Enhancing Understanding and Recall of Quantitative Information about Medical Risks: A Cross-Cultural Comparison between Germany and Spain

Abstract

In two experiments, we analyzed cross-cultural differences in understanding and recalling information about medical risks in two countries-Germany and Spain-whose students differ substantially in their quantitative literacy according to the 2003 Programme for International Student Assessment (PISA; OECD, 2003OECD, , 2010. We further investigated whether risk understanding can be enhanced by using visual aids (Experiment 1), and whether different ways of describing risks affect recall (Experiment 2). Results showed that Spanish students are more vulnerable to misunderstanding and forgetting the risk information than their German counterparts. Spanish students, however, benefit more than German students from representing the risk information using ecologically rational formats-which exploit the way information is represented in the human mind. We concluded that our results can have important implications for clinical practice. Keywords: medical risks, Programme for International Student Assessment (PISA), risk perception, risk communication.En dos experimentos, hemos analizado si existen diferencias culturales en la comprensión y recuerdo de información sobre riesgos médicos. Nos hemos centrado en dos países-Alemania y España-ya que, según los resultados encontrados en el Programme for International Student Assessment (PISA; OECD, 2003OECD, , 2010. los estudiantes procedentes de los mismos difieren substancialmente en sus habilidades para procesar información cuantitativa. Así mismo hemos investigado si es posible mejorar la comprensión de los riesgos médicos mediante el uso de material visual de apoyo (Experimento 1), o del uso de diferentes formatos verbales para describir dichos riesgos (Experimento 2). Los resultados de nuestros experimentos han puesto de manifiesto que los estudiantes españoles son más vulnerables a interpretar incorrectamente y a olvidar la información sobre los riesgos que los estudiantes alemanes. Sin embargo, los primeros se benefician en mayor medida que los segundos de la representación de la información sobre riesgos médicos a través del uso de formatos ecológicos-los cuales representan la información de un modo similar a como lo hace la mente humana. Concluimos que nuestros resultados pueden tener implicaciones importantes para la práctica clínica.

Pictures speak louder than numbers: on communicating medical risks to immigrants with limited non‐native language proficiency

“…These results extend our own and others’ findings about the usefulness of visual aids in communicating medical risks 13,18,26,29–31,58–61 . Specifically, they provide experimental support of Ancker et al.…”

“…These results extend our own and othersÕ findings about the usefulness of visual aids in communicating medical risks. 13,18,26,[29][30][31][58][59][60][61] Specifically, they provide experimental support of Ancker et alÕs 27 hypothesis that visual aids making part-to-whole relations visually available, help people attend to the relationship between the numerator (i.e. the number of treated or non-treated patients who are affected) and the denominator (i.e.…”

How to Reduce the Effect of Framing on Messages About Health

“…These results extend our own and others' previous findings about the usefulness of visual aids to enhance comprehension of medical risks, especially in people with low numeracy. 1,46,[61][62][63][64][65][68][69][70][71]73,75,76 They also support the notion that problems in communicating risks occur because inappropriate information formats are often used and not because of cognitive biases. 91,92 Similar reductions in what superficially looked like biased thinking were observed in the case of conditional probabilities (when expressed as natural frequencies, 93 ), relative risk reductions (when expressed as absolute risk reductions, 94 ), and singleevent probabilities.…”

“…68 Visual aids are also effective in eliminating errors induced by anecdotal narratives 69 and biases. 70,71 In addition, risk information presented via visual aids is perceived as easier to understand 72,73 and has been shown to substantially increase risk avoidance. 74 What is still an open question is whether visual aids can reduce framing effects.…”

Habilidades numéricas y salud: una revisión crítica

“…Sin embargo, la investigación reciente indica que tanto los médicos como sus pacientes muestran dificultades para entender y/o comunicar esta información Gigerenzer, Gaissmaier, Kurz-Milcke, Schwartz & Woloshin, 2007;Nelson, Reyna, Fagerlin, Lipkus & Peters, 2008;Schwartz et al, 1997;Woloshin, Schwartz, Byram, Fischhoff & Welch, 2000). Estudios recientes también han puesto de manifiesto que muchas personas presentan escasa habilidad numérica en diversos países (por ejemplo, Estados Unidos y Alemania) Garcia-Retamero, Galesic & Gigerenzer, 2011;Lipkus et al, 2001;Peters et al, 2006). En España, esta tendencia es especialmente acusada, tal y como muestran los datos recientes sobre el desempeño en escalas que miden las habilidades numéricas .…”