High Numerates Count Icons and Low Numerates Process Large Areas in Pictographs: Results of an Eye-Tracking Study

Risk Analysis

Volumn 36, Issue 8, 2016, Pages 1599-1614

  Kreuzmair, Christina ^a   Siegrist, Michael ^a   Keller, Carmen ^a  

^a ETH ZURICH   (Switzerland)

Author keywords

Eye tracking; information processing strategies; medical risk communication; numeracy; pictograph

Indexed keywords

EYE MOVEMENTS; INFORMATION SCIENCE; STATISTICS;

EYE-TRACKING; EYE-TRACKING STUDIES; LARGE-AREA PROCESSING; NUMERACY; NUMERICAL INFORMATION; PICTOGRAPH; PROCESSING STRATEGIES; RISK COMMUNICATION;

RISK PERCEPTION;

CANCER; COMMUNICATION; EXPERIMENTAL STUDY; EYE; GRAPHICAL METHOD; HEALTH RISK; HEALTH SURVEY; INFORMATION PROCESSING; NUMERICAL METHOD; RISK PERCEPTION; TRACKING;

EID: 85027954099     PISSN: 02724332     EISSN: 15396924     Source Type: Journal    
DOI: 10.1111/risa.12531     Document Type: Article

References (58)

1. Peters E, Västfjäll D, Slovic P, Mertz CK, Mazzocco K, Dickert S. Numeracy and decision making. Psychological Science, 2006; 17(5):407–413.
2. Lipkus IM, Samsa G, Rimer BK. General performance on a numeracy scale among highly educated samples. Medical Decision Making, 2001; 21(1):37–44.
3. Reyna VF, Nelson WL, Han PK, Dieckmann NF. How numeracy influences risk comprehension and medical decision making. Psychological Bulletin, 2009; 135(6):943–973.
4. Lipkus IM, Peters E. Understanding the role of numeracy in health: Proposed theoretical framework and practical insights. Health Education & Behavior, 2009; 36(6):1065–1081.
5. Garcia-Retamero R, Okan Y, Cokely ET. Using visual aids to improve communication of risks about health: A review. Scientific World Journal, 2012.
6. Keller C. Using a familiar risk comparison within a risk ladder to improve risk understanding by low numerates: A study of visual attention. Risk Analysis, 2011; 31(7):1043–1054.
7. Keller C, Siegrist M, Visschers V. Effect of risk ladder format on risk perception in high- and low-numerate individuals. Risk Analysis, 2009; 29(9):1255–1264.
8. Schwartz LM, Woloshin S, Black WC, Welch HG. The role of numeracy in understanding the benefit of screening mammography. Annals of Internal Medicine, 1997; 127(11):966–972.
9. Apter AJ, Paasche-Orlow MK, Remillard JT, Bennett IM, Ben-Joseph EP, Batista RM, Hyde J, Rudd RE. Numeracy and communication with patients: They are counting on us. Journal of General Internal Medicine, 2008; 23(12):2117–2124.
10. Nelson W, Reyna VF, Fagerlin A, Lipkus IM, Peters E. Clinical implications of numeracy: Theory and practice. Annals of Behavioral Medicine, 2008; 35(3):261–274.
11. Ancker JS, Senathirajah Y, Kukafka R, Starren JB. Design features of graphs in health risk communication: A systematic review. Journal of the American Medical Informatics Association, 2006; 13(6):608–618.
12. Hawley ST, Zikmund-Fisher B, Ubel P, Jancovic A, Lucas T, Fagerlin A. The impact of the format of graphical presentation on health-related knowledge and treatment choices. Patient Education and Counseling, 2008; 73(3):448–455.
13. Lipkus IM. Numeric, verbal, and visual formats of conveying health risk: Suggested best practices and future recommendations. Medical Decision Making, 2007; 27(5):696–713.
14. Schapira MM, Nattinger AB, McAuliffe TL. The influence of graphic format on breast cancer risk communication. Journal of Health Communication, 2006; 11(6):569–582.
15. Tait AR, Voepel-Lewis T, Zikmund-Fisher BJ, Fagerlin A. The effect of format on parents' understanding of the risks and benefits of clinical research: A comparison between text, tables, and graphics. Journal of Health Communication, 2010; 15(5):487–501.
16. Timmermans D, Molewijk B, Stiggelbout A, Kievit J. Different formats for communicating surgical risks to patients and the effect on choice of treatment. Patient Education and Counseling, 2004; 54(3):255–263.
17. Fagerlin A, Wang C, Ubel PA. Reducing the influence of anecdotal reasoning on people's health care decisions: Is a picture worth a thousand statistics? Medical Decision Making, 2005; 25(4):398–405.
18. Galesic M, Garcia-Retamero R, Gigerenzer G. Using icon arrays to communicate medical risks: Overcoming low numeracy. Health Psychology, 2009; 28(2):210–216.
