Patterson Chavis A, Barakat Lamia P, Henderson Phyllis K, Nall Faith, Westin Anna, Dampier Carlton D, Hsu Lewis L
Marian Anderson Comprehensive Sickle Cell Center, St. Christopher's Hospital for Children, Philadelphia, PA 19134, USA.
J Pediatr Hematol Oncol. 2011 Jan;33(1):4-9. doi: 10.1097/MPH.0b013e3181f46884.
Communicating risk is an important activity in medical decision-making; yet, numeracy is not a universal skill among the American public. We examined the hypothesis that numerical risk information about the use of hydroxyurea for children with sickle cell disease would elicit different risk assessment responses when visual depictions were used instead of abstract numbers and depending on the disease severity. Parents of 81 children with sickle cell disease participated in a survey in which hydroxyurea was first described as carrying a certain chance of risk for both birth defects and cancer. Then, the parents indicated the highest risk at which they would hypothetically consent to the treatment to help their child. Risk presentations were repeated with abstract numerical, pie graph, and 1000 people histogram formats. The χ analyses comparing high-risk to low-risk assessment across presentation formats showed high consistency between visual depictions but low consistency of abstract numerical with visual depictions. The parents of children with SC and other less severe types of SCD were less willing to accept higher risk than those with SS when the data were presented numerically. Given earlier concerns about poor "numeracy" in the US population, visual depictions of risk could be an effective tool for routine communication in health education and medical decision-making.
传达风险是医疗决策中的一项重要活动；然而，具备数字运算能力并非美国公众普遍拥有的技能。我们检验了这样一个假设：对于镰状细胞病患儿使用羟基脲的数值风险信息，当使用直观描述而非抽象数字呈现，且取决于疾病严重程度时，会引发不同的风险评估反应。81名镰状细胞病患儿的家长参与了一项调查，在调查中，羟基脲首先被描述为对出生缺陷和癌症均有一定的风险几率。然后，家长们指出在假设情况下他们会同意为帮助孩子接受治疗的最高风险水平。风险呈现以抽象数字、饼状图和千人群直方图形式重复进行。比较不同呈现形式下高风险与低风险评估的χ分析表明，直观描述之间具有高度一致性，但抽象数字与直观描述之间的一致性较低。当以数字形式呈现数据时，与患有SS型镰状细胞病的患儿家长相比，患有SC型及其他病情较轻类型镰状细胞病的患儿家长更不愿意接受更高的风险。鉴于此前对美国人群“数字运算能力”较差的担忧，风险的直观描述可能是健康教育和医疗决策中常规沟通的有效工具。
