Lucia Savadori

Information Sampling and Confidence Within Groups and Judge Advisor Systems

This study compared how the judge advisor system (JAS) and unstructured groups discuss common and unique information. Three differences between the two were measured for their effect on communication of information. These were responsibility for decision, consensus seeking, and equity of participation. Participants were given information about two drugs and had to decide which of the two to market. Half met in unstructured 3-person groups and made the decision as a group. The rest met in JASs whereby the judge discussed the information with each advisor separately and then made the decision individually. Advisors mentioned but did not repeat a higher proportion of unique information than group members. Judges felt more responsible for, reported putting more effort toward, and had higher confidence in the decision than did group members. There was more inequity of participation and consensus seeking in JASs compared to groups. Differences are discussed in light of results found on information exchange.

Bringing appraisal theory to environmental risk perception: a review of conceptual approaches of the past 40 years and suggestions for future research

An intensive program of 40 years of research has produced various conceptual cognitive and affective approaches to environmental risk perception. In this short review of the most relevant conceptual approaches, appraisal theory is presented as a useful means of integrating cognitive and affective approaches to risk perception. Appraisal theory offers an opportunity to advance our understanding of how environmental risk perception operates in an emotion-specific manner and enables identification of new research directions. Although within other conceptual approaches there are still open research questions, the potential for examining environmental risk perception within appraisal theory has not yet been fully explored. Reviewing current appraisal theoretical models, seven research questions are suggested to structure future research on environmental risk perception.

The 1-in-X Effect on the Subjective Assessment of Medical Probabilities

Among numerical formats available to express probability, ratios are extensively used in risk communication, perhaps because of the health professional’s intuitive sense of their clarity and simplicity. Moreover, health professionals, in the attempt to make the data more meaningful, tend to prefer proportions with a numerator of 1 and shifting denominators (e.g., 1 in 200) rather than equivalent rates of disease per unit of population exposed to the threat (e.g., 5 in 1000). However, in a series of 7 experiments, it is shown that individual subjective assessments of the same probability presented through proportions rather than rates vary significantly. A 1-in-X format (e.g., 1 in 200) is subjectively perceived as bigger and more alarming than an N-in-X*N format (e.g., 5 in 1000). The 1-in-X effect generalizes to different populations, probabilities, and medical conditions. Further-more, the effect is not attenuated by a communicative intervention (verbal analogy), but it disappears with an icon array visual aid.

Improving public interpretation of probabilistic test results: distributive evaluations.

Health service users err in posttest probability evaluations. Here we document for the first time that users succeed when they reason about numbers of cases and make distributive evaluations. A sample of women interested in prenatal testing incorrectly evaluated the posttest probability that a given fetus had an anomaly, but regardless of their numeracy level, they correctly apportioned the cases for and against that hypothesis. This finding shows that health service users are not doomed to fail in dealing with single-case probabilities and suggests that probabilistic data can be used effectively for communicating test results.

Natural Frequencies Do Not Foster Public Understanding of Medical Test Results.

Major organizations recommend presenting medical test results in terms of natural frequencies, rather than single-event probabilities. The evidence, however, is that natural frequency presentations benefit at most one-fifth of samples of health service users and patients. Only one study reported a substantial benefit of these presentations. Here, we replicate that study, testing online survey respondents. Study 1 attributed the previously reported benefit of natural frequencies to a scoring artifact. Study 2 showed that natural frequencies may elicit evaluations that conflict with the normatively correct one, potentially hindering informed decision making. Ironically, these evaluations occurred less often when respondents reasoned about single-event probabilities. These results suggest caution in promoting natural frequencies as the best way to communicate medical test data to health service users and patients.

