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Too Much Information? Risk-benefit data does not always lead to informed decision-making
Date:4/14/2011

pplying probabilistic and mathematical concepts. National surveys suggest that at least 22 percent of adults have only the most basic quantitative skills, such as counting, while another 33 percent fare only slightly better and are able to do simple arithmetic.

But even people who have a good grasp of probability and math are prone to biases in how they interpret data on risks, Schwartz says, citing 30 years of psychology literature. They may give exaggerated importance to small risks or, conversely, exhibit "optimism bias" and exaggerate the chance that they will be in the "lucky" group. "Which of these biases come into play in a given situation. depends on the individual's psychology and the way the information is presented," he writes. Either way, the bias can lead patients to make decisions about medical interventions that are not based on reason or facts.

Schwartz cites as an example the interpretation of the new mammography guidelines announced by the United States Preventive Services Task Force in 2009, which proposed that screening start at age 50 instead of 40 and be done every two years instead of annually. While mammograms for women ages 40 to 49 slightly reduce mortality from breast cancer, they also result in significantly more false positives and overtreatment. Thus a woman's decision to get mammograms while she is in this age range involves important trade-offs, and the choice depends on the individual's beliefs and values.

Schwartz argues that clinicians should not always disclose all available quantitative data to all patients. "While the data should always be available to patients who want it, the question is, how to offer it and in what form," he writes. "These issues suggest that much more empirical research and ethical analysis are required about the use of quantitative information in decision-making."

"Questions about how and when to disclose quantitative information will become ever more pressing as advan
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Contact: Michael Turton
turtonm@thehastingscenter.org
845-424-4040 x242
The Hastings Center
Source:Eurekalert

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