Han Paul K J, Klein William M P, Lehman Thomas C, Massett Holly, Lee Simon C, Freedman Andrew N
Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA.
Med Decis Making. 2009 May-Jun;29(3):391-403. doi: 10.1177/0272989X08327396. Epub 2009 May 21.
To explore laypersons' responses to the communication of uncertainty associated with individualized cancer risk estimates and to identify reasons for individual differences in these responses.
A qualitative study was conducted using focus groups. Participants were informed about a new colorectal cancer risk prediction model, and presented with hypothetical individualized risk estimates using presentation formats varying in expressed uncertainty (range v. point estimate). Semistructured interviews explored participants' responses to this information.
Eight focus groups were conducted with 48 adults aged 50 to 74 residing in 2 major US metropolitan areas, Chicago, IL and Washington, DC. Purposive sampling was used to recruit participants with a high school or greater education, some familiarity with information technology, and no personal or immediate family history of cancer.
Participants identified several sources of uncertainty regarding cancer risk estimates, including missing data, limitations in accuracy and source credibility, and conflicting information. In comparing presentation formats, most participants reported greater worry and perceived risk with the range than with the point estimate, consistent with the phenomenon of "ambiguity aversion.'' However, others reported the opposite effect or else indifference between formats. Reasons suggested by participants' responses included individual differences in optimism and motivations to reduce feelings of vulnerability and personal lack of control. Perceptions of source credibility and risk mutability emerged as potential mediating factors.
Laypersons' responses to the communication of uncertainty regarding cancer risk estimates differ, and include both heightened and diminished risk perceptions. These differences may be attributable to personality, cognitive, and motivational factors.
探讨非专业人士对与个性化癌症风险评估相关的不确定性信息传达的反应，并确定这些反应中个体差异的原因。
采用焦点小组进行定性研究。向参与者介绍一种新的结直肠癌风险预测模型，并使用表达不确定性程度不同的展示形式（范围估计与点估计）呈现假设的个性化风险评估。通过半结构化访谈探究参与者对这些信息的反应。
在美国两个主要大都市地区伊利诺伊州芝加哥市和华盛顿特区，对48名年龄在50至74岁之间的成年人进行了8个焦点小组访谈。采用目的抽样法招募具有高中及以上学历、对信息技术有所了解且无个人或直系家族癌症病史的参与者。
参与者确定了癌症风险评估中几个不确定性来源，包括数据缺失、准确性和来源可信度的局限性以及相互矛盾的信息。在比较展示形式时，大多数参与者报告称，与点估计相比，范围估计会引发更多担忧和更高的感知风险，这与“模糊厌恶”现象一致。然而，其他人报告了相反的效果，或者对两种形式无差异。参与者反应中提出的原因包括乐观程度的个体差异以及减少脆弱感和个人失控感的动机。对来源可信度和风险可变性的认知成为潜在的中介因素。
非专业人士对癌症风险评估不确定性信息传达的反应各不相同，包括风险感知的增强和减弱。这些差异可能归因于人格、认知和动机因素。
