Improving understanding of adjuvant therapy options by using simpler risk graphics

To help oncologists and breast cancer patients make informed decisions about adjuvant therapies, online tools such as Adjuvant! provide tailored estimates of mortality and recurrence risks. However, the graphical format used to display these results (a set of 4 horizontal stacked bars) may be suboptimal. The authors tested whether using simpler formats would improve comprehension of the relevant risk statistics.

[1]  R. Thomson,et al.  Decision aids for people facing health treatment or screening decisions. , 2003, The Cochrane database of systematic reviews.

[2]  P. Ubel,et al.  Reducing the Influence of Anecdotal Reasoning on People’s Health Care Decisions: Is a Picture Worth a Thousand Statistics? , 2005, Medical decision making : an international journal of the Society for Medical Decision Making.

[3]  B. Marx The Visual Display of Quantitative Information , 1985 .

[4]  P. Ubel,et al.  Hope I Die before I Get Old: Mispredicting Happiness Across the Adult Lifespan , 2006 .

[5]  P. Ubel,et al.  Measuring Numeracy without a Math Test: Development of the Subjective Numeracy Scale , 2007, Medical decision making : an international journal of the Society for Medical Decision Making.

[6]  Erika A. Waters,et al.  Formats for Improving Risk Communication in Medical Tradeoff Decisions , 2006, Journal of health communication.

[7]  J G Hollands,et al.  Judgments of Change and Proportion in Graphical Perception , 1992, Human factors.

[8]  Edward R. Tufte,et al.  The Visual Display of Quantitative Information , 1986 .

[9]  M. F. Luce,et al.  Choice processing in emotionally difficult decisions. , 1997, Journal of experimental psychology. Learning, memory, and cognition.

[10]  S. Kosslyn Understanding charts and graphs , 1989 .

[11]  Erika A. Waters,et al.  Reducing aversion to side effects in preventive medical treatment decisions. , 2007, Journal of experimental psychology. Applied.

[12]  Eric J. Johnson,et al.  The Adaptive Decision-Maker : Effort and Accuracy in Choice , 2022 .

[13]  M. Lepper,et al.  The Construction of Preference: When Choice Is Demotivating: Can One Desire Too Much of a Good Thing? , 2006 .

[14]  J. N. Bassili,et al.  RESPONSE LATENCY AS A SIGNAL TO QUESTION PROBLEMS IN SURVEY RESEARCH , 1996 .

[15]  Kevin Lane Keller,et al.  Effects of Quality and Quantity of Information on Decision Effectiveness , 1987 .

[16]  P. Ubel,et al.  Validation of the Subjective Numeracy Scale: Effects of Low Numeracy on Comprehension of Risk Communications and Utility Elicitations , 2007, Medical decision making : an international journal of the Society for Medical Decision Making.

[17]  P. Ubel,et al.  Communicating side effect risks in a tamoxifen prophylaxis decision aid: the debiasing influence of pictographs. , 2008, Patient education and counseling.

[18]  Ian Spence,et al.  Judging Proportion with Graphs: The Summation Model , 1998 .

[19]  P. Ravdin,et al.  A decision aid to assist in adjuvant therapy choices for breast cancer , 2006, Psycho-oncology.

[20]  L. Esserman,et al.  Risk communication with patients with breast cancer: cautionary notes about printing Adjuvant! estimates. , 2008, The Lancet. Oncology.

[21]  B. Schwartz The Paradox of Choice: Why More Is Less , 2004 .

[22]  Priti Shah,et al.  A Model of the Perceptual and Conceptual Processes in Graph Comprehension , 1998 .

[23]  Stephen Michael Kosslyn,et al.  Graph Design for the Eye and Mind , 2006 .

[24]  Kevin Wise,et al.  The effect of available choice on the cognitive processing of pictures , 2008, Comput. Hum. Behav..

[25]  Angela Fagerlin,et al.  Alternate Methods of Framing Information About Medication Side Effects: Incremental Risk Versus Total Risk of Occurrence , 2008, Journal of health communication.

[26]  Melanie Price,et al.  Communicating risk information: the influence of graphical display format on quantitative information perception-Accuracy, comprehension and preferences. , 2007, Patient education and counseling.

[27]  P. Ravdin,et al.  Computer program to assist in making decisions about adjuvant therapy for women with early breast cancer. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[28]  P. Fayers,et al.  The Visual Display of Quantitative Information , 1990 .

[29]  M. Brundage,et al.  Further Insight into the Perception of Quantitative Information: Judgments of Gist in Treatment Decisions , 2007, Medical decision making : an international journal of the Society for Medical Decision Making.

[30]  R McGill,et al.  Graphical Perception and Graphical Methods for Analyzing Scientific Data , 1985, Science.

[31]  P. Ravdin,et al.  Decreased Use of Adjuvant Breast Cancer Therapy in a Randomized Controlled Trial of a Decision Aid with Individualized Risk Information , 2005, Medical decision making : an international journal of the Society for Medical Decision Making.