify points of highest survival than mortality curves (contrast outcome), 3) adding an average population probability to a message about an individual probability may not affect recall, 4) computation performance is better with bar charts combined with data labels than with either numbers or graphics alone, 5) computation performance with rates is better when denominators match, and 6) framing strongly affects risky choices (contrast). <b>Limitations.</b> Heterogeneous study designs reduced the ability to develop strong evidence. <b>Conclusions.</b> Few findings assessing identification or recall, contrast, categorization, or computation outcomes for point tasks were comparable enough to each other to generate strong evidence.</p><p><strong>Highlights: </strong>Many researchers have studied the effects of data presentation formats of single probabilities on different outcomes.However, few findings are comparable enough to allow for strong evidence-based conclusions about the impact on identification, recall, contrast, categorization, and computation outcomes.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241255333"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MDM Policy and PracticePub Date : 2025-02-24eCollection Date: 2025-01-01DOI: 10.1177/23814683241255337
Jessica S Ancker, Natalie C Benda, Mohit M Sharma, Stephen B Johnson, Michelle Demetres, Diana Delgado, Brian J Zikmund-Fisher
{"title":"How Point (Single-Probability) Tasks Are Affected by Probability Format, Part 2: A Making Numbers Meaningful Systematic Review.","authors":"Jessica S Ancker, Natalie C Benda, Mohit M Sharma, Stephen B Johnson, Michelle Demetres, Diana Delgado, Brian J Zikmund-Fisher","doi":"10.1177/23814683241255337","DOIUrl":"10.1177/23814683241255337","url":null,"abstract":"<p><p><b>Background.</b> The Making Numbers Meaningful review is intended to create guidance on the effect of data presentation format on comprehension of numbers in health. <b>Purpose.</b> This article (one of a series) covers research studying so-called \"point tasks,\" in which a reader examines materials to obtain information about single probabilities. The current article presents evidence on the effects of data presentation format on probability perceptions and feelings, health behaviors and behavioral intentions, trust, preference, and discrimination outcomes. <b>Data Sources.</b> MEDLINE, Embase, CINAHL, the Cochrane Library, PsycINFO, ERIC, ACM Digital Library; hand search of 4 journals. <b>Study Selection.</b> Manual pairwise screening to identify experimental and quasi-experimental research that compared 2 or more formats for presenting quantitative health information to patients or other lay audiences. This article reports 466 findings of probability communication from 161 articles. <b>Data Extraction.</b> Pairwise extraction of information on stimulus (data in a data presentation format), task, and outcomes. <b>Data Synthesis.</b> Moderate to strong evidence is available on the effects of several format interventions to influence probability perceptions and feelings, including the 1-in-X number format, foreground-only (numerator-only) icon arrays, bar charts, anecdotes, framing, and verbal probabilities. However, only 3 (the 1-in-X effect, anecdotes, and framing) had moderate to strong evidence of influencing health behaviors and behavioral intentions. Research on patient preferences for numerical, graphical, and verbal formats yielded only weak evidence. <b>Conclusions.</b> The link between probability perceptions/feelings and health behaviors is not strongly reflected in the evidence about communicating numbers because many communication-focused studies measure short-term response rather than longer-term behaviors. Also, research into patient preferences for numerical, graphical, and verbal formats has not yielded strong evidence suggesting stable and predictable preferences.</p><p><strong>Highlights: </strong>Formatting a probability as 1 in X, using a foreground-only icon array, adding anecdotes to numbers, and gain-loss framing all affect probability perceptions and feelings.The evidence on communicating numbers to influence perceptions is far stronger than the evidence on using it to change health behavior or behavioral intention.Only weak evidence is available on patient preferences for verbal, graphical, and numerical probability formats.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241255337"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MDM Policy and PracticePub Date : 2025-02-24eCollection Date: 2025-01-01DOI: 10.1177/23814683251314517
Kevin E Tiede
{"title":"Learning from the Past to Guide the Future of Research on Risk Communication.","authors":"Kevin E Tiede","doi":"10.1177/23814683251314517","DOIUrl":"10.1177/23814683251314517","url":null,"abstract":"","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683251314517"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MDM Policy and PracticePub Date : 2025-02-24eCollection Date: 2025-01-01DOI: 10.1177/23814683241301702
Mohit M Sharma, Jessica S Ancker, Natalie C Benda, Stephen B Johnson, Michelle Demetres, Diana Delgado, Brian J Zikmund-Fisher
