DDRIG in DRMS: Lay Understanding of Vaccine Efficacy

COVID-19疫苗的有效性在科学期刊文章和新闻媒体上受到了极大关注。此外，许多消息来源强调在美国获得FDA或FDA EUA地位的三种疫苗的高效率。例如，基于mrna的辉瑞- biontech疫苗对COVID-19病毒的原始菌株的有效率为95%，这意味着在未接种疫苗的人口中有1%感染COVID-19的3个月期间，我们可以预计约0.05%的接种疫苗的人感染COVID-19（低95%）。然而，许多非专业人士可能不了解疫苗效力是如何计算的，95%的效力可能被误解为95%的接种者将免受疾病的侵害，这意味着5%的接种者将患上COVID-19。该项目考察了非专业人员（如患者）如何使用与健康相关的数字信息，揭示了滥用疫苗功效数字的基本认知过程，并探讨了如何以非专业人员能够理解和有效使用的方式呈现数字健康信息的更广泛问题。该研究确定了认知过程的不同方面（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）作为提供规范反应的促进者的程度。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COVID-19大流行期间，了解外行人如何理解疫苗功效非常重要，因为有关疫苗功效的对话越来越受到患者的关注和兴趣。鉴于感知到的疫苗效力与接种意愿之间存在很强的相关性，识别并纠正患者对疫苗效力统计的误解至关重要。COVID-19大流行引发了科学期刊文章和新闻媒体对COVID-19疫苗效力的广泛讨论，但对于外行人对疫苗效力的了解程度知之甚少，这需要相当复杂的数学计算。这项研究验证了一个预测，即外行人会被一个看似合理且计算简单但不正确的计算所吸引：接种疫苗后感染的风险= 1 -效力。例如，诱饵反应是，在接种了95%有效的疫苗后，一个人被感染的风险为5%。以往的医疗决策研究表明，患者，特别是那些计算能力差的患者，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重大影响。此外，先前的认知研究提供了快速，直觉反应的证据，可能类似于疫苗功效背景下的诱饵反应。这一系列研究调查了外行人对功效的不正确解释程度，以及这种误解是否与个人特征（如计算能力、认知反射和科学素养）有关。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功效的信息。关于虚构疫苗的不同信息的情景说明了外行人对有效性的不正确理解程度（例如，通过回答95%有效的疫苗意味着5%的接种者将被感染）。另外的研究测试了一个教程，旨在提高观众对疫苗功效的概念理解。两个版本的教程在强调数学公式和相对降低风险的概念方面有所不同，从而能够测试这些方面中哪一个是规范反应的主要障碍。最后的研究考察了一种消除偏见的方法，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性比较，从而验证了这样一种假设，即对疫苗功效的误解源于未能考虑安慰剂组和接种组之间的比较。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值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.