Skip Navigation
Grant Details

Grant Number: 5R18CA091052-02 Interpret this number
Primary Investigator: Woloshin, Steven
Organization: Dartmouth College
Project Title: Understanding Numbers in Health-a Primer for Patients
Fiscal Year: 2001
Back to top


Abstract

Context. To understand the important health risks they face and whether they can do anything to reduce these risks, people need data that is intrinsically quantitative and probabalistic. Unfortunately, there is evidence that people have trouble with the basic skills required to understand such data: working with probabilities, recognizing the additional information needed to give probability meaning, and making basic assessments about data quality. Objectives: * To develop and evaluate a general education booklet to help people think about and make use of numbers in health. Tentatively entitled, Understanding Numbers in Health, the booklet will cover the following areas: risk, what to look for in statements about risk, how to put cancer risk and treatment benefit in perspective, how to make sense of changes in risk, and quality of evidence. * To facilitate the communication of data by putting risk into context, we will develop and evaluate 3 basic risk communication tools to supplement the tutorial: Cancer risk charts: tables containing age-specific mortality rates for a range of diseases plus all-cause mortality. Prevention benefit charts: tables presenting the mortality benefit of various preventive strategies. Standard disease summary templates: a standard format to present information about a specific disease. Methods. Development Phase. Iterative review process of draft materials with content experts in the fields of education mathematics, epidemiology and genetics to ensure that the material is accurate and clearly articulated. Pilot testing (debriefing interviews for understandability) in two populations most likely to benefit from the tutorial: people with low numeracy and people currently concerned about the screening or treatment of cancer (i.e., cancer genetic testing, cancer treatment decisions, and women undergoing screening mammography). Evaluation Phase. We plan to conduct a formal evaluation of the tutorial and risk communication tools using a before-after study design (immediate and longer-term follow up at 3 months). The sample will be drawn from the same two populations as in the development phase. The primary outcome measure will be critical reading skills of medical data (i.e., ability to make use of data). Secondary measures will include comfort working with numbers, attention to medical data and ratings of materials for usability and satisfaction. Significance. This project is the groundwork for a body of research testing the effect of general education in a range of patient decisions from whether to undergo genetic testing for cancer susceptibility to choosing among health plans based on their report cards.

Back to top


Publications

Patients and medical statistics. Interest, confidence, and ability.
Authors: Woloshin S, Schwartz LM, Welch HG
Source: J Gen Intern Med, 2005 Nov;20(11), p. 996-1000.
PMID: 16307623
Related Citations

Back to top


Can patients interpret health information? An assessment of the medical data interpretation test.
Authors: Schwartz LM, Woloshin S, Welch HG
Source: Med Decis Making, 2005 May-Jun;25(3), p. 290-300.
PMID: 15951456
Related Citations

Back to top


Celebrity endorsements of cancer screening.
Authors: Larson RJ, Woloshin S, Schwartz LM, Welch HG
Source: J Natl Cancer Inst, 2005 May 4;97(9), p. 693-5.
PMID: 15870440
Related Citations

Back to top


Advertising by academic medical centers.
Authors: Larson RJ, Schwartz LM, Woloshin S, Welch HG
Source: Arch Intern Med, 2005 Mar 28;165(6), p. 645-51.
PMID: 15795340
Related Citations

Back to top


The value of benefit data in direct-to-consumer drug ads.
Authors: Woloshin S, Schwartz LM, Welch HG
Source: Health Aff (Millwood), 2004 Jan-Jun;Suppl Web Exclusives, p. W4-234-45.
PMID: 15452006
Related Citations

Back to top


The media matter: a call for straightforward medical reporting.
Authors: Schwartz LM, Woloshin S
Source: Ann Intern Med, 2004 Feb 3;140(3), p. 226-8.
PMID: 14757622
Related Citations

Back to top


Enthusiasm for cancer screening in the United States.
Authors: Schwartz LM, Woloshin S, Fowler FJ Jr, Welch HG
Source: JAMA, 2004 Jan 7;291(1), p. 71-8.
PMID: 14709578
Related Citations

Back to top


Screening men for prostate and colorectal cancer in the United States: does practice reflect the evidence?
Authors: Sirovich BE, Schwartz LM, Woloshin S
Source: JAMA, 2003 Mar 19;289(11), p. 1414-20.
PMID: 12636464
Related Citations

Back to top


Tobacco money: up in smoke?
Authors: Woloshin S, Schwartz LM, Welch HG
Source: Lancet, 2002 Jun 15;359(9323), p. 2108-11.
PMID: 12086781
Related Citations

Back to top


News media coverage of screening mammography for women in their 40s and tamoxifen for primary prevention of breast cancer.
Authors: Schwartz LM, Woloshin S
Source: JAMA, 2002 Jun 19;287(23), p. 3136-42.
PMID: 12069679
Related Citations

Back to top


Risk charts: putting cancer in context.
Authors: Woloshin S, Schwartz LM, Welch HG
Source: J Natl Cancer Inst, 2002 Jun 5;94(11), p. 799-804.
PMID: 12048267
Related Citations

Back to top


Media coverage of scientific meetings: too much, too soon?
Authors: Schwartz LM, Woloshin S, Baczek L
Source: JAMA, 2002 Jun 5;287(21), p. 2859-63.
PMID: 12038934
Related Citations

Back to top


Press releases: translating research into news.
Authors: Woloshin S, Schwartz LM
Source: JAMA, 2002 Jun 5;287(21), p. 2856-8.
PMID: 12038933
Related Citations

Back to top


Marketing medicine to the public: a reader's guide.
Authors: Schwartz LM, Woloshin S
Source: JAMA, 2002 Feb 13;287(6), p. 774-5.
PMID: 11851550
Related Citations

Back to top


Assessing values for health: numeracy matters.
Authors: Woloshin S, Schwartz LM, Moncur M, Gabriel S, Tosteson AN
Source: Med Decis Making, 2001 Sep-Oct;21(5), p. 382-90.
PMID: 11575488
Related Citations

Back to top


The case for letting information speak for itself.
Authors: Schwartz LM, Woloshin S
Source: Eff Clin Pract, 2001 Mar-Apr;4(2), p. 76-9.
PMID: 11329989
Related Citations

Back to top