The meaning of 6.8: Numeracy and normality in health information talks (original) (raw)

Understanding basic numbers: examples from Brexit, Covid and common medical conditions

Research Methods in Medicine & Health Sciences, 2020

The UK Brexit debate and the current Covid pandemic have been fertile grounds for people seeking poor use of statistics, and demonstrate a need to reiterate some basic principles of data presentation. Communicating basic numbers to convey the correct message is a vital skill for a public health professional but even basic numbers can be difficult to understand, and are susceptible to misuse. The first issue is how to understand ‘orphan’ numbers; numbers quoted without comparison or context. This leads on to the problems of understand numbers as proportions and how to make comparisons using proportions. Percentages, and in particular percentage changes, are also a major source of misunderstanding and the baseline percentage should always be given. The use of relative risk can also convey the wrong message and should always be accompanied by a measure of absolute risk. Similarly, numbers needed to treat should also refer to baseline risks. Communicating numbers is often more effective...

Improving Understanding of Health-Relevant Numerical Information

2018

In this chapter, we discuss why risks are often not communicated in a transparent and understandable way and why this is problematic. At the core of the chapter are four examples that illustrate how risk communication can be improved. These examples are (a) the use of natural frequencies in the context of diagnostic reasoning, (b) the use of visual aids to support the beneficial effect of natural frequency representations, (c) the use of natural frequencies to clarify the distinction between relative and absolute risk reduction, and (d) a clarification of the meaning and pitfalls of survival rates that are often used to quantify the benefit of screening programs. In each of these topics, we describe original empirical studies illuminating a specific problem as well as how these problems can be overcome, and we discuss practical implications of the results and the proposed solutions. Subsequently, we illustrate, using an example from mammography screening, what transparent risk commu...

Understanding the role of numeracy in health: proposed theoretical framework and practical insights

2009

Abstract Numeracy���that is, how facile people are with mathematical concepts and their applications���is gaining importance in medical decision making and risk communication. This article proposes six critical functions of health numeracy. These functions are integrated into a theoretical framework on health numeracy that has implications for risk communication and medical decision-making processes.

Making statistics relevant: An introduction to the uses and misuses of statistics in health

Probability and statistics can help people make good decisions, but can also be used to wreak havoc. This paper provides examples to students of how statistics can be used and misused to mislead the public and result in poor decision-making. We discuss the use of statistics in evaluating healthcare decisions, and how they can mislead patients. We describe evaluation criteria like number needed to treat (NNT) and number needed to harm (NNH), which are important to a patient in deciding whether to undergo a medical procedure. We also describe how information about medications' effectiveness often focuses on the relative risk reduction (RRR), which can be misleading to consumers. This is particularly useful to those looking to introduce a discussion of framing and ethical issues into a statistics course.

Strategic Numeracy: Self-Serving Reasoning About Health Statistics

Basic and Applied Social Psychology, 2015

This research shows that the same people who appear to have low numerical competence when analyzing personally irrelevant health-related numerical information are able to overcome their reasoning shortcomings and make better judgments when they are shown equivalent information that is personally relevant, and when only a sophisticated kind of reasoning enables them to interpret this information in a favorable way. The fact that people can engage in poorer or more sophisticated numerical reasoning depending on whether that reasoning produces favorable or unfavorable conclusions has implications both for the concept of numeracy as an individual-difference variable and for health communication. BARRIERS TO HEALTH AND RISK COMMUNICATION One factor that hinders the understanding of health and risk information is innumeracy (Paulos, 1988), the difficulty that people have in understanding and using numbers. Studies and national surveys indicate that many people, even among those who are highly educated, have poor numerical skills (e.g.

Risk assessment: ‘numbers' and ‘values’

Psychiatric Bulletin, 2003

Risk assessment has two components, which I shall term ‘numbers' and ‘values'. ‘Numbers' refer to the estimation of the likelihood that an adverse event will occur in a stated period of time. The methods are mathematical and statistical. ‘Values' refer to the processes of attaching a value to the risk and deciding what should be done about it. Benefits are weighed against costs in what is largely a moral enterprise. Maden (2003, this issue) asks ‘why all the fuss?’ about standardised risk assessment. My fuss is largely about the ‘values', not so much about the ‘numbers'.

COVID-19 and Numeracy: How about Them Numbers?

Numeracy, 2020

Quantitative efforts to understand the emergence of the COVID-19 pandemic need to be viewed through the lens of social construction. I begin by comparing the efforts to quantitatively measure the plague in London in 1665. Then I develop five propositions for studying the social construction of statistics: (1) facts are social constructions; (2) measuring involves making decisions, (3) counting is not straightforward; (4) all comparisons involve choices; and (5) social patterns shape numbers. After examining how these propositions affect what we know about COVID-19, I consider their implications for moving beyond mathematics when approaching numeracy.

Clinical Implications of Numeracy: Theory and Practice

Annals of Behavioral Medicine, 2008

Background Low numeracy is pervasive and constrains informed patient choice, reduces medication compliance, limits access to treatments, impairs risk communication, and affects medical outcomes; therefore, it is incumbent upon providers to minimize its adverse effects. Purpose We provide an overview of research on health numeracy and discuss its implications in clinical contexts. Conclusions Low numeracy cannot be reliably inferred on the basis of patients' education, intelligence, or other observable characteristics. Objective and subjective assessments of numeracy are available in short forms and could be used to tailor health communication. Low scorers on these assessments are subject to cognitive biases, irrelevant cues (e.g., mood), and sharper temporal discounting. Because prevention of the leading causes of death (e.g., cancer and cardiovascular disease) depends on taking action now to prevent serious consequences later, those low in numeracy are likely to require more explanation of risk to engage in prevention behaviors. Visual displays can be used to make numerical relations more transparent, and different types of displays have different effects (e.g., greater risk avoidance). Ironically, superior quantitative processing seems to be achieved by focusing on qualitative gist and affective meaning, which has important implications for empowering patients to take advantage of the evidence in evidence-based medicine.