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Making Sense of Numbers: Understanding Risks and Benefits

Making Sense of Numbers: Understanding Risks and Benefits. Michelle Burda NNLM MAR Education and Health Literacy Coordinator February 20, 2019. Communicating Numerical Health Information.

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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 Michelle Burda NNLM MAR Education and Health Literacy Coordinator February 20, 2019 Communicating Numerical Health Information

  2. 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

  3. Agenda • Overview of risks, benefits, numeracy, data visualization • Making numbers more meaningful, data visualization • Using MedlinePlus as a resource • 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

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

  5. Numeracy

  6. 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)

  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. 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.”

  9. 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

  10. 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

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

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

  13. Icon Array- Basic

  14. Clinician Icon Array

  15. 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

  16. 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

  17. Compare the numbers using % 0.3% 2%

  18. 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

  19. Framing • Presenting information in different ways Positive-Survival Negative-Death Example: • Over 10 years, the average person’s chance of dying from colon cancer is 2 out of 1,000. • Or rephrase: Your chance of not dying from colon cancer is 998 out of 1,000.”

  20. Question How would you present this information to someone? 2% of people who undergo surgery for ____ develop a serious blood infection.

  21. Example: Framing the risk • 2% of people who undergo this surgery develop a serious blood infection. OR • 98% of people who undergo surgery do not develop a blood infection. 1 or 2 better?

  22. What? You are Confusing Me

  23. How can both be true? • 1 out of 8 American women will be diagnosed with invasive breast cancer. • 2 out of 3American women will be diagnosed with invasive breast cancer. https://www.cdc.gov/cancer/dcpc/images/woman-doctor-300x200.jpg

  24. How can both statements be true? • 1 out of 8 American women will be diagnosed with invasive breast cancerin their lifetime. 12.5% • 2 out of 3 American women will be diagnosed with invasive breast cancerin their lifetime. 66.7% • 1 out of 8 American women younger than 45 will be diagnosed with breast cancer • 2 out of 3 American women older than • age 55 will be • diagnosed with breast cancer. Statistics URL

  25. Putting Risk in PerspectiveorMaking Numbers Meaningful

  26. 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

  27. 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.

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

  29. Make sure you are clear about your message Men and Bladder Cancer (during a lifetime) • Risk of developing bladder is 3.76% • 1 in 27 chance • 1 out of every 27 men in the US will develop bladder cancer during his lifetime • Risk of dying • 0.94% • 1 in 106 American Cancer Society URL

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

  31. 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

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

  33. Data Visualization

  34. FDAColorectal Cancer

  35. Prediabetes: Could It Be You? • prediabetes

  36. 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

  37. NIH MedlinePlus Magazine

  38. MedlinePlus

  39. Medline plus MedlinePlus

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

  41. 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

  42. MedlinePlusTrusted Health Information for You Medlineplus homepage

  43. About MedlinePlus

  44. Searching MedlinePlus by Health Topic

  45. Smoking Cessation • Quitting smoking

  46. Teenagers: How can I quit smoking ? • teens

  47. E-cigarettes

  48. Visualizing the Numbers

  49. 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!

  50. Is reducing my risk worth it? • What outcome is being reduced? • How big is the reduction? • Are they comparing people like me?

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