{"title":"How Time-Trend Tasks Are Affected by Probability Format: A Making Numbers Meaningful Systematic Review.","authors":"Mohit M Sharma, Jessica S Ancker, Natalie C Benda, Stephen B Johnson, Michelle Demetres, Diana Delgado, Brian J Zikmund-Fisher","doi":"10.1177/23814683241301702","DOIUrl":"10.1177/23814683241301702","url":null,"abstract":"<p><p><b>Background.</b> To develop guidance on the effects of format on communication of health probabilities, the Making Numbers Meaningful team conducted a systematic review. <b>Purpose.</b> This article (one of a series) covers research on time-trend tasks, in which participants evaluate stimuli for information about probability trends, such as changing chances of cancer recurrence over time. <b>Data Sources.</b> MEDLINE, Embase, CINAHL, the Cochrane Library, PsycINFO, ERIC, ACM Digital Library; hand search of 4 journals. <b>Study Selection.</b> We conducted independent dual screening to identify experimental or quasi-experimental research comparing 2 or more formats for presenting quantitative health information to lay audiences. This article reports on 11 findings from 6 unique studies. <b>Data Extraction.</b> Independent dual extraction of information on stimulus (data in a data presentation format), task, and perceptual, affective, cognitive, and behavioral outcomes. <b>Data Synthesis.</b> We identified research on the impact of format on the following outcomes: contrast, computation, effectiveness perceptions, health behaviors and behavioral intentions, discrimination, and preference. Strong evidence suggests that graphing probability curves over longer (rather than shorter) time periods increases perceived differences between curves (effectiveness perception outcome). Weak evidence suggested 1) survival versus mortality curves do not affect perceived differences between curves or ability to perform computations, 2) survival curves may help people identify the option with the highest survival, and 3) graphing probabilities over longer time periods may not affect the ability to identify the highest survival. <b>Limitations.</b> Granular data extraction and evidence syntheses lead to narrow conclusions rather than broader statements. <b>Conclusions.</b> The very limited evidence available about probability time-trend tasks is primarily about the effects of framing (survival v. mortality curves) and the effects of using shorter versus longer time periods.</p><p><strong>Highlights: </strong>This systematic review found that few studies of probability trend data compared similar formats or used comparable outcome measures.The only strong piece of evidence was that graphing probabilities over longer time periods such that the distance between curves widens will tend to increase the perceived difference between the curves.Weak evidence suggests that survival curves (versus mortality curves) may make it easier to identify the option with the highest overall survival.Weak evidence suggests that graphing probabilities over longer (rather than shorter) time periods may increase the ability to distinguish between small survival differences.Evidence was insufficient to determine whether any format influenced behaviors or behavioral intentions.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241301702"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MDM Policy and PracticePub Date : 2025-02-24eCollection Date: 2025-01-01DOI: 10.1177/23814683241312337
Brian J Zikmund-Fisher, Jessica S Ancker
{"title":"How to Make Sense of the Making Numbers Meaningful Systematic Review.","authors":"Brian J Zikmund-Fisher, Jessica S Ancker","doi":"10.1177/23814683241312337","DOIUrl":"10.1177/23814683241312337","url":null,"abstract":"","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241312337"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MDM Policy and PracticePub Date : 2025-02-24eCollection Date: 2025-01-01DOI: 10.1177/23814683251314784
Paul K J Han
{"title":"Tolerating Uncertainty About the Communication of Risk.","authors":"Paul K J Han","doi":"10.1177/23814683251314784","DOIUrl":"10.1177/23814683251314784","url":null,"abstract":"","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683251314784"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MDM Policy and PracticePub Date : 2025-02-24eCollection Date: 2025-01-01DOI: 10.1177/23814683251314519
Marilyn M Schapira
{"title":"Reflecting on the Universal Meaning of Numbers in Health and Risk Communication.","authors":"Marilyn M Schapira","doi":"10.1177/23814683251314519","DOIUrl":"10.1177/23814683251314519","url":null,"abstract":"","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683251314519"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MDM Policy and PracticePub Date : 2025-02-24eCollection Date: 2025-01-01DOI: 10.1177/23814683241310242
Natalie C Benda, Brian J Zikmund-Fisher, Mohit M Sharma, Stephen B Johnson, Michelle Demetres, Diana Delgado, Jessica S Ancker
{"title":"How Difference Tasks Are Affected by Probability Format, Part 2: A Making Numbers Meaningful Systematic Review.","authors":"Natalie C Benda, Brian J Zikmund-Fisher, Mohit M Sharma, Stephen B Johnson, Michelle Demetres, Diana Delgado, Jessica S Ancker","doi":"10.1177/23814683241310242","DOIUrl":"https://doi.org/10.1177/23814683241310242","url":null,"abstract":"<p><p><b>Background.</b> To evaluate the effect of data presentation format on communication of health probabilities, the Making Numbers Meaningful team undertook a systematic review. <b>Purpose.</b> This article presents evidence about difference tasks, in which a reader examines information to evaluate differences between probabilities, such as the effect of a therapy on the chance of recurrence. This article covers the effect of format on 5 outcomes: 1) perceptions of or feelings about effectiveness, 2) behavioral intentions or behaviors, 3) trust, 4) preference for the format, and 5) discrimination. <b>Data Sources.</b> MEDLINE, Embase, CINAHL, the Cochrane Library, PsycINFO, ERIC, ACM Digital Library; hand search. <b>Finding Selection.</b> Experimental/quasi-experimental studies comparing 2 or more formats for presenting quantitative health information. This article covers 205 findings from 101 unique studies reported in 84 articles. <b>Data Extraction.