scholarly journals Risk communication in tables vs. text: a Registered Report randomised trial on 'fact boxes'

2019 ◽  
Author(s):  
Cameron Brick ◽  
Michelle McDowell ◽  
Alexandra Lee Jessica Freeman
Keyword(s):  
Decision Making ◽  
Science Communication ◽  
Online Survey ◽  
Primary Outcome ◽  
Randomised Trial ◽  
Medical Decision ◽  
Preventative Intervention ◽  
Wide Range ◽  
Message Format ◽  
Communication Supports

ObjectivesAbstractIdentifying effective summary formats is fundamental to multiple fields including science communication, systematic reviews, evidence-based policy, and medical decision making. This study will test whether table or text-only formats lead to better comprehension of the potential harms and benefits of different options, here in a medical context.DesignPre-registered, longitudinal experiment: between-subjects factorial 2 (message format) x 2 topic (topic: therapeutic or preventative intervention) on comprehension and later recall (CONSORT- SPI 2018).SettingLongitudinal online survey experiment.Participants[[ N ]] census-matched UK residents recruited through the survey panel firm YouGov. Primary outcome measureComprehension of harms and benefits and knowledge recall after one month.ResultsFact boxes—simple tabular messages—led to [[ less, equal, more ]] comprehension than text- only formats and [[ greater, equal, lower ]] knowledge recall after one month. Fact boxes led to [[more, equivalent, fewer]] treatment decisions compared to the text-only control. These patterns of results were [[ the same, different ]] between the two topics [[ explain any differences ]].ConclusionsThe brief table format of the fact box [[ improved, did not improve ]] comprehension of harms and benefits relative to the text-only control. Effective communication supports informed consent and decision making and brings ethical and practical advantages. Fact boxes and other summary formats may be effective in a wide range of communication contexts.

scholarly journals Risk communication in tables versus text: a registered report randomized trial on ‘fact boxes'

2020 ◽  
Vol 7 (3) ◽  
pp. 190876 ◽  
Author(s):  
Cameron Brick ◽  
Michelle McDowell ◽  
Alexandra L. J. Freeman
Keyword(s):  
Decision Making ◽  
Science Communication ◽  
Online Survey ◽  
Primary Outcome ◽  
Primary Outcome Measure ◽  
Medical Decision ◽  
Preventative Intervention ◽  
Wide Range ◽  
Message Format ◽  
Communication Supports

Objectives: identifying effective summary formats is fundamental to multiple fields including science communication, systematic reviews, evidence-based policy and medical decision-making. This study tested whether table or text-only formats lead to better comprehension of the potential harms and benefits of different options, here in a medical context. Design: pre-registered, longitudinal experiment: between-subjects factorial 2 (message format) × 2 topic (therapeutic or preventative intervention) on comprehension and later recall (CONSORT-SPI 2018). Setting: longitudinal online survey experiment. Participants: 2305 census-matched UK residents recruited through the survey panel firm YouGov. Primary outcome measure: comprehension of harms and benefits and knowledge recall after six weeks. Results: fact boxes—simple tabular messages—led to more comprehension ( d = 0.39) and slightly more knowledge recall after six weeks ( d = 0.12) compared to the same information in text. These patterns of results were consistent between the two medical topics and across all levels of objective numeracy and education. Fact boxes were rated as more engaging than text, and there were no differences between formats in treatment decisions, feeling informed or trust. Conclusions: the brief table format of the fact box improved the comprehension of harms and benefits relative to the text-only control. Effective communication supports informed consent and decision-making and brings ethical and practical advantages. Fact boxes and other summary formats may be effective in a wide range of communication contexts.

scholarly journals Within-Gender Differences in Medical Decision Making Among Male Carriers of the BRCA Genetic Mutation for Hereditary Breast Cancer

2015 ◽  
Vol 11 (5) ◽  
pp. 1444-1459 ◽  
Author(s):  
Sharlene Hesse-Biber ◽  
Chen An
Keyword(s):  
Breast Cancer ◽  
Gender Differences ◽  
Decision Making ◽  
Hereditary Breast Cancer ◽  
Online Survey ◽  
Genetic Mutation ◽  
Self Concept ◽  
Medical Decision ◽  
Primary Reason ◽  
Convenience Sample

