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

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.




Patients and medical statistics. Interest, confidence, and ability.
Authors: Woloshin S. , Schwartz L.M. , Welch H.G. .
Source: Journal Of General Internal Medicine, 2005 Nov; 20(11), p. 996-1000.
PMID: 16307623
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Celebrity endorsements of cancer screening.
Authors: Larson R.J. , Woloshin S. , Schwartz L.M. , Welch H.G. .
Source: Journal Of The National Cancer Institute, 2005-05-04 00:00:00.0; 97(9), p. 693-5.
PMID: 15870440
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Can patients interpret health information? An assessment of the medical data interpretation test.
Authors: Schwartz L.M. , Woloshin S. , Welch H.G. .
Source: Medical Decision Making : An International Journal Of The Society For Medical Decision Making, 2005 May-Jun; 25(3), p. 290-300.
PMID: 15951456
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Advertising by academic medical centers.
Authors: Larson R.J. , Schwartz L.M. , Woloshin S. , Welch H.G. .
Source: Archives Of Internal Medicine, 2005-03-28 00:00:00.0; 165(6), p. 645-51.
PMID: 15795340
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Screening for cervical cancer: will women accept less?
Authors: Sirovich B.E. , Woloshin S. , Schwartz L.M. .
Source: The American Journal Of Medicine, 2005 Feb; 118(2), p. 151-8.
PMID: 15694900
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The media matter: a call for straightforward medical reporting.
Authors: Schwartz L.M. , Woloshin S. .
Source: Annals Of Internal Medicine, 2004-02-03 00:00:00.0; 140(3), p. 226-8.
PMID: 14757622
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Enthusiasm for cancer screening in the United States.
Authors: Schwartz L.M. , Woloshin S. , Fowler F.J. , Welch H.G. .
Source: Jama : The Journal Of The American Medical Association, 2004-01-07 00:00:00.0; 291(1), p. 71-8.
PMID: 14709578
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The value of benefit data in direct-to-consumer drug ads.
Authors: Woloshin S. , Schwartz L.M. , Welch H.G. .
Source: Health Affairs (project Hope), 2004 Jan-Jun; Suppl Web Exclusives, p. W4-234-45.
PMID: 15452006
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Screening men for prostate and colorectal cancer in the United States: does practice reflect the evidence?
Authors: Sirovich B.E. , Schwartz L.M. , Woloshin S. .
Source: Jama : The Journal Of The American Medical Association, 2003-03-19 00:00:00.0; 289(11), p. 1414-20.
PMID: 12636464
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News media coverage of screening mammography for women in their 40s and tamoxifen for primary prevention of breast cancer.
Authors: Schwartz L.M. , Woloshin S. .
Source: Jama, 2002-06-19 00:00:00.0; 287(23), p. 3136-42.
PMID: 12069679
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Tobacco money: up in smoke?
Authors: Woloshin S. , Schwartz L.M. , Welch H.G. .
Source: Lancet (london, England), 2002-06-15 00:00:00.0; 359(9323), p. 2108-11.
PMID: 12086781
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Press releases: translating research into news.
Authors: Woloshin S. , Schwartz L.M. .
Source: Jama, 2002-06-05 00:00:00.0; 287(21), p. 2856-8.
PMID: 12038933
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Media coverage of scientific meetings: too much, too soon?
Authors: Schwartz L.M. , Woloshin S. , Baczek L. .
Source: Jama, 2002-06-05 00:00:00.0; 287(21), p. 2859-63.
PMID: 12038934
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Risk charts: putting cancer in context.
Authors: Woloshin S. , Schwartz L.M. , Welch H.G. .
Source: Journal Of The National Cancer Institute, 2002-06-05 00:00:00.0; 94(11), p. 799-804.
PMID: 12048267
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Marketing medicine to the public: a reader's guide.
Authors: Schwartz L.M. , Woloshin S. .
Source: Jama, 2002-02-13 00:00:00.0; 287(6), p. 774-5.
PMID: 11851550
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Direct-to-consumer advertisements for prescription drugs: what are Americans being sold?
Authors: Woloshin S. , Schwartz L.M. , Tremmel J. , Welch H.G. .
Source: Lancet (london, England), 2001-10-06 00:00:00.0; 358(9288), p. 1141-6.
PMID: 11597668
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Assessing values for health: numeracy matters.
Authors: Woloshin S. , Schwartz L.M. , Moncur M. , Gabriel S. , Tosteson A.N. .
Source: Medical Decision Making : An International Journal Of The Society For Medical Decision Making, 2001 Sep-Oct; 21(5), p. 382-90.
PMID: 11575488
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The case for letting information speak for itself.
Authors: Schwartz L.M. , Woloshin S. .
Source: Effective Clinical Practice : Ecp, 2001 Mar-Apr; 4(2), p. 76-9.
PMID: 11329989
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