A demonstration of ''less can be more'' in risk graphics.
A demonstration of ''less can be more'' in risk graphics.
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DOI：
10.1177/0272989x10364244
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发表时间：
2010-11
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影响因子：
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通讯作者：
Ubel PA
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作者：
Zikmund-Fisher BJ;Fagerlin A;Ubel PA
在线工具，如Adjuvant！提供对乳腺癌患者可用的辅助治疗选择的可能结果的量身定做的估计。图形格式通常同时显示四个结果：存活率、癌症死亡率、其他原因死亡率和辅助治疗增加的存活率。测试只显示基线和增量存活率的更简单的格式是否会提高对相关风险统计数据的理解和/或影响治疗意向。风险图表的随机实验操作包括在互联网管理的关于ER+肿瘤乳腺癌患者辅助治疗决定的调查插曲中。从互联网研究小组招募的年龄在40-74岁之间的女性的人口统计学差异，分层随机抽样。参与者被随机分成两组，一组观看显示所有四种可能结果的象形图(图标数组)，另一组观看仅显示生存结果的象形图。理解关键统计数据、任务完成时间、图表评估评级以及对辅助化疗的感知兴趣。在初步研究中(N=832)，观察仅存活的象形图的参与者在报告化疗和激素治疗的总存活率时有更好的准确性(63%比50%，p<；0.001；更高的图表评估评级(M=7.98vs.7.67，p=0.04)，以及对激素治疗中加入化疗的兴趣不大(43%比50%，p=0.04；调整后的OR=0.68，p=0.008)。一项重复研究(N=714)证实，观看仅存活图表的参与者有更高的图表评估评级(M=8.06比7.72，p=0.04)，对化疗的兴趣降低(OR=0.67，p=0.03)。研究使用了普通公众样本；实际患者可能会以不同的方式处理风险信息。采用“少即是多”的方法，省略多余的死亡率结果统计数据，可能是一种有效的风险沟通方法，在使用象形图等可视格式时可能更可取。
Online tools such as Adjuvant! provide tailored estimates of the possible outcomes of adjuvant therapy options available to breast cancer patients. The graphical format typically displays four outcomes simultaneously: survival, mortality due to cancer, other cause mortality, and incremental survival due to adjuvant treatment. To test whether simpler formats that only present baseline and incremental survival would improve comprehension of the relevant risk statistics and/or affect treatment intentions. Randomized experimental manipulation of risk graphics shown included in Internet-administered survey vignettes about adjuvant therapy decisions for breast cancer patients with ER+ tumors. Demographically diverse, stratified random samples of women ages 40–74 recruited from an Internet research panel. Participants were randomized to view either pictographs (icon arrays) that displayed all four possible outcomes or pictographs that showed only survival outcomes. Comprehension of key statistics, task completion times, graph evaluation ratings, and perceived interest in adjuvant chemotherapy. In the primary study (N=832), participants who viewed survival-only pictographs had better accuracy when reporting the total chance of survival with both chemotherapy and hormonal therapy (63% vs. 50%, p<0.001; higher graph evaluation ratings (M=7.98 vs. 7.67, p=0.04), and less interest in adding chemotherapy to hormonal therapy (43% vs. 50%, p=0.04; adjusted OR=0.68, p=0.008). A replication study (N=714) confirmed that participants who viewed survival-only graphs had higher graph evaluation ratings (M=8.06 vs. 7.72, p=0.04) and reduced interest in chemotherapy (OR=0.67, p=0.03). Studies used general public samples; actual patients may process risk information differently. Taking a “less is more” approach by omitting redundant mortality outcome statistics can be an effective method of risk communication and may be preferable when using visual formats such as pictographs.