An intersectional approach was used to understand sex/gender differences in men’s health decisions with regard to hereditary breast cancer (BRCA). A sequential explanatory mixed method design was employed consisting of an online survey with a convenience sample of 101 men who tested positive for the breast cancer mutation following up with an in-depth interview with a subsample of 26 males who participated in the survey. The survey results revealed that 70.3% ( n = 45) considered “Family Risk” as the primary reason for getting BRCA tested; 21.9% ( n = 14) considered “Medical Considerations,” and 7.8% ( n = 5) considered “Social Support” as their primary reason. Male participants who were 50 years old or younger or who did not have children were more likely to consider medical reasons as the primary reason to get tested. In terms of self-concept, younger men were more stigmatized than their older counterparts; married men felt a greater loss of control with regard to their BRCA-positive mutation diagnosis than single men; and professional men as a whole felt more vulnerable to the negative influences of the disease than those who had already retired. Regression analysis results indicated that negative self-concept was strongly related to sampled males’ BRCA involvement 6 months after testing. Applying an intersectional approach to health care, decision-making outcomes among BRCA-positive mutation males provides an important lens for ascertaining the within-sex/gender demographic and psychosocial factors that affect the diversity of men’s pretesting and posttesting medical decisions.

scholarly journals How Urban Forest Managers Evaluate Management and Governance Challenges in Their Decision-Making

Forests ◽  
2020 ◽  
Vol 11 (9) ◽  
pp. 963
Author(s):  
Camilo Ordóñez ◽  
Dave Kendal ◽  
Caragh G. Threlfall ◽  
Dieter F. Hochuli ◽  
Melanie Davern ◽  
...  
Keyword(s):  
Decision Making ◽  
Local Government ◽  
Local Governments ◽  
Online Survey ◽  
Urban Forest ◽  
Forest Protection ◽  
Regional Strategies ◽  
Wide Range ◽  
Governance Challenges ◽  
Forest Managers

Decisions about urban forests are critical to urban liveability and resilience. This study aimed to evaluate the range of positions held by urban forest managers from local governments in the state of Victoria, Australia, regarding the management and governance challenges that affect their decision-making. This study was based on a Q-method approach, a procedure that allows researchers to evaluate the range of positions that exist about a topic in a structured manner based on the experiences of a wide group of people. We created statements on a wide range of urban forest management and governance challenges and asked urban forest managers to rate their level of agreement with these statements via an online survey. Managers generally agreed about the challenges posed by urban development and climate change for implementing local government policies on urban forest protection and expansion. However, there were divergent views about how effective solutions based on increasing operational capacities, such as increasing budgets and personnel, could address these challenges. For some managers, it was more effective to improve critical governance challenges, such as inter-departmental and inter-municipal coordination, community engagement, and addressing the culture of risk aversion in local governments. Urban forest regional strategies aimed at coordinating management and governance issues across cities should build on existing consensus on development and environmental threats and address critical management and governance issues not solely related to local government operational capacity.

scholarly journals Perceptions of Internal Medicine–Pediatrics Residents About Autonomy During Residency

2014 ◽  
Vol 6 (2) ◽  
pp. 330-334 ◽  
Author(s):  
Alexandra E. Mieczkowski ◽  
Doris Rubio ◽  
Reed Van Deusen
Keyword(s):  
Internal Medicine ◽  
Decision Making ◽  
Residency Training ◽  
Online Survey ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Autonomous Decision

Abstract Background The development of autonomy is a key component of residency training. Although studies have examined levels of graduated autonomy within specialties, they have not, to our knowledge, examined how residents' perceptions of autonomy differ among specialties. Objective We surveyed residents in internal medicine–pediatrics programs to determine their perceptions of the autonomy they experienced when they were serving on internal medicine (IM) and pediatrics inpatient rotations. Methods In 2012, we administered a 24-item online survey to residents in 36 internal medicine–pediatrics programs. Results Of 698 eligible residents, 143 (20.5%) participated. Participants were distributed equally among all 4 postgraduate years and between IM and pediatrics rotations. Participants were more likely to agree they experienced an appropriate level of autonomy when they were on IM rotations than when they were on pediatrics rotations (97.9% versus 34.3%, P < .001), were more likely to report experiencing frustration with too little oversight while on IM rotations (32.9% versus 2.2%, P < .001), and were more likely to report experiencing frustration with too much oversight while on pediatrics rotations (48.2% versus 0.7%, P < .001). Responses to items that described frequently encountered circumstances and hypothetical medical cases indicated participants were more likely to feel anxiety and discomfort with autonomous decision making while on pediatrics rotations. Conclusions Residents in internal medicine–pediatrics programs perceive significant differences in the autonomy they experience during IM and pediatrics rotations. This may influence their confidence in medical decision making.

