Aiding risk information learning through simulated experience (ARISE): Using simulated outcomes to improve understanding of conditional probabilities in prenatal Down syndrome screening |
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| Affiliation: | 1. Department of Health Sciences, University of Missouri, Columbia, MO, USA;2. Department of Psychological Sciences, University of Missouri, Columbia, MO, USA;1. Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Ontario, Canada;2. Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada;3. Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada;1. Cryopreservation, German Cancer Research Center (DKFZ), Heidelberg, Germany;2. Center for Preclinical Research, German Cancer Research Center (DKFZ), Heidelberg, Germany;3. Department of Physiology and Pathophysiology, University of Heidelberg, Heidelberg, Germany;1. School of Economics and Management, University of Firenze, 50127 Firenze, Italy;2. Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON N2L3G1, Canada;1. Department of Electrical and Computer Engineering, University of Alberta, Edmonton T6R 2V4, Canada;2. Department of Electrical and Computer Engineering, Faculty of Engineering, King Abdulaziz University, Jeddah 21589, Saudi Arabia;3. Systems Research Institute, Polish Academy of Sciences, Warsaw, Poland;4. Institute of Geophysics and Geomatics, China University of Geosciences, Wuhan 430074, PR China;1. Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York;2. Weill-Cornell Medical College, New York, New York;3. Maternal Fetal Medicine Associates, PLLC, New York, New York |
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| Abstract: | ObjectiveTo determine whether the use of visually-presented simulated experiences to communicate statistical information can improve an individual’s understanding of conditional probabilities—specifically the positive predictive value (PPV) of prenatal screening tests for Down syndrome.MethodsIn Experiment 1 (N = 64) and Experiment 2 (N = 180) participants were asked to estimate the PPV of a prenatal screening test for Down syndrome based on either (1) explicit statistics regarding the prevalence of Down syndrome and the sensitivity and specificity of a prenatal screening test for Down syndrome, or (2) experiencing up to 5000 simulated test results over a short time.ResultsParticipants’ estimates of the PPV were more accurate when they had learned via simulated experiences (79% accuracy) compared with estimates based on explicitly described statistics (14%). Participants in the simulated experience condition also reported decreased interest in screening and decreased concern with a positive test result.ConclusionA visual paradigm presenting simulated experiences improves PPV estimates, compared to estimates derived from explicitly provided statistics, while also shifting attitudes away from screening.Practice implicationsThe use of simulated experiences may prove to be simple but powerful tool to communicate complex statistical information to patients in medical decision making situations. |
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| Keywords: | Simulated experience Screening tests Conditional probabilities Positive predictive value Attitudes towards screening |
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