DDRIG in DRMS: Lay Understanding of Vaccine Efficacy

新冠肺炎疫苗的有效率在科学期刊文章和新闻媒体上受到了极大的关注。此外，许多消息来源强调，在美国，FDA或FDA EUA地位的三种疫苗的有效率很高。例如，基于信使核糖核酸的辉瑞-生物技术疫苗对新冠肺炎原始毒株的有效率为95%，这意味着在1%的未接种疫苗的人口中，在3个月的持续时间内，我们预计约0.05%的接种疫苗的人会感染新冠肺炎(发病率降低95%)。然而，许多外行可能不明白疫苗有效率是如何计算的，95%的有效率可能被误解为意味着95%的接种者将获得疾病保护，意味着5%的接种者将感染新冠肺炎。该项目研究了外行人(如患者)如何使用与健康相关的数字信息，揭示了滥用疫苗效力数字背后的基本认知过程，并谈到了如何以外行人可以理解和有效使用的方式呈现数字健康信息这一更广泛的问题。这项研究确定了认知处理的不同方面(例如，知道如何使用数学公式，理解相对风险降低的概念，以及参与审议或比较过程)在多大程度上充当了提供标准化反应的促进者。这项拟议研究的结果有可能促进知情的医疗决策和患者代理。在新冠肺炎大流行期间，当有关疫苗效力的对话受到患者越来越多的关注和兴趣时，了解普通人如何理解疫苗效力是高度相关的。鉴于感知的疫苗效力和接种意向之间的强烈关联，识别和纠正患者对疫苗效力统计数据的误解至关重要。新冠肺炎疫情在科学期刊文章和新闻媒体上引发了对新冠肺炎疫苗有效率的广泛讨论，但对于外行人对疫苗效力的了解程度鲜为人知，这需要相当复杂的数学计算。这项研究验证了外行人被一个看似合理且计算简单但错误的计算所吸引的预测：接种疫苗后感染风险=1-疗效。例如，引诱反应将是，在接种95%有效疫苗后，一个人有5%的感染风险。以前的医疗决策研究表明，患者，特别是那些算术能力低下的患者，往往难以理解数字信息，这对他们的健康决策和健康结果产生了相应的影响。此外，先前的认知研究提供了快速、直观的反应的证据，这可能类似于疫苗效力背景下的诱饵反应。这一系列研究调查了外行人对疗效的不恰当解释的程度，以及这种误解是否与个人特征有关，如计算能力、认知反思和科学素养。首先，采用假设情景实验来更好地了解外行人如何利用有关疫苗效力的信息。关于虚构疫苗的不同信息的情景说明了普通人对疗效的不正确理解程度(例如，通过回答95%有效的疫苗意味着5%的接种者将被感染)。其他研究测试了一个旨在提高观众对疫苗效力的概念性理解的教程。本教程的两个版本在强调数学公式和相对风险降低的概念上有所不同，从而能够测试这些方面中的哪些方面是标准化反应的主要障碍。最后的研究检验了一种去偏见方法，该方法促使参与者对未治疗组和治疗组之间的疾病风险进行隐含的比较，测试对疫苗有效性的误解源于未能考虑安慰剂组和疫苗组之间的比较的假设。这一奖项反映了NSF的法定使命，并通过使用基金会的智力优势和更广泛的影响审查标准进行评估，被认为值得支持。

Efficacy rates for COVID-19 vaccines have received major attention in scientific journal articles and news media outlets. Further, many sources emphasize the high efficacy rates for the three vaccines with FDA or FDA EUA status in the United States. For example, the mRNA-based Pfizer-BioNTech vaccine boasts an efficacy rate of 95% against the original strain of the COVID-19 virus, meaning that over the duration of a 3-month period in which 1% of the population without the vaccine contracted COVID-19, we could expect about 0.05% of vaccinated people to contract COVID-19 (95% lower). However, many lay people may not understand how vaccine efficacy rates are computed, and the 95% efficacy rate could be misunderstood to mean that 95% of vaccinated people will be protected from disease, implying that 5% of vaccinated people will become diseased with COVID-19. This project examines how lay people (such as patients) use health-related numerical information, sheds light on the basic cognitive processes underlying misuse of vaccine efficacy numbers and speaks to the broader question of how to present numerical health information in a way that lay people can understand and effectively use. The research identifies the degree to which different facets of cognitive processing (e.g., knowing how to use the mathematical formula, understanding the concept of relative risk reduction, and engaging in deliberation or comparison processes) act as facilitators to providing the normative response. Findings from the proposed research have the potential to foster informed medical decision making and patient agency. Understanding how lay people understand vaccine efficacy is highly relevant during the COVID-19 pandemic when conversations about vaccine efficacy receive increased attention and interest from patients. Given the strong association between perceived vaccine efficacy and vaccination intention, it is critical to identify and correct misconceptions in patients’ understanding of vaccine efficacy statistics.The COVID-19 pandemic prompted widespread discussion of efficacy rates for COVID-19 vaccines in scientific journal articles and news media outlets, but little is known about how well lay people understand vaccine efficacy, which entails a fairly sophisticated mathematical calculation. This research tests the prediction that lay people are lured by a plausible and computationally simple but incorrect calculation: post-vaccination risk of infection = 1 - efficacy. For example, the lure response would be that after receiving a 95% effective vaccine a person has a 5% risk of getting infected. Previous medical decision-making research demonstrates that patients, especially those low in numeracy, often have difficulty understanding numerical information, which has a consequential impact on their health decisions and health outcomes. Moreover, prior cognition research provides evidence of quick, intuitive responses that may be analogous to the lure response in the vaccine efficacy context. This series of studies investigates the extent to which laypeople improperly interpret efficacy and whether this misunderstanding is associated with individual characteristics such as numeracy, cognitive reflection, and scientific literacy. First, hypothetical scenario experiments are employed to better understand how lay people utilize information about vaccine efficacy. Scenarios that vary information about fictitious vaccines illuminate the extent to which lay people improperly understand efficacy (for example, by answering that a vaccine that is 95% effective means that 5% of vaccinated people will get infected). Additional studies test a tutorial designed to improve viewers’ conceptual understanding of vaccine efficacy. Two versions of the tutorial differ in their emphasis on the mathematical formula vs. the concept of relative risk reduction, enabling a test of which of these facets is the major barrier to normative responses. Final studies examine a debiasing method that prompts participants to make an implicit comparison of disease risk between untreated and treated groups, testing the hypothesis that misunderstandings about vaccine efficacy stem from a failure to consider a comparison between a placebo group and a vaccinated group.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.