</b> Dual extraction of information on stimulus, task, and perceptual, affective, cognitive, and behavioral outcomes. <b>Data Synthesis.</b> Evidence is moderate to strong that behavioral intention is affected more by relative differences than absolute ones, by numerator-only graphics than part-to-whole graphics, by messages with anecdotes than without, and by information about what others chose. Evidence is strong that perceived and felt effectiveness is affected more by relative differences than by absolute ones and more by numerator-only graphics rather than part-to-whole graphics. For graphic preferences, bar charts were preferred to icon arrays and graphics with data labels to graphics without. Other comparisons had weak or insufficient evidence. <b>Limitations.</b> The detailed approach to evidence syntheses provides narrowly targeted evidence rather than broad statements. <b>Conclusions.</b> Moderate to strong evidence can be derived on effects of probability difference format on behavioral intention, perceived or felt effectiveness, and preference for format.</p><p><strong>Highlights: </strong>Communicating relative risk differences as opposed to absolute risk differences, using numerator-only instead of part-to-whole graphics, and including anecdotes or information about others' decisions will all increase intentions to engage in a behavior.Relative risks (rather than absolute risk differences) and numerator-only graphics (rather than part-to-whole) will also increase felt and perceived effectiveness.To illustrate probability differences, people tend to prefer bar charts over icon arrays and graphics with labels over those without.All findings regarding the impact of different presentation formats for probability differences on trust produced insufficient evidence.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241310242"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MDM Policy and PracticePub Date : 2025-02-24eCollection Date: 2025-01-01DOI: 10.1177/23814683251314513
Lauren E Cipriano
{"title":"The Peer Review Process for the Making Numbers Meaningful Article Collection and Thanks to Collection Editor Marilyn Schapira.","authors":"Lauren E Cipriano","doi":"10.1177/23814683251314513","DOIUrl":"https://doi.org/10.1177/23814683251314513","url":null,"abstract":"","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683251314513"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MDM Policy and PracticePub Date : 2025-01-21eCollection Date: 2025-01-01DOI: 10.1177/23814683241310146
Naomi Kate Gibbs, Susan Griffin, Nils Gutacker, Adrián Villaseñor, Simon Walker
{"title":"Prioritizing Patients from the Most Deprived Areas on Elective Waiting Lists in the NHS in England: Estimating the Health and Health Inequality Impact.","authors":"Naomi Kate Gibbs, Susan Griffin, Nils Gutacker, Adrián Villaseñor, Simon Walker","doi":"10.1177/23814683241310146","DOIUrl":"10.1177/23814683241310146","url":null,"abstract":"<p><p><b>Introduction.</b> Reducing hospital waiting lists for elective procedures is a policy concern in the National Health Service (NHS) in England. Following growth in waiting lists after COVID-19, the NHS published an elective recovery plan that includes an aim to prioritize patients from deprived areas. We use a previously developed model to estimate the health and health inequality impact under hypothetical targeted versus universal policies to reduce waiting time. <b>Methods.</b> We use a Markov model to estimate the health impact of waiting, by index of multiple deprivation quintile group, for 8 elective procedures. We estimate patients' remaining quality-adjusted life-years (QALYs) with baseline waiting times and under 2 hypothetical policy scenarios: 1) a universal policy in which all patients receive an equal reduction in wait and 2) a targeted policy in which patients living in the most deprived quintile are prioritized. We estimate individual and population level health under each of the 2 policies and compare it with baseline. We also estimate how health inequality changes from baseline using the slope index of inequality, reflecting the difference in health between the least and most deprived quintile based on QALYs. <b>Results.</b> A universal reduction in waiting time is estimated to improve overall population health but increase health inequality. A targeted reduction would achieve nearly the same overall health gain and would also increase population-level health inequalities but to a lesser extent than the universal policy would. <b>Discussion.</b> If the NHS is successful in prioritizing patients on waiting lists from the most deprived areas, this may result in smaller increases in health inequalities while maintaining a similar level of overall health gain compared with a universal policy.</p><p><strong>Highlights: </strong>The NHS elective recovery plans include prioritizing patients who live in the most deprived areas of England.Evaluating a hypothetical targeted wait time reduction policy against a universal wait time reduction policy suggests almost the same level of population health gain could be achieved while lessening the negative impact on health inequality.Expected outcomes of government health policies should be quantified to explore the impact on both health maximization and health inequality minimization, as both represent legitimate policy concerns.</p>","PeriodicalId":36567,"journal":{"name":"MDM Policy and Practice","volume":"10 1","pages":"23814683241310146"},"PeriodicalIF":1.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}