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Making Sense of Numbers: Understanding Risks and Benefits

Learn about risk communication, numeracy, and visualization in health information. Improve your decision-making skills regarding benefits and risks.

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Making Sense of Numbers: Understanding Risks and Benefits

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  1. Making Sense of Numbers:Understanding Risks and Benefits Communicating Numerical Health Information Michelle Burda NNLM MAR Education and Health Literacy Coordinator July 17, 2019

  2. About today’s session • The session is being close captioned and recorded. • Please use the chat feature to ask questions or share comments as we go along. Make sure “everyone” is selected so we all can see them. • PPT slides and a link to the recording will be made available following the presentation. • The class is available for 1.5 MLA and is CHIS eligible. A link to the class evaluation will be given at the end. When you complete the evaluation you will receive a MLA CE code for your credit.

  3. ObjectivesAfter this class you will be able: • To understand your role in risk communication and (health literacy)numeracy • To understand risk and benefit (numeracy) health information from an individual’s perspective • To understand that the communication of numbers must be clear and easy to understand • To understand that numeracy is a necessary skill of health literacy and is a key component of shared-decision making when managing one’s health

  4. Agenda • Overview of risks, benefits, numeracy, and visualization of data • Making numbers more meaningful, data visualization • Using MedlinePlus as a resource • What happens when you don’t have the answers • Evidence and evaluation of information • Looking ahead & the importance of numeracy, shared decision making • Review, summarize, exercises, resources

  5. Making Sense of Numbers To be continued…..

  6. Numeracy

  7. Rima Rudd MSPH, ScD says “…….. Rima Rudd, a longtime health literacy researcher at Harvard University says, “We give people findings and tell them about risk and expect people to make decisions based on those concepts, but we don’t explain them very well.” Rudd, R. E. 2016. Numbers get in the way. Commentary, National Academy of Medicine, Washington, DC

  8. Definitions: • Numeracy is about more than numbers — it’s about developing the critical thinking skills we all need for everyday life and work. (National Adult Literacy Agency) • Numeracy, also known as quantitative literacy, refers to a set of mathematical and advanced problem-solving skills that are necessary to succeed in a society increasingly driven by data.(National Association of Secondary School Principals)

  9. Figuring out the numbers % per cent means 1% =0.01=1/100 • 25%=0.25=25/100 =1/4 • 0.45% = .45 X.01=.0045 = 45/10,000 Converting fractions to per cent % • 1/4 = 1 by 4 X 100 = 25% ( 4 denominator into 1 numerator) • 25/1000 =? % 25/1000 =2.5/100 .025 = 2.5% “Numeracy is essential to science.”

  10. Definitions • Risk - the chancethat “something’” will happen • Risk - the chance “something” will happen good or bad • Outcome - is the “something” (good or bad) that may happen • Benefit - a good or helpful result or effect • Statistics - are numbers that summarize information

  11. Relative Risk vs. Absolute Risk Relative Risk • is a comparison between two groups of people, or in the same group of people over time • it can be expressed as a ratio. RR = Risk of outcome in treated Grp X /Risk in control Grp Y. Absolute Risk • is the absolute difference in outcomes between one group (usually the control grp. Y) and the group receiving treatment X • Absolute risk is the number of people experiencing an event in relation to the population at risk. AR= #of events in treated or control grp./#in the group

  12. VisualizationUsing pictures to represent numbers 3 out of 4 or 75% = 75 out of 100

  13. Cont. 75% or 75 out of 100 7.5 out of 10 Iconarray

  14. Icon Array- Basic

  15. Clinician Icon Array

  16. What should Mr. Jones do?* 3 out 1,000 people who have diabetes improved as a result of taking the medication and2 out of 100 people who have diabetes improved as a result of dietary changes. ? *poll question 1

  17. Comparing the numbers • 3 out 1,000 people improved as a result of taking medication • 2 out of 100 improved as a result of dietary changes. 3 out 1,000 improved as a result of the medication 20 out of 1,000 improved as a result of dietary changes. Easier to compare when we use the same denominator

  18. Compare the numbers using % 0.3% 2%

  19. Comparing all three numbers • 3 out 1,000 • improved as a • result of taking medication • 2 out of 100 improved as • a result of • dietary changes 3 out 1,000 improved as a result of the medication 20 out of 1,000 improved as a result of dietary changes 0.3% improved as a result of the medication 2 % improved as a result of dietary changes

  20. Framing • Presenting information in different ways Positive-Survival Negative-Death Example: • Over 5 years, the average person’s chance of dying from thyroid cancer is 3% (3 out of 100). • Or rephrase: Your chance of not dying from thyroid cancer is 97% (97 out of 100).” (United States Cancer Statistics: Data Visualizations)

  21. Question How would you present the following information to a person? 3% of people who undergo surgery for (XYZ) develop a serious blood infection.

