Medicine - Communicating statistical information
Medicine - Communicating statistical information
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DOI：
10.1126/science.290.5500.2261
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发表时间：
2000-12-22
期刊：
影响因子：
56.9
通讯作者：
Gigerenzer, G
中科院分区：
文献类型：
--
作者：
Hoffrage, U;Lindsey, S;Gigerenzer, G
基于统计信息的决定可能意味着生与死的区别，例如，当癌症患者必须根据成功的可能性决定是否接受痛苦的医疗程序时，或者当陪审团必须根据DNA证据决定是否定罪时。不幸的是，我们大多数人，包括专家，都很难有效地理解和组合统计信息。例如，哈佛医学院的教职员工和学生被要求估计一种疾病的概率，给定以下信息：（1）：“如果检测一种患病率为1/1000的疾病的测试具有5%的假阳性率，那么一个被发现具有阳性结果的人实际患有这种疾病的概率是多少，假设你对这个人的症状或体征一无所知？”估计值变化很大，从最常见的估计值95%（60名参与者中有27名参与者）到正确答案2%（60名参与者中有11名参与者）。在一项需要解释乳房X光检查结果的研究中，几乎所有的医生都混淆了测试的敏感性（阳性测试结果在疾病患者中的比例）及其阳性预测值（接受阳性测试结果的患者中疾病患者的比例）。这是一种常见的混淆，甚至出现在学术文章（3）和统计教科书（4）中，当然会影响外行人（5）理解统计信息的能力。最近关于基因检测的讨论表明，遗传咨询师也遇到了同样的困难（6）。
Decisions based on statistical information can mean the difference between life and death—for instance, when a cancer patient has to decide whether to undergo a painful medical procedure based on the likelihood that it will succeed, or when a jury has to decide whether to convict someone based on DNA evidence. Unfortunately, most of us, experts included, have difficulty understanding and combining statistical information effectively.For example, faculty, staff, and students at Harvard Medical School were asked to estimate the probability of a disease given the following information (1):“If a test to detect a disease whose prevalence is 1/1000 has a false positive rate of 5 per cent, what is the chance that a person found to have a positive result actually has the disease, assuming that you know nothing about the person's symptoms or signs?” The estimates varied wildly, ranging from the most frequent estimate, 95%(given by 27 out of 60 participants), to the correct answer, 2%(given by 11 out of 60 participants)(2). In a study requiring interpretation of mammography outcomes (3), almost all physicians confused the sensitivity of the test (the proportion of positive test results among people with the disease) with its positive predictive value (the proportion of people with the disease among those who receive a positive test result). This is a common confusion that even crops up in scholarly articles (3) and statistical textbooks (4) and certainly affects the ability of lay people (5) to understand the statistical information. Recent discussions of genetic testing have indicated that genetic counselors are experiencing the same difficulty (6).