The impact of the format of graphical presentation on health-related knowledge and treatment choices
Objective: To evaluate the ability of six graph formats to impart knowledge about treatment risks/benefits to low and high numeracy individuals.
Methods: Participants were randomized to receive numerical information about the risks and benefits of a hypothetical medical treatment in one of six graph formats. Each described the benefits of taking one of two drugs, as well as the risks of experiencing side effects. Main outcome variables were verbatim (specific numerical) and gist (general impression) knowledge. Participants were also asked to rate their perceptions of the graphical format and to choose a treatment.
Results: 2412 participants completed the survey. Viewing a pictograph was associated with adequate levels of both types of knowledge, especially for lower numeracy individuals. Viewing tables was associated with a higher likelihood of having adequate verbatim knowledge vs. other formats (p < 0.001) but lower likelihood of having adequate gist knowledge (p < 0.05). All formats were positively received, but pictograph was trusted by both high and low numeracy respondents. Verbatim and gist knowledge were significantly (p < 0.01) associated with making a medically superior treatment choice.
Conclusion: Pictographs are the best format for communicating probabilistic information to patients in shared decision making environments, particularly among lower numeracy individuals.
Practice Implications: Providers can consider using pictographs to communicate risk and benefit information to patients of different numeracy levels.
Related Topics:
Doctor-patient communication,
Risk communication graphics,
Risk communication,
Numeracy
Keywords:
Graphical format
Informed decision making
Numeracy
Citation
(view)
Hawley ST, Zikmund-Fisher BJ, Ubel PA, Jankovic A, Lucas T, Fagerlin A. The impact of the format of graphical presentation on health-related knowledge and treatment choices. Patient Education and Counseling 2008;73(3):448-455.
Sarah Hawley, PhD, MPH
Sarah T. Hawley holds a PhD in health services research from the University of North Carolina and an MPH from Yale University Department of Public Health. Her primary research is in decision making related to cancer prevention and control, particularly among racial/ethnic minority and underserved...
Brian Zikmund-Fisher, PhD
Brian J. Zikmund-Fisher is an Assistant Professor in the Department of Health Behavior and Health Education, University of Michigan School of Public Health, as well as a Research Assistant Professor in the Division of General Internal Medicine, University of Michigan Medical School. He is...
Peter Ubel, MD
Peter A. Ubel, MD, is Professor of Medicine and Professor of Psychology at the University of Michigan; a primary care physician at the Ann Arbor Veterans Affairs Medical Center; Associate Director of the Michigan Robert Wood Johnson Clinical Scholars...
Aleksandra Jankovic, MS
Sanja grew up in Belgrade, Serbia, where she earned her bachelor’s degree in psychology from the University of Belgrade. She moved to the United States in 1999, and in December 2002, she graduated from the Master of General Experimental Psychology program at Eastern Michigan University. Her...
Angela Fagerlin, PhD
Angie Fagerlin studied psychology and literature at Hope College and received her PhD in experimental (cognitive) psychology at Kent State University. Her primary research focus is testing methods for communicating the risks and benefits of treatment to patients (e.g., in decision aids). Her other...