QUIZ: How well do you think about risk and uncertainty?

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Understanding the risks and benefits of all options is critical for effective decision-making. Those who are comfortable with uncertainty and who understand the magnitude of risks tend to excel with decision-making in health, finance, and other high-stakes fields.  By taking the time to consider a problem and engage in self-reflection, more sound decisions can be taken - but a foundation that includes statistical literacy is also required.

The very basic understanding of risk and uncertainty apparently leads you to become more reflective about the information you consume, creating a more rational and informed worldview. In technical terms, it seems to increase your “metacognition” – your capacity to question your own reasoning and judgements.
— Predicting biases in very highly educated samples: Numeracy and metacognition - http://journal.sjdm.org/13/13919/jdm13919.pdf

Many of my peers in the overdiagnosis community are professionally skeptical. These patients, clinicians, and researchers tend to ask questions like: "is that really what the data show?" "how do we know this?" "through what lens was this interpreted, are there any biases?" It is because of this type of reflection that they can distance themselves from the evidence and view it critically. It is not surprising, given our interests, that members of our community score highly on the Berlin Numeracy Test.

Curious about your performance? Test your risk literacy now.

Read the original BBC Article:  How well do you think about risk and uncertainty? for more.

While historically health care providers and administrators have been preoccupied with people underestimating risk, there are profound implications of low statistical numeracy and risk literacy for overtesting/treatment and diagnosis.

These skills are of even greater importance today. “Nowadays patients are expected to make decisions, and they are given much more information than in the past,” [Valerie Reyna] says. You might be given more data about the side effects of different drugs, for instance, when choosing a treatment option – a little like the example question above. Or imagine you have taken a test that reveals a genetic predisposition to certain kinds of cancer. Misinterpreting the risk could lead you to needlessly undergo surgery. “We want patients to be empowered to make decisions – but now that means the burden is on them to understand a lot more technical information, so that makes it particularly important that they are numerate and literate.

Should we enhance risk evaluation and statistical skills education in high schools? What differences would we see in our society if the majority of people had an increased capacity to question their own reasoning and judgements?

Source: http://www.bbc.com/future/story/20180814-h...

Mammogram Theater: A Visual Aid For Medical Decision-Making

With a title like "mammogram theatre" you would wonder if this post is meant to poke fun at the elaborate song and dance of mammography; we have spent years promising women that "early detection is key," only to realize that screening mammography cannot do what we originally hoped it could (but many still pretend it can).

Of course women want their breasts and lives saved. But the information on the benefits of mammography has been largely overstated in part due to cognitive biases (like lead-time bias, base-rate fallacy, etc), and the risks are too often left out of the conversation.

Every test has risk and benefits, but it can be challenging to decide if a test or treatment is right for you or your patient when there is too much information, experts disagree when they review the same studies, and the media has a constant see-saw back and forth of "yes" and "no" headlines that seem only to confuse. It can feel a bit like ping-pong, following the discussion back and forth. It's not really fair to ask patients to make sense of all this.

So yes, the promise of benefit of mammography may have been a bit of dramatization, but the theatre I speak of is a literal one. 

Dr. Andrew Lazris is an American internist who partnered with environmental scientist Erik Rifkin to popularize a simple, easy way of showing how many are helped and harmed by common tests and procedures.

Lazris and Rifkin have developed a tool to give people a realistic way of evaluating 'hope and worry;'

Their "benefit-risk characterization theater" images vividly show the odds, based on solid research. (read more on NPR)

This is a tool to help doctors and patients have informed discussions about the risks and benefits of breast cancer screening with mammography, to engage in shared-decision making on the topic. Take a look:

This tool has been added to the "hands-on tools" section of this website, where you can find other tools like it.

Source: http://www.npr.org/sections/health-shots/2...