Why Clinicians Choose Their Language Intervention Approach: An International Perspective on Intervention for Children with Developmental Language Disorder

2021 ◽  
pp. 1-15
Author(s):  
Rachel Forsythe ◽  
Carol-Anne Murphy ◽  
Josie Tulip ◽  
James Law
Keyword(s):  
Decision Making ◽  
Online Survey ◽  
Language Disorder ◽  
Scientific Evidence ◽  
Continuing Professional Development ◽  
International Perspective ◽  
Research Network ◽  
Developmental Language Disorder ◽  
Wide Range ◽  
Context Specific

<b><i>Purpose:</i></b> Considerable progress has been made in recent years in generating external evidence underpinning interventions for children with developmental language disorder (DLD), but less is known about the practitioner decision-making process underpinning such interventions and whether such decisions are context specific or are internationally generalizable. <b><i>Methods:</i></b> An online survey about clinical practice was developed by members of COST Action IS1406, an EU-funded research network, which included representation from 39 countries. The participants were 2,408 practitioners who answered questions in relation to their decision making for a specific child of their choosing with DLD. Analysis of open-ended questions was undertaken, and data were converted into codes for the purpose of quantitative analysis. <b><i>Results:</i></b> Although a wide range of intervention approaches and rationales were reported, the majority of responses referenced a client-centred approach. Level of functioning was used as a rationale only if a child had severe DLD. Practitioners with university level education or above were less likely to report basing intervention on client-centred factors. A number of differently named interventions with variable theoretical and empirical underpinnings were used in different countries. <b><i>Conclusions:</i></b> Specific client and practitioner characteristics have an impact on the intervention approaches and rationales adopted across countries. A limited number of practitioners reported use of external scientific evidence, which suggests that there should be more initiatives in basic training of practitioners and continuing professional development to encourage the uptake of scientific evidence-based practice.

Threats from patients and their effects on medical decision making: a cross-sectional, randomised trial

The Lancet ◽  
2001 ◽  
Vol 357 (9264) ◽  
pp. 1258-1261 ◽  
Author(s):  
Ivar Sønbø Kristiansen ◽  
Olav Helge Førde ◽  
Olaf Aasland ◽  
Ragnar Hotvedt ◽  
Roar Johnsen ◽  
...  
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Randomised Trial ◽  
Medical Decision ◽  
Cross Sectional

scholarly journals Software implementation for diagnostic decision-making based on multiparametric ultrasonography parameters of breast masses

2020 ◽  
Vol 35 (4) ◽  
pp. 137-142
Author(s):  
A. B. Goncharova ◽  
E. A. Busko
Keyword(s):  
Decision Making ◽  
Ultrasound Examination ◽  
Software Implementation ◽  
Medical Decision ◽  
Breast Diseases ◽  
Breast Masses ◽  
Diagnostic Decision ◽  
Ultrasound Diagnostics ◽  
Wide Range ◽  
Diagnostic Decision Making

Purpose. To build a system for making diagnostic decisions based on multiparametric ultrasound examination of the mammary gland.Material and Methods. A total of 277 women with various complaints of breast diseases were examined using a wide range of ultrasound technologies, including elastography and contrast enhancement. To verify the lesions, the patients underwent histological or cytological examination. The results of ultrasound examination, histological and cytological conclusions were entered into the database. The system was trained with 219 patient samples selected from the database. The patient’s samples were grouped according to the visual ultrasound characteristics. The data groups’ analysis allowed the compilation of a table with relative frequencies (probability) of symptoms for this diagnosis. Based on the convolution and the Bayesian method, the system for support of the medical decision by age, clinical picture, and ultrasound diagnostics results were built. Sensitivity and specificity were determined for software implementation in the initial database.Conclusion. The proposed decision support system allows us to determine the probability of malignancy and standardize decision-making in the differential diagnosis of breast masses.