Using Comparison Scenarios to Improve Prenatal Risk Communication

The present research provides empirical evidence of whether communicating the prenatal risk of chromosomal anomalies using comparison scenarios influences women’s ability to distinguish between different risk levels. In 2 experiments, participants read a description of a hypothetical woman who was learning of the risk of chromosomal anomaly as a result of a prenatal screening test. Both experiments used a 3 (risk level) × 3 (scenario) full between-subjects design. In accordance with the experimental condition, participants were presented with a low (e.g., 1 in 5390), a medium (e.g., 1 in 770), or a high risk value (e.g., 1 in 110). Such risk values were presented either on their own or along with additional information illustrating a comparison scenario that provided 2 numerical comparison points. Participants were asked to evaluate the risk of chromosomal anomaly. In Experiment 2, participants’ numeracy skills were also assessed. Results showed that the use of comparison scenarios results in significant differences in perceived risk across risk levels whereas such differences are not significant without the comparison scenario, but such a technique has differential effects according to participants’ capacity to deal with numbers. Although the technique is beneficial for high-numerate participants, it has no effect on low-numerate participants.

Sociocognitive Factors Associated with Nonadherence to Medication After Hospital Discharge

Poor adherence to prescribed medication is a well-known problem and continues to be a major challenge in all medical specialties. Unlike previous studies that have mainly focused on nonadherence behaviors in specific diseases, this study sought to examine socio-cognitive factors associated with nonadherence behavior in a sample of a general clinical population. A questionnaire investigating socio-demographic and cognitive factors and a telephone follow-up interview were administered to 84 patients recruited in a General Medicine Unit before their discharge. Half of the participants were informed about that follow-up procedure. One month after hospital discharge, 42% of uninformed patients reported nonadherence behaviors, as against 21% of informed patients. Middle-aged patients and short-term treatments were associated significantly more often with nonadherence. Among cognitive factors, patients’ perceived risks and benefits of nonadherence, personal susceptibility to diseases, subjective health value, and reported memory failures were significantly associated with adherence. We conclude that a patients perception may be more important than medication load, illness severity, and complexity of regimen in influencing medication adherence, and that a telephone call follow-up helps in monitoring medication adherence after hospital discharge.

Communicating Down syndrome risk according to maternal age: “1‐in‐X” effect on perceived risk

The appropriateness of the 1‐in‐X numerical format to convey quantitative medical probabilities is currently under discussion because of its distortive effect on subjective probability assessment. Previous research, however, always asked participants to imagine a hypothetical scenario. The aim of the present research is to support the existence of the 1‐in‐X effect in a real setting: when pregnant women have to evaluate their personal risk of Down syndrome according to their maternal age.

Acute exercise increases sex differences in amateur athletes' risk taking

The research presented here investigates the interaction between acute exercise, biological sex and risk-taking behavior. The study involved 20 amateur athletes (19-33 years old), 10 males and 10 females, who were asked to undergo subsequent experimental sessions designed to compare their risky behaviors on the Balloon Analogue Risk Task (BART) 34 at rest and while exercising at moderate intensity (60% of their maximal aerobic power). Results showed that physical exercise affected male and female participants differently: Whereas males became more risk seeking, females became more risk averse during exercise.

Loss aversion and hypoxia: less loss aversion in oxygen-depleted environment

Abstract Hypoxia, the deprivation of adequate oxygen supply, constitutes a direct threat to survival by disrupting cardiovascular or respiratory homeostasis and eliciting a respiratory distress. Although hypoxia has been shown to increase brain vulnerability and impair basic cognitive functions, only one study has examined its effect on decision-making. The present study examined the effect of mild hypoxia on individual’s loss aversion, that is, the tendency to be more affected by losses than equal sized gains. A sample of 26 participants were asked to either accept or reject a series of mixed gambles once in an oxygen-depleted environment (14.1% oxygen concentration) and once in a normoxic environment (20.9% oxygen concentration). Each gamble involved a 50–50 chance of winning or losing specified amounts of money. Mild hypoxia decreased loss aversion: on average in the normoxic condition participants accepted gambles if the gain was at least 2.4 times as large as the loss, whereas in the oxygen-depleted condition participants accepted gambles if the gain was at least 1.7 times as large as the loss. Mild hypoxia may push individuals to be less cautious in daily decisions that involve a trade-off between a gain and a loss.