减少轶事推理对人们医疗保健决策的影响：一张图片能抵得上一千个统计数据吗？
Reducing the influence of anecdotal reasoning on people's health care decisions: is a picture worth a thousand statistics?
作者信息
Fagerlin Angela, Wang Catharine, Ubel Peter A
机构信息
VA Health Services Research & Development Center of Excellence, VA Ann Arbor Healthcare System, Ann Arbor, MI 48109-0429, USA.
出版信息
Med Decis Making. 2005 Jul-Aug;25(4):398-405. doi: 10.1177/0272989X05278931.
BACKGROUND
People's treatment decisions are often influenced by anecdotal rather than statistical information. This can lead to patients making decisions based on others' experiences rather than on evidence-based medicine.
OBJECTIVE
. To test whether the use of a quiz or pictograph decreases people's reliance on anecdotal information.
DESIGN
. Two cross-sectional survey studies using hypothetical scenarios. Participants read a scenario describing angina and indicated a preference for either bypass surgery or balloon angioplasty. The cure rate of both treatments was presented using prose, a pictograph, a quiz, or a pictograph and quiz combination. Participants read anecdotes from hypothetical patients who described the outcome of their treatment; the number of successful anecdotes was either representative or unrepresentative of the cure rates. Setting and Participants. Prospective jurors at the Philadelphia County Courthouse and travelers at the Detroit-Wayne County Metropolitan Airport. Measurements. Proportion of respondents preferring bypass over balloon angioplasty.
RESULTS
. In study 1, when statistical information was presented in prose, treatment choices were influenced by anecdotes, with 41% of participants choosing bypass when the anecdotes were representative and only 20% choosing it when the anecdotes were unrepresentative (x(2) = 14.40, P < 0.001). When statistics were reinforced with the pictograph and quiz, anecdotes had no significant influence on treatment decisions (38% choosing bypass when anecdotes were representative v. 44% when unrepresentative, x(2) = 1.08, P > 0.20). In study 2, the tradeoff quiz did not reduce the impact of the anecdotes (27% v. 28% choosing bypass after receiving or not receiving the quiz, x(2) < 1, P > 0.20). However, the pictograph significantly reduced the impact of anecdotes, with 27% choosing bypass after receiving no pictograph and 40% choosing bypass after receiving a pictograph (x(2) = 6.44, P < 0.001).
CONCLUSIONS
. Presenting statistical information using a pictograph can reduce the undue influence of anecdotal reasoning on treatment choices.
背景
人们的治疗决策往往受传闻而非统计信息的影响。这可能导致患者基于他人的经验而非循证医学来做决定。
目的
测试使用测验或象形图是否会降低人们对传闻信息的依赖。
设计
两项使用假设情景的横断面调查研究。参与者阅读一个描述心绞痛的情景，并表明对搭桥手术或球囊血管成形术的偏好。两种治疗方法的治愈率通过散文、象形图、测验或象形图与测验的组合来呈现。参与者阅读来自假设患者描述其治疗结果的轶事；成功轶事的数量要么代表治愈率，要么不代表治愈率。地点和参与者：费城县法院的潜在陪审员和底特律 - 韦恩县大都会机场的旅客。测量指标：选择搭桥手术而非球囊血管成形术的受访者比例。
结果
在研究1中，当以散文形式呈现统计信息时，治疗选择受轶事影响，当轶事具有代表性时，41%的参与者选择搭桥手术，而当轶事不具有代表性时，只有20%的参与者选择搭桥手术（χ² = 14.40，P < 0.001）。当用象形图和测验强化统计信息时，轶事对治疗决策没有显著影响（当轶事具有代表性时38%选择搭桥手术，不具有代表性时为44%，χ² = 1.08，P > 0.20）。在研究2中，权衡测验并没有减少轶事的影响（接受或未接受测验后选择搭桥手术的比例分别为27%和28%，χ² < 1，P > 0.20）。然而，象形图显著降低了轶事的影响，未接受象形图时27%的人选择搭桥手术，接受象形图后这一比例为40%（χ² = 6.44，P < 0.001）。
结论
使用象形图呈现统计信息可以减少传闻推理对治疗选择的不当影响。
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