scholarly journals Natural Frequencies Help Older Adults and People with Low Numeracy to Evaluate Medical Screening Tests

2009 ◽  
Vol 29 (3) ◽  
pp. 368-371 ◽  
Author(s):  
Mirta Galesic ◽  
Gerd Gigerenzer ◽  
Nils Straubinger
2021 ◽  
Author(s):  
Bonnie A. Armstrong

Aging is associated with an increase in the frequency of medical screening tests. Bayesian inference is used to estimate posterior probabilities of medical tests such as positive or negative predictive values (PPVs or NPVs). Both laypeople and experts are typically poor at estimating PPVs and NPVs when relevant probabilities are communicated descriptively. Decision making research has revealed dissociations between described and experience-based judgments. This study examined the accuracy of posterior probability estimates of 80 younger and 81 older adults when statistical information was presented through description or experience. Results show that both younger and older adults can make more accurate posterior probability estimates if they experience probabilities compared to when probabilities are described as either natural frequencies or conditional probabilities. Results also indicate that most people prefer to rely on physicians to make their medical decisions regardless of how confident they are in their judgments of probabilities.


2021 ◽  
Author(s):  
Bonnie A. Armstrong

Aging is associated with an increase in the frequency of medical screening tests. Bayesian inference is used to estimate posterior probabilities of medical tests such as positive or negative predictive values (PPVs or NPVs). Both laypeople and experts are typically poor at estimating PPVs and NPVs when relevant probabilities are communicated descriptively. Decision making research has revealed dissociations between described and experience-based judgments. This study examined the accuracy of posterior probability estimates of 80 younger and 81 older adults when statistical information was presented through description or experience. Results show that both younger and older adults can make more accurate posterior probability estimates if they experience probabilities compared to when probabilities are described as either natural frequencies or conditional probabilities. Results also indicate that most people prefer to rely on physicians to make their medical decisions regardless of how confident they are in their judgments of probabilities.


2009 ◽  
Vol 3 (2) ◽  
pp. 94-100 ◽  
Author(s):  
Thaís Bento Lima-Silva ◽  
Mônica Sanches Yassuda

Abstract Normal aging can be characterized by a gradual decline in some cognitive functions, such as memory. Memory complaints are common among older adults, and may indicate depression, anxiety, or cognitive decline. Objectives: To investigate the association between memory complaints and age in cognitively unimpaired older adults, and the relationship between memory complaints and memory performance. Methods: Cognitive screening tests as well as memory complaint questionnaires validated for the Brazilian population were used: the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Memory Complaint Questionnaire (MAC-Q), Memory test of 18 pictures, Forward and Backward Digit Span (WAIS-III). Fifty seven regular members of the SESC social club participated (50 women), having a mean age of 71.4 years, and 4 to 8 years of education - 34 from 4 to 7 years and 23 with 8 years of education. Results: Results revealed no significant association between cognitive complaints and age or cognitive performance. Older participants in this sample did not show worse performance or a higher level of complaints. There was no significant association between age and GDS scores. Conclusions: The studied sample constitutes a particular group of older adults whose participation in activities may be protecting them from cognitive decline, thus highlighting the impact of lifestyle on cognitive performance during the aging process.


1995 ◽  
Vol 2 (4) ◽  
pp. 224-227 ◽  
Author(s):  
Jill Cockburn ◽  
Selina Redman ◽  
David Hill ◽  
Elaine Henry

Aim –To estimate the extent of public understanding of mass screening for disease and of the benefits and limitations of screening. Methods – Telephone interviews were conducted with a national sample of 835 Australians. Results – Of total respondents, 68% claimed to have heard of screening tests, but only 21% correctly understood that screening tests are for asymptomatic people. This understanding was related to education. The most frequently named tests were mammography (51%) and Pap tests (33%), and for all age groups these were mentioned by more women than men. Around 27% of respondents thought that the Pap test would detect 95% or more of cases, 45% thought the test would detect 90% or more, while 60% of respondents thought the test would detect 80% or more of cases. Around 29% of respondents thought that mammography would detect 95% or more of cases, 49% thought the test would detect 90% or more, while 65% of respondents thought the test would detect 80% or more of cases. Of all respondents, 33% favoured compensation when cases were “missed” by screening provided people were warned beforehand, 58% were not in favour, and 9% were unsure. Conclusions – There are misconceptions among the public concerning the purpose of screening and the accuracy of screening tests. However, most people accept that some cases of disease will be missed by screening and that if people are adequately informed beforehand compensation should not automatically follow for those whose disease is missed.


