J. Med. Internet Res. - Cool but counterproductive: interactive, Web-based risk communications can backfire.

Tópicos

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Resumo

CKGROUND: Paper-based patient decision aids generally present risk information using numbers and/or static images. However, limited psychological research has suggested that when people interactively graph risk information, they process the statistics more actively, making the information more available for decision making. Such interactive tools could potentially be incorporated in a new generation of Web-based decision aids.OBJECTIVE: The objective of our study was to investigate whether interactive graphics detailing the risk of side effects of two treatments improve knowledge and decision making over standard risk graphics.METHODS: A total of 3371 members of a demographically diverse Internet panel viewed a hypothetical scenario about two hypothetical treatments for thyroid cancer. Each treatment had a chance of causing 1 of 2 side effects, but we randomly varied whether one treatment was better on both dimensions (strong dominance condition), slightly better on only one dimension (mild dominance condition), or better on one dimension but worse on the other (trade-off condition) than the other treatment. We also varied whether respondents passively viewed the risk information in static pictograph (icon array) images or actively manipulated the information by using interactive Flash-based animations of "fill-in-the-blank" pictographs. Our primary hypothesis was that active manipulation would increase respondents' ability to recognize dominance (when available) and choose the better treatment.RESULTS: The interactive risk graphic conditions had significantly worse survey completion rates (1110/1695, 65.5% vs 1316/1659, 79.3%, P < .001) than the static image conditions. In addition, respondents using interactive graphs were less likely to recognize and select the dominant treatment option (234/380, 61.6% vs 343/465, 73.8%, P < .001 in the strong dominance condition).CONCLUSIONS: Interactivity, however visually appealing, can both add to respondent burden and distract people from understanding relevant statistical information. Decision-aid developers need to be aware that interactive risk presentations may create worse outcomes than presentations of static risk graphic formats.

Resumo Limpo

ckground paperbas patient decis aid general present risk inform use number andor static imag howev limit psycholog research suggest peopl interact graph risk inform process statist activ make inform avail decis make interact tool potenti incorpor new generat webbas decis aidsobject object studi investig whether interact graphic detail risk side effect two treatment improv knowledg decis make standard risk graphicsmethod total member demograph divers internet panel view hypothet scenario two hypothet treatment thyroid cancer treatment chanc caus side effect random vari whether one treatment better dimens strong domin condit slight better one dimens mild domin condit better one dimens wors tradeoff condit treatment also vari whether respond passiv view risk inform static pictograph icon array imag activ manipul inform use interact flashbas anim fillintheblank pictograph primari hypothesi activ manipul increas respond abil recogn domin avail choos better treatmentresult interact risk graphic condit signific wors survey complet rate vs p static imag condit addit respond use interact graph less like recogn select domin treatment option vs p strong domin conditionconclus interact howev visual appeal can add respond burden distract peopl understand relev statist inform decisionaid develop need awar interact risk present may creat wors outcom present static risk graphic format

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