scholarly journals Use of Urology-Based Clinical Practice Guidelines in International Settings

2021 ◽  
Vol 2 (1) ◽  
pp. 10-17
Author(s):  
German Patino ◽  
Medina Ndoye ◽  
Hannah S. Thomas ◽  
Andrew J. Cohen ◽  
Nnenaya A. Mmonu ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Online Survey ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Medical Decision ◽  
Local Health ◽  
Cross Sectional

Objective Clinical practice guidelines (CPGs) serve as frameworks to unify diagnostic criteria and guide clinical decision-making. There is a paucity of literature surrounding the uptake of CPGs in urology practice settings with varied levels of resources worldwide. This study aims to evaluate reported use of CPGs within the context of international urology practice, identify local barriers to uptake, and evaluate the role of stakeholders in the CPG-development process. Methods This was an international, multi-center, cross-sectional study. An online survey collecting variables pertaining to the use of CPGs was distributed to attending/consultant urologists in Latin America, Africa, and China. Statistical analysis was conducted using R software. Result A total of 249 practicing urologists from 28 countries completed the survey. The majority of participants were males, aged 36 to 45, and practiced in a non-academic setting. Ninety-three percent of urologists used CPGs in their everyday clinical practice, and 43% believed CPGs were very important to medical decision-making. However, barriers such as the lack of adaptability or applicability of CPGs to local settings were mentioned by 29% and 24% of participants, respectively. Urologists believed scientific associations (81%), national urology boards (68%), and ministries of health (56%), were important stakeholders to consult to foster the development of local CPGs. Conclusions Globally, CPGs are widely used tools for clinical practice. However, there are concerns about the adaptability and applicability of CPGs to settings that may lack the resources to implement their recommendations. Efforts should be directed towards incorporating scientific and medical stakeholders into the review and adaptation of urology CPGs to suit the unique features of local health care systems.

scholarly journals Religious and Spiritual Beliefs of Gynecologic Oncologists May Influence Medical Decision Making

2011 ◽  
Vol 21 (3) ◽  
pp. 573-581 ◽  
Author(s):  
Lois Ramondetta ◽  
Alaina Brown ◽  
Gwyn Richardson ◽  
Diana Urbauer ◽  
Premal H. Thaker ◽  
...  
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Assisted Suicide ◽  
Online Survey ◽  
Medical Decision Making ◽  
Medical Community ◽  
Complex Case ◽  
Medical Decision ◽  
Clinical Practices ◽  
Survey Tool

BackgroundReligious (R) and spiritual (S) beliefs often affect patients' health care decisions, particularly with regard to care at the end of life. Furthermore, patients desire more R/S involvement by the medical community; however, physicians typically do not incorporate R/S assessment into medical interviews with patients. The effects of physicians' R/S beliefs on willingness to participate in controversial clinical practices such as medical abortions and physician-assisted suicide has been evaluated, but how a physician's R/S beliefs may affect other medical decision-making is unclear.MethodsUsing SurveyMonkey, an online survey tool, we surveyed 1972 members of the International Gynecologic Oncologists Society and the Society of Gynecologic Oncologists to determine the R/S characteristics of gynecologic oncologists and whether their R/S beliefs affected their clinical practice. Demographics, religiosity, and spirituality data were collected. Physicians were also asked to evaluate 5 complex case scenarios.ResultsTwo hundred seventy-three (14%) physicians responded. Sixty percent "agreed" or "somewhat agreed" that their R/S beliefs were a source of personal comfort. Forty-five percent reported that their R/S beliefs ("sometimes," "frequently," or "always") play a role in the medical options they offered patients, but only 34% "frequently" or "always" take a R/S history from patients. Interestingly, 90% reported that they consider patients' R/S beliefs when discussing end-of-life issues. Responses to case scenarios largely differed by years of experience, although age and R/S beliefs also had influence.ConclusionsOur results suggest that gynecologic oncologists' R/S beliefs may affect patient care but that most physicians fail to take an R/S history from their patients. More work needs to be done to evaluate possible barriers that prevent physicians from taking a spiritual history and engaging in discussions over these matters with patients.

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