Fuzzy‐Trace Theory, Risk Communication, and Product Labeling in Sexually Transmitted Diseases

Abstract

Health care professionals are a major source of risk communications, but their estimation of risks may be compromised by systematic biases. We examined fuzzy-trace theory's predictions of professionals' biases in risk estimation for sexually transmitted infections (STIs) linked to: knowledge deficits (producing underestimation of STI risk, re-infection, and gender differences), gist-based mental representation of risk categories (producing overestimation of condom effectiveness for psychologically atypical but prevalent infections), retrieval failure for risk knowledge (producing greater risk underestimation when STIs are not specified), and processing interference involving combining risk estimates (producing biases in post-test estimation of infection, regardless of knowledge). One-hundred-seventy-four subjects (experts attending a national workshop, physicians, other health care professionals, and students) estimated the risk of teenagers contracting STIs, re-infection rates for males and females, and condom effectiveness in reducing infection risk. Retrieval was manipulated by asking estimation questions in two formats, a specific format that "unpacked" the STI category (infection types) and a global format that did not provide specific cues. Requesting estimates of infection risk after relevant knowledge was directly provided, isolating processing effects, assessed processing biases. As predicted, all groups of professionals underestimated the risk of STI transmission, re-infection, and gender differences, and overestimated the effectiveness of condoms, relative to published estimates. However, when questions provided better retrieval supports (specified format), estimation bias decreased. All groups of professionals also suffered from predicted processing biases. Although knowledge deficits contribute to estimation biases, the research showed that biases are also linked to fuzzy representations, retrieval failures, and processing errors Hence, interventions that are designed to improve risk perception among professionals must incorporate more than knowledge dissemination. They should also provide support for information representation, effective retrieval, and accurate processing.

Semantic coherence and fallacies in estimating joint probabilities

“…One hopes, for example, that physicians would readily recognize that ''surgeries with complications'' is a subset of ''surgeries,'' and that their estimates of medical risk would exhibit appropriate semantic coherence. However, research with medical experts (Reyna & Adam, 2003) suggests that reasoning biases in medicine predicted by FTT are common. Theoretically motivated experimental manipulations such as the use of Venn diagrams, priming set relations, and changes in problem wording may also influence semantic coherence in estimating joint probabilities.…”

“…FTT 1 holds that people combine world knowledge with naïve probability theory to make joint probability judgments (e.g., Reyna & Adam, 2003). Problematic performance with joint probability estimation may be explained by subjects' tendency to ignore normatively relevant denominators.…”

Human development of the ability to learn from bad news

“…This was verified to the best of our ability by online resources (as indicated below) and by a medical doctor [we note that medical doctors are themselves subject to biases and errors when reporting risk statistics (e.g., ref. 48)]. For each adverse event the average probability of that event occurring at least once was calculated from data compiled from online resources (including the Office for National Statistics and PubMed; see Table S4 for a list of online resources).…”

Risk taking under the influence: A fuzzy-trace theory of emotion in adolescence

“…Therefore, it is easy to underestimate adolescents' ability to understand quantitative probabilities. In one study, for instance, 256 high school students solved the same conditional probability judgment problem as 82 physicians, as well as other groups of adult professionals (e.g., Reyna, 2004;Reyna & Adam, 2003). The high-school students' performance was virtually identical to that of experienced physicians solving a familiar posttest diagnostic judgment problem.…”