How Numeracy Influences Risk Comprehension and Medical Decision Making

Valerie F. Reyna, Wendy L. Nelson, Paul K. Han, Nathan Dieckmann

Research output: Contribution to journalArticle

575 Citations (Scopus)

Abstract

We review the growing literature on health numeracy, the ability to understand and use numerical information, and its relation to cognition, health behaviors, and medical outcomes. Despite the surfeit of health information from commercial and noncommercial sources, national and international surveys show that many people lack basic numerical skills that are essential to maintain their health and make informed medical decisions. Low numeracy distorts perceptions of risks and benefits of screening, reduces medication compliance, impedes access to treatments, impairs risk communication (limiting prevention efforts among the most vulnerable), and, based on the scant research conducted on outcomes, appears to adversely affect medical outcomes. Low numeracy is also associated with greater susceptibility to extraneous factors (i.e., factors that do not change the objective numerical information). That is, low numeracy increases susceptibility to effects of mood or how information is presented (e.g., as frequencies vs. percentages) and to biases in judgment and decision making (e.g., framing and ratio bias effects). Much of this research is not grounded in empirically supported theories of numeracy or mathematical cognition, which are crucial for designing evidence-based policies and interventions that are effective in reducing risk and improving medical decision making. To address this gap, we outline four theoretical approaches (psychophysical, computational, standard dual-process, and fuzzy trace theory), review their implications for numeracy, and point to avenues for future research.

Original languageEnglish (US)
Pages (from-to)943-973
Number of pages31
JournalPsychological Bulletin
Volume135
Issue number6
DOIs
StatePublished - Nov 2009
Externally publishedYes

Fingerprint

Cognition
Health
Aptitude
Medication Adherence
Health Behavior
Research
Decision Making
Communication
Clinical Decision-Making
Medical Decision Making
Numeracy
Surveys and Questionnaires
Susceptibility

Keywords

  • dual processes
  • intuition
  • mathematical cognition
  • risk communication
  • risk perception

ASJC Scopus subject areas

  • Psychology(all)
  • History and Philosophy of Science

Cite this

How Numeracy Influences Risk Comprehension and Medical Decision Making. / Reyna, Valerie F.; Nelson, Wendy L.; Han, Paul K.; Dieckmann, Nathan.

In: Psychological Bulletin, Vol. 135, No. 6, 11.2009, p. 943-973.

Research output: Contribution to journalArticle

Reyna, Valerie F. ; Nelson, Wendy L. ; Han, Paul K. ; Dieckmann, Nathan. / How Numeracy Influences Risk Comprehension and Medical Decision Making. In: Psychological Bulletin. 2009 ; Vol. 135, No. 6. pp. 943-973.
@article{2ac3b08492984437bfc963d33448af5a,
title = "How Numeracy Influences Risk Comprehension and Medical Decision Making",
abstract = "We review the growing literature on health numeracy, the ability to understand and use numerical information, and its relation to cognition, health behaviors, and medical outcomes. Despite the surfeit of health information from commercial and noncommercial sources, national and international surveys show that many people lack basic numerical skills that are essential to maintain their health and make informed medical decisions. Low numeracy distorts perceptions of risks and benefits of screening, reduces medication compliance, impedes access to treatments, impairs risk communication (limiting prevention efforts among the most vulnerable), and, based on the scant research conducted on outcomes, appears to adversely affect medical outcomes. Low numeracy is also associated with greater susceptibility to extraneous factors (i.e., factors that do not change the objective numerical information). That is, low numeracy increases susceptibility to effects of mood or how information is presented (e.g., as frequencies vs. percentages) and to biases in judgment and decision making (e.g., framing and ratio bias effects). Much of this research is not grounded in empirically supported theories of numeracy or mathematical cognition, which are crucial for designing evidence-based policies and interventions that are effective in reducing risk and improving medical decision making. To address this gap, we outline four theoretical approaches (psychophysical, computational, standard dual-process, and fuzzy trace theory), review their implications for numeracy, and point to avenues for future research.",
keywords = "dual processes, intuition, mathematical cognition, risk communication, risk perception",
author = "Reyna, {Valerie F.} and Nelson, {Wendy L.} and Han, {Paul K.} and Nathan Dieckmann",
year = "2009",
month = "11",
doi = "10.1037/a0017327",
language = "English (US)",
volume = "135",
pages = "943--973",
journal = "Psychological Bulletin",
issn = "0033-2909",
publisher = "American Psychological Association Inc.",
number = "6",

}

TY - JOUR

T1 - How Numeracy Influences Risk Comprehension and Medical Decision Making

AU - Reyna, Valerie F.

AU - Nelson, Wendy L.

AU - Han, Paul K.

AU - Dieckmann, Nathan

PY - 2009/11

Y1 - 2009/11

N2 - We review the growing literature on health numeracy, the ability to understand and use numerical information, and its relation to cognition, health behaviors, and medical outcomes. Despite the surfeit of health information from commercial and noncommercial sources, national and international surveys show that many people lack basic numerical skills that are essential to maintain their health and make informed medical decisions. Low numeracy distorts perceptions of risks and benefits of screening, reduces medication compliance, impedes access to treatments, impairs risk communication (limiting prevention efforts among the most vulnerable), and, based on the scant research conducted on outcomes, appears to adversely affect medical outcomes. Low numeracy is also associated with greater susceptibility to extraneous factors (i.e., factors that do not change the objective numerical information). That is, low numeracy increases susceptibility to effects of mood or how information is presented (e.g., as frequencies vs. percentages) and to biases in judgment and decision making (e.g., framing and ratio bias effects). Much of this research is not grounded in empirically supported theories of numeracy or mathematical cognition, which are crucial for designing evidence-based policies and interventions that are effective in reducing risk and improving medical decision making. To address this gap, we outline four theoretical approaches (psychophysical, computational, standard dual-process, and fuzzy trace theory), review their implications for numeracy, and point to avenues for future research.

AB - We review the growing literature on health numeracy, the ability to understand and use numerical information, and its relation to cognition, health behaviors, and medical outcomes. Despite the surfeit of health information from commercial and noncommercial sources, national and international surveys show that many people lack basic numerical skills that are essential to maintain their health and make informed medical decisions. Low numeracy distorts perceptions of risks and benefits of screening, reduces medication compliance, impedes access to treatments, impairs risk communication (limiting prevention efforts among the most vulnerable), and, based on the scant research conducted on outcomes, appears to adversely affect medical outcomes. Low numeracy is also associated with greater susceptibility to extraneous factors (i.e., factors that do not change the objective numerical information). That is, low numeracy increases susceptibility to effects of mood or how information is presented (e.g., as frequencies vs. percentages) and to biases in judgment and decision making (e.g., framing and ratio bias effects). Much of this research is not grounded in empirically supported theories of numeracy or mathematical cognition, which are crucial for designing evidence-based policies and interventions that are effective in reducing risk and improving medical decision making. To address this gap, we outline four theoretical approaches (psychophysical, computational, standard dual-process, and fuzzy trace theory), review their implications for numeracy, and point to avenues for future research.

KW - dual processes

KW - intuition

KW - mathematical cognition

KW - risk communication

KW - risk perception

UR - http://www.scopus.com/inward/record.url?scp=70449467152&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70449467152&partnerID=8YFLogxK

U2 - 10.1037/a0017327

DO - 10.1037/a0017327

M3 - Article

C2 - 19883143

AN - SCOPUS:70449467152

VL - 135

SP - 943

EP - 973

JO - Psychological Bulletin

JF - Psychological Bulletin

SN - 0033-2909

IS - 6

ER -