Communicating side effect risks in a tamoxifen prophylaxis decision aid: The debiasing influence of pictographs
Communicating side effect risks in a tamoxifen prophylaxis decision aid: The debiasing influence of pictographs
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DOI：
10.1016/j.pec.2008.05.010
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发表时间：
2008-11-01
影响因子：
3.5
通讯作者：
Fagerlin, Angela
中科院分区：
文献类型：
--
作者：
Zikmund-Fisher, Brian J.;Ubel, Peter A.;Fagerlin, Angela
目的：通过实验测试在关于预防性使用他莫昔芬预防原发性乳腺癌的在线决策辅助中，使用象形文字（图像矩阵）、增量风险格式和不同的风险分母是否会影响对副作用风险的认知和理解。方法：我们从两个医疗机构招募了 631 名乳腺癌风险较高的女性。参与者看到了对 5 种副作用风险的定制估计：子宫内膜癌、凝血、白内障、荷尔蒙症状和性问题。呈现格式在三因素设计中随机变化：（A）风险信息以数字文本的象形文字显示； (B) 演示要么报告了使用和不使用他莫昔芬的总风险，要么强调了与决策最相关的增量风险； (C) 使用 100 或 1000 人分母进行风险估计。主要结果指标包括风险认知和要点知识。结果：增量 Fisk 格式始终降低副作用的感知风险，但仅通过数字文本显示时导致知识水平较低。然而，添加象形文字可以显着提高理解水平。结论：象形文字使风险统计数据更易于解释，减少与增量风险呈现相关的偏差。实践意义：在 Fisk 通信中包含图表对于支持知情治疗决策过程至关重要。由爱思唯尔爱尔兰有限公司出版
Objective: To experimentally test whether using pictographs (image matrices), incremental risk formats, and varied risk denominators would influence perceptions and comprehension of side effect risks in an online decision aid about Prophylactic use of tamoxifen to prevent primary breast cancers.Methods: We recruited 631 women with elevated breast cancer risk from two healthcare organizations. Participants saw tailored estimates of the risks of 5 side effects: endometrial cancer, blood clotting, cataracts, hormonal symptoms, and sexual problems. Presentation format was randomly varied in a three factor design: (A) risk information was displayed either in Pictographs OF numeric text; (B) presentations either reported total risks with and without tamoxifen or highlighted the incremental risk most relevant for decision making; and (C) risk estimates used 100 or 1000 person denominators. Primary outcome measures included risk perceptions and gist knowledge.Results: Incremental Fisk formats consistently lowered perceived risk of side effects but resulted in low knowledge when displayed by numeric text only. Adding pictographs, however, produced significantly higher comprehension levels.Conclusions: Pictographs make risk statistics easier to interpret, reducing biases associated with incremental risk presentations.Practice implications: Including graphs in Fisk communications is essential to Support in informed treatment decision-making process. Published by Elsevier Ireland Ltd.