Statistical illiteracy undermines informed shared decision making
Statistical illiteracy undermines informed shared decision making
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DOI：
10.1016/j.zefq.2008.08.013
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发表时间：
2008-01-01
影响因子：
1.1
通讯作者：
Gigerenzer, Gerd
中科院分区：
文献类型：
--
作者：
Gaissmaier, Wolfgang;Gigerenzer, Gerd
共享决策依赖于医生和患者之间的信息交换以及患者和医生在决策过程中的参与。因此，知情的共同决策要求患者和医生了解不同治疗方案的好处和坏处。然而，这一点受到我们所称的集体统计文盲的严重破坏。患者和医生都难以理解数字的含义，因此无法进行有效的风险沟通。然而，基于误解的风险沟通会使知情的共同决策中的“知情”过时。我们表明，通过改变统计信息的表示形式，统计文盲问题在很大程度上可以得到解决。洞察可以通过以下方式实现：以绝对而不是相对的方式传达风险；使用频数公式使参考类别清晰，而不是传达单个事件概率；通过传达自然频率而不是条件概率来实现洞察。
Shared decision making relies on the exchange of information between the physician and the patient and the involvement of both patient and physician in making the decision. Informed shared decision making thus requires that patients and doctors understand the benefits and harms of different treatment options. This, however, is severely undermined by what we call collective statistical illiteracy. Both patients and physicians have difficulties to understand the meaning of numbers so that an effective risk communication cannot take place. Risk communication based on misunderstandings, however, renders the "informed" in informed shared decision making obsolete. We show that the problem of statistical illiteracy can largely be solved by changing the representation of statistical information. Insight can be achieved by communicating risks in absolute, not relative terms; by using a frequentist formulation, which makes the reference class clear instead of communicating single event probabilities; and by communicating natural frequencies instead of conditional probabilities.