Search

Introduction: Despite decades of research on risk-communication approaches, questions remain about the optimal methods for conveying risks for different outcomes across multiple time points, which can be necessary in applications such as discrete choice experiments (DCEs). We sought to compare the effects of 3 design factors: 1) separated versus integrated presentations of the risks for different outcomes, 2) use or omission of icon arrays, and 3) vertical versus horizontal orientation of the time dimension. Methods: We conducted a randomized study among a demographically diverse sample of 2,242 US adults recruited from an online panel (mean age 59.8 y, s = 10.4 y; 21.9% African American) that compared risk-communication approaches that varied in the 3 factors noted above. The primary outcome was the number of correct responses to 12 multiple-choice questions asking survey respondents to identify specific numbers, contrast options to recognize dominance (larger v. smaller risks), and compute differences. We used linear regression to test the effects of the 3 design factors, controlling for health literacy, graph literacy, and numeracy. We also measured choice consistency in a subsequent DCE choice module Results: Mean comprehension varied significantly across versions (P < 0.001), with higher comprehension in the 3 versions that provided separated risk information for each risk. In the multivariable regression, separated risk presentation was associated with 0.58 more correct responses (P < 0.001; 95% confidence interval: 0.39, 0.77) compared with integrated risk information. Neither providing icon arrays nor using vertical versus horizontal time formats affected comprehension rates, although participant understanding did correlate with DCE choice consistency. Conclusions: In presentations of multiple risks over multiple time points, presenting risk information separately for each health outcome appears to increase understanding. Highlights: When conveying information about risks of different outcomes at multiple time points, separate presentations of single-outcome risks resulted in higher comprehension than presentations that combined risk information for different outcomes. We also observed benefits of presenting single-outcome risks separately among respondents with lower numeracy and graph literacy. Study participants who scored higher on risk understanding were more internally consistent in their responses to a discrete choice experiment. [ABSTRACT FROM AUTHOR]

Data visualizations can be effective and inclusive means for helping people understand health-related data. Yet numerous high-quality studies comparing data visualizations have yielded relatively little practical design guidance because of a lack of clarity about what communicators want their audience to accomplish. When conducting rigorous evaluations of communication (eg, applying the ISO 9186 method), describing the process simply as evaluating "comprehension" or "interpretation" of visualizations fails to do justice to the true range of outcomes being studied. We present newly developed taxonomies of outcome measures and tasks that are guiding a large-scale systematic review of the health numbers communication literature. Using these taxonomies allows a designer to determine whether a specific data presentation format or feature supports or inhibits the desired audience cognitions, feelings, or behaviors. We argue that taking a granular, outcomes-based approach to designing and evaluating information visualization research is essential to deriving practical, actionable knowledge from it. [ABSTRACT FROM AUTHOR]

Background: Treatment with corticosteroids is common for patients with idiopathic and multiple sclerosis-associated optic neuritis (I/MS-ON). Yet, the Optic Neuritis Treatment Trial and meta-analyses confirm that few patients benefit and that visual benefit is of questionable clinical significance, short-lived, and comes with potential harms. The purpose of this study was to uncover the breadth of factors that underlie clinicians' treatment decisions and determine how these factors may influence corticosteroid use for I/MS-ON., Methods: We performed semistructured, one-on-one, qualitative interviews with neurologists, neuro-ophthalmologists, and emergency department clinicians at 15 academic and private practices across the United States. The interview guide used the Theoretical Domain Framework and a vignette to explore numerous factors that might influence decision making for definite I/MS-ON. We analyzed transcripts using inductive thematic analysis to generate themes., Results: A total of 22 clinicians were interviewed before thematic saturation was reached: 8 neuro-ophthalmologists, 8 neurologists, and 6 emergency medicine (EM) clinicians (2 physician assistants, 4 physicians). All neuro-ophthalmologists and nearly all neurologists (7 of 8) were aware of risks/benefits of corticosteroid treatment for I/MS-ON. However, neuro-ophthalmologists varied in their corticosteroid treatment recommendation (n = 3 recommended treatment, n = 2 recommended observation, n = 3 recommended shared decision making), whereas all neurologists recommended corticosteroids, indicating that knowledge of corticosteroid risk/benefit alone does not drive decision making. EM clinicians were not aware of risk/benefits of corticosteroid treatment for I/MS-ON and relied on the treatment recommendations of neurologists. Clinicians recommending corticosteroids held personal beliefs that corticosteroids benefit those with worse vision loss, relieve pain, allow earlier return to work, or have easily mitigated side effects. They also perceived that prescribing steroid was the principal method of "doing something," which fit a key provider role. Clinicians who did not recommend corticosteroids or were neutral perceived the risks as nontrivial, considered discussing treatment trade-offs as "doing something" and incorporated patient preferences., Conclusions: Knowledge of risk/benefits of corticosteroids are necessary but not sufficient for evidence-based I/MS-ON practice. Variation in how clinicians treat patients with acute I/MS-ON is influenced largely by psychosocial factors, such as beliefs about corticosteroid risk/benefit trade-offs and the role of the clinician to provide treatment. Interventions to support evidence-based decision making for I/MS-ON treatment will need to provide risk/benefit information to support clinicians with varying levels of expertise, incorporate patient preference, and normalize the option to observe., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by North American Neuro-Ophthalmology Society.)

Objectives: We sought to analyze interactive visualizations and animations of health probability data (such as chances of disease or side effects) that have been studied in head-to-head comparisons with either static graphics or numerical communications., Materials and Methods: Secondary analysis of a large systematic review on ways to communicate numbers in health., Results: We group the research to show that 4 types of animated or interactive visualizations have been studied by multiple researchers: those that simulate experience of probabilistic events; those that demonstrate the randomness of those events; those that reduce information overload by directing attention sequentially to different items of information; and those that promote elaborative thinking. Overall, these 4 types of visualizations do not show strong evidence of improving comprehension, risk perception, or health behaviors over static graphics., Discussion: Evidence is not yet strong that interactivity or animation is more effective than static graphics for communicating probabilities in health. We discuss 2 possibilities: that the most effective visualizations haven't been studied, and that the visualizations aren't effective., Conclusion: Future studies should rigorously compare participant performance with novel interactive or animated visualizations against their performance with static visualizations. Such evidence would help determine whether health communicators should emphasize novel interactive visualizations or rely on older forms of visual communication, which may be accessible to broader audiences, including those with limited digital access., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Medical Informatics Association.)

Communicating health-related probabilities to patients and the public presents challenges, although multiple studies have demonstrated that we can promote comprehension and appropriate application of numbers by matching presentation formats (e.g., percentage, bar charts, icon arrays) to communication goal (e.g., improving recall, decreasing worry, taking action). We used this literature to create goal-driven, evidence-based guidance to support health communicators in conveying probabilities. We then conducted semi-structured interviews with 39 health communicators to understand: communicators' goals for expressing probabilities, formats they choose to convey probabilities, and perceptions of prototypes of our "communicating numbers clearly" guidance. We found that communicators struggled to articulate granular goals for their communication, impeding their ability to select appropriate guidance. Future work should consider how best to support health communicators in selecting granular, differentiable goals to support broadly comprehensible information design., (©2023 AMIA - All rights reserved.)