Author(s):  
Ana Maria Lopez ◽  
Lauren Hudson ◽  
Nathan L. Vanderford ◽  
Robin Vanderpool ◽  
Jennifer Griggs ◽  
...  

Successful cancer prevention strategies must be tailored to support usability. In this article, we will focus on cancer prevention strategies in populations that differ by race and ethnicity, place and location, sexual orientation and gender identity, and age by providing examples of effective approaches. An individual may belong to none of these categories, to all of these categories, or to some. This intersectionality of belonging characterizes individuals and shapes their experiences. Even within a category, broad diversity exists. Effective cancer prevention strategies comprehensively engage the community at multiple levels of influence and may effectively include lay health workers and faith-based cancer education interventions. Health system efforts that integrate cancer health with other health promotion activities show promise. At the individual physician level, culturally literate approaches have demonstrated success. For example, when discussing cancer screening tests with older adults, clinicians should indicate whether any data suggest that the screening test improves quality or quantity of life and the lag time to benefit from the screening test. This will allow older adults to make an informed cancer screening decision based on a realistic understanding of the potential benefits and risks and their values and preferences. Addressing individual and health system bias remains a challenge. Quality improvement strategies can address gaps in quality of care with respect to timeliness of care, coordination of care, and patient experience. The time is ripe for research on effective and interdisciplinary prevention strategies that harness expertise from preventive medicine, behavioral medicine, implementation science, e-health, telemedicine, and other diverse fields of health promotion.


2006 ◽  
Vol 29 (1) ◽  
pp. 33-39 ◽  
Author(s):  
Tiffany E. Shubert ◽  
Lori A. Schrodt ◽  
Vicki S. Mercer ◽  
Jan Busby-Whitehead ◽  
Carol A. Giuliani
Keyword(s):  

2017 ◽  
Vol 29 (6) ◽  
pp. 897-929 ◽  
Author(s):  
Stella-Maria Paddick ◽  
William K. Gray ◽  
Jackie McGuire ◽  
Jenny Richardson ◽  
Catherine Dotchin ◽  
...  

ABSTRACTBackground:The majority of older adults with dementia live in low- and middle-income countries (LMICs). Illiteracy and low educational background are common in older LMIC populations, particularly in rural areas, and cognitive screening tools developed for this setting must reflect this. This study aimed to review published validation studies of cognitive screening tools for dementia in low-literacy settings in order to determine the most appropriate tools for use.Method:A systematic search of major databases was conducted according to PRISMA guidelines. Validation studies of brief cognitive screening tests including illiterate participants or those with elementary education were eligible. Studies were quality assessed using the QUADAS-2 tool. Good or fair quality studies were included in a bivariate random-effects meta-analysis and a hierarchical summary receiver operating characteristic (HSROC) curve constructed.Results:Forty-five eligible studies were quality assessed. A significant proportion utilized a case–control design, resulting in spectrum bias. The area under the ROC (AUROC) curve was 0.937 for community/low prevalence studies, 0.881 for clinic based/higher prevalence studies, and 0.869 for illiterate populations. For the Mini-Mental State Examination (MMSE) (and adaptations), the AUROC curve was 0.853.Conclusion:Numerous tools for assessment of cognitive impairment in low-literacy settings have been developed, and tools developed for use in high-income countries have also been validated in low-literacy settings. Most tools have been inadequately validated, with only MMSE, cognitive abilities screening instrument (CASI), Eurotest, and Fototest having more than one published good or fair quality study in an illiterate or low-literate setting. At present no screening test can be recommended.


2014 ◽  
Vol 72 (12) ◽  
pp. 913-918 ◽  
Author(s):  
Ivan Aprahamian ◽  
Marcia Radanovic ◽  
Paula Villela Nunes ◽  
Rodolfo Braga Ladeira ◽  
Orestes Vicente Forlenza

There is limited data regarding the cognitive profile from screening tests of older adults with bipolar disorder (BD) with dementia. Objective To investigate the Clock Drawing Test (CDT) among older adults with BD with and without Alzheimer’s disease (AD). Method 209 older adults (79 with BD without dementia and 70 controls; 60 with AD, being 27 with BD) were included to evaluate the performance of three CDT scoring scales, beyond the Mini-Mental State Examination (MMSE) and verbal fluency (VFT). Results Patients with BD without dementia presented with lower scores in MMSE, VF and one CDT scoring scale than controls. Patients with BD and AD presented with lower scores in VF and CDT scoring scales than patients with only AD. All CDT scales presented similar sensitivity and specificity for BD and non-BD groups. Conclusion Elderly subjects with BD showed greater impairment in CDT in both groups of normal cognition and AD.


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