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AJPH First Look, published online ahead of print Oct 15, 2009
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December 2009, Vol 99, No. 12 | American Journal of Public Health 2196-2202
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2009.160234

RESEARCH AND PRACTICE

Communicating Treatment Risk Reduction to People With Low Numeracy Skills: A Cross-Cultural Comparison

Rocio Garcia-Retamero, PhD and Mirta Galesic, PhD

Rocio Garcia-Retamero is with University of Granada, Granada, Spain, and the Max Planck Institute for Human Development, Berlin, Germany. Mirta Galesic is with the Max Planck Institute for Human Development.

Correspondence: Correspondence should be sent to Rocio Garcia-Retamero, PhD, Facultad de Psicología, Universidad de Granada, Campus Universitario de Cartuja s/n, 18071 Granada, Spain (e-mail: rretamer{at}ugr.es; galesic{at}mpib-berlin.mpg.de).

Objectives. We sought to address denominator neglect (i.e. the focus on the number of treated and nontreated patients who died, without sufficiently considering the overall numbers of patients) in estimates of treatment risk reduction, and analyzed whether icon arrays aid comprehension.

Methods. We performed a survey of probabilistic, national samples in the United States and Germany in July and August of 2008. Participants received scenarios involving equally effective treatments but differing in the overall number of treated and nontreated patients. In some conditions, the number who received a treatment equaled the number who did not; in others the number was smaller or larger. Some participants received icon arrays.

Results. Participants—particularly those with low numeracy skills—showed denominator neglect in treatment risk reduction perceptions. Icon arrays were an effective method for eliminating denominator neglect. We found cross-cultural differences that are important in light of the countries' different medical systems.

Conclusions. Problems understanding numerical information often reside not in the mind but in the problem's representation. These findings suggest suitable ways to communicate quantitative medical data.






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