  22. Example: Framing the risk • 3% of people who undergo surgery develop a serious blood infection. OR • 97% of people who undergo surgery do not develop a blood infection. 1 or 2 better?

  23. What? You are Confusing Me

  24. How can both be true? • 5-year relative survival for melanomas of the skin in the United States is 89.6%. • 5-year relative survival for melanomas of the skin in the United States is 66.9 %. * Estimates are based on cases reported by NPCR registries from 2001-2015 and follow-up of patients through December 31, 2015. https://visualsonline.cancer.gov/details.cfm?imageid=9186

  25. Survival: 5- Year (melanoma invasive cancers only) • Chart

  26. How can both statements be true? • 5-year relative survival for Melanomas of the skin in the United States is 89.6%. • 5-year relative survival for Melanomas of the skin in the United States is 66.9 %. • 5-year relative survival for Melanomas of the skin in the United States is (%) by both sexes and all races. • 5-year relative survival for Melanomas of the skin in the United States is % by race (Black), both sexes

  27. Putting Risk in PerspectiveorMaking Numbers Meaningful

  28. Putting risk in perspective • Diagnosis of a disease vs. dying from a disease • Does it apply to me? • Add in age • Add in sex • Racial and ethnic background • How does the risk of contracting one disease compare to another? • How big is the risk? • Risk visualization

  29. Resource: Cancer Facts & Figures 2019 Lifetime risk of developing or dying from cancer • The risk is expressed both in terms of a percentage and as odds. • These numbers are average risks for the overall US population. • Your risk may be higher or lower, depending on your particular risk factors.

  30. Probability % & odds (p.14)Cancer Facts & Figures 2019

  31. Make sure you are clear about your message Men and prostate cancer(during a lifetime) • Risk of developing prostate cancer is 11.55% • 1 in 9 chance • 1 out of every 9 men in the US will develop prostate cancer during his lifetime • Risk of dying • 2.45% • 1 in 41 American Cancer Society URL

  32. Life After Cancer: Survivorship By the Numbers American Cancer Society Infographic 2017 cancer.org

  33. Conveying Risk

  34. Language we use with risk • Eliminating the word “factor” also makes it easier to address your readers directly by writing in second person, which is another great strategy for writing actionable content. • The bottom line: “factor” increases the risk for confusion — so when you talk about risk, factor it out. Communicate Health Blog

  35. How can I reduce my risk? • Are the interventions worth the risk? • Benefits vs downside, adverse effects…. Question: how can you help people mange their disease using a visual tool?

  36. Infographics Visual Communication

  37. FDA Colorectal Cancer

  38. Prediabetes: Could It Be You? • prediabetes

  39. Electronic cig Electronic Cigarettes and Youth • More than 18 million (7 in 10) US middle and high school youth were exposed to e-cigarette ads in 2014. • More than 1 in 2 middle and high school youth were exposed to e-cigarette ads in retail stores. • Nearly 2 in 5 middle and high school youth saw e-cigarette ads online. CDC: URL

  40. Atrial fibrillation • infographic

  41. NIH MedlinePlus Magazine

  42. What we (do or don’t) remember Kessels R. P. (2003). Patients' memory for medical information. Journal of the Royal Society of Medicine, 96(5), 219-22. PMID: 12724430 Patients forget up to 80% what a doctor told them as soon as they leave the office! Nearly 50% of what they do remember is remembered incorrectly!

  43. MedlinePlus

  44. Medline plus MedlinePlus

  45. MedlinePlus • Access to quality health information • anytime • anywhere • and now on ANY device!

  46. MedlinePlus.gov Links to reliable, authoritative health websites Health Topics on children/teens Easy-to-read articles Lab test information Medical encyclopedia Links to local services Information in > 45 languages No advertisements or endorsements

  47. MedlinePlusTrusted Health Information for You Medlineplus homepage

  48. About MedlinePlus

  49. Searching MedlinePlus by Health Topic

  50. Topic E-Cigarettes

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