The use of narrative evidence and explicit likelihood by decisionmakers varying in numeracy.

Decisionmakers are often presented with explicit likelihood assessments (e.g., there is a 10% chance that an attack will occur over the next three months) and supporting narrative evidence in forecasting and risk communication domains. Decisionmakers are thought to rely on both numerical and narrative information to the extent that they perceive the information to be diagnostic, accurate, and trustworthy. In two studies, we explored how lay decisionmakers varying in numeracy evaluated and used likelihood assessments and narrative evidence in forecasts. Overall, the less numerate reported higher risk and likelihood perceptions. In simple probabilistic forecasts without narrative evidence, decisionmakers at all levels of numeracy were able to use the stated likelihood information, although risk perceptions of the less numerate were more affected by likelihood format. When a forecast includes narrative evidence, decisionmakers were better able to use stated likelihood in a percentage as compared to frequency or verbal formats. The more numerate used stated likelihood more in their evaluations whereas the less numerate focused more on the narrative evidence. These results have important implications for risk analysts and forecasters who need to report the results of their analyses to decisionmakers. Decisionmakers varying in numerical ability may evaluate forecasts in different ways depending on the types of information they find easiest to evaluate.

Communication and decision making in cancer care: setting research priorities for decision support/patients' decision aids.

The following is a summary report from a special symposium titled, "Translating Research into Practice: Setting a Research Agenda for Clinical Decision Tools in Cancer Prevention, Early Detection, and Treatment," that was held on 23 October 2005 in San Francisco at the Annual Meeting of the Society for Medical Decision Making (SMDM). The symposium was designed to answer the question: "What are the top 2 research priorities in the field of patients' cancer-related decision aids?" After introductory remarks by Dr. Barry, each of four panelists-Drs. Hilary Llewellyn-Thomas, Ellen Peters, Laura Siminoff, and Dale Collins-addressed the question and provided their rationale during prepared remarks. The moderator, Dr. Michael Barry, then facilitated a discussion between the panelists, with input from the audience, to further explore and add to the various proposed research questions. Finally, Dr. Amber Barnato conducted a simple vote count (see Table 1) to prioritize the panelists' and the audience's recommendations.

An emotion-based model of risk perception and stigma susceptibility: cognitive appraisals of emotion, affective reactivity, worldviews, and risk perceptions in the generation of technological stigma.

A study (N=198) was conducted to examine hypotheses derived from an emotion-based model of stigma responses to radiation sources. A model of stigma susceptibility is proposed in which affective reactions and cognitive worldviews activate predispositions to appraise and experience events in systematic ways that result in the generation of negative emotion, risk perceptions, and stigma responses. Results of structural equation modeling supported the hypotheses. Radiation sources that scored higher on a measure of stigma were included in the analyses (i.e., nuclear power plants, radioactive waste from nuclear power plants, radiation from nuclear weapons testing). Individual differences in negative reactivity and worldviews were associated with the strength of emotional appraisals that were associated, in turn, with negative emotion toward stigmatized radiation sources. As hypothesized, the model fit better with perceived risk as a function of negative emotion rather than vice versa. Finally, a measure of stigma was associated with negative emotion and, to a lesser extent, with risk perceptions. Risk communication about stigmatized objects may benefit from a more complete understanding of how affective and emotional reactions are constructed and the routes through which they affect responses and behaviors.