19. Tait AR, Voepel-Lewis T, Zikmund-Fisher BJ, Fagerlin A. Presenting research risks and benefits to parents: Does format matter? Anesthesia and Analgesia, 2010; 111(3):718–723.
20. Zikmund-Fisher BJ, Fagerlin A, Ubel PA. A demonstration of "less can be more" in risk graphics. Medical Decision Making, 2010; 30(6):661–671.
21. Fagerlin A, Zikmund-Fisher BJ, Ubel PA. Helping patients decide: Ten steps to better risk communication. Journal of the National Cancer Institute, 2011; 103(19):1436–1443.
22. Feldman-Stewart D, Brundage MD, Zotov V. Further insight into the perception of quantitative information: Judgments of gist in treatment decisions. Medical Decision Making, 2007; 27(1):34–43.
23. Garcia-Retamero R, Galesic M, Gigerenzer G. Do icon arrays help reduce denominator neglect? Medical Decision Making, 2010; 30(6):672–684.
24. Zikmund-Fisher BJ, Ubel PA, Smith DM, Derry HA, McClure JB, Stark A, Pitsch RK, Fagerlin A. Communicating side effect risks in a tamoxifen prophylaxis decision aid: The debiasing influence of pictographs. Patient Education and Counseling, 2008; 73(2):209–214.
25. Just MA, Carpenter PA. Eye fixations and cognitive processes. Cognitive Psychology, 1976; 8(4):441–480.
26. Glöckner A, Herbold AK. An eye-tracking study on information processing in risky decisions: Evidence for compensatory strategies based on automatic processes. Journal of Behavioral Decision Making, 2011; 24(1):71–98.
27. Horstmann N, Ahlgrimm A, Glöckner A. How distinct are intuition and deliberation? An eye-tracking analysis of instruction-induced decision modes. Judgment and Decision Making, 2009; 4(5):335–354.
28. Schulte-Mecklenbeck M, Kuhberger A, Ranyard R. The role of process data in the development and testing of process models of judgment and decision making. Judgment and Decision Making, 2011; 6(8):733–739.
29. Ratwani RM, Trafton JG, Boehm-Davis DA. Thinking graphically: Connecting vision and cognition during graph comprehension. Journal of Experimental Psychology-Applied, 2008; 14(1):36–49.
30. Peters E. Numeracy and the perception and communication of risk. Annals of the New York Academy of Sciences, 2008; 1128:1–7.
31. Peters E, Slovic P, Vastfjall D, Mertz CK. Intuitive numbers guide decisions. Judgment and Decision Making, 2008; 3(8):619–635.
32. Peters E. Beyond comprehension: The role of numeracy in judgments and decisions. Current Directions in Psychological Science, 2012; 21(1):31–35.
33. Reyna VF. How people make decisions that involve risk: A dual-processes approach. Current Directions in Psychological Science, 2004; 13(2):60–66.
34. Reyna VF, Brainerd CJ. Dual processes in decision making and developmental neuroscience: A fuzzy-trace model. Developmental Review, 2011; 31(2):180–206.
35. Reyna VF. Risk perception and communication in vaccination decisions: A fuzzy-trace theory approach. Vaccine, 2012; 30(25):3790–3797.
36. Reyna VF, Farley F. Risk and rationality in adolescent decision making: Implications for theory, practice, and public policy. Psychological Science, 2006; 7(1):1–44.
37. Reyna VF, Hamilton AJ. The importance of memory in informed consent for surgical risk. Medical Decision Making, 2001; 21(2):152–155.
38. Wolfe CR, Reyna VF. Semantic coherence and fallacies in estimating joint probabilities. Journal of Behavioral Decision Making, 2010; 23(2):203–223.
39. Reyna VF. A new intuitionism: Meaning, memory, and development in fuzzy-trace theory. Judgment and Decision Making, 2012; 7(3):332–359.
40. Reyna VF. A theory of medical decision making and health: Fuzzy trace theory. Medical Decision Making, 2008; 28(6):850–865.
41. Fukukura J, Ferguson MJ, Fujita K. Psychological distance can improve decision making under information overload via gist memory. Journal of Experimental Psychology-General, 2013; 142(3):658–665.
42. Reyna VF, Mills BA. Theoretically motivated interventions for reducing sexual risk taking in adolescence: A randomized controlled experiment applying fuzzy-trace theory. Journal of Experimental Psychology-General, 2014; 143(4):1627–1648.
43. Reyna VF, Chick CF, Corbin JC, Hsia AN. Developmental reversals in risky decision making: Intelligence agents show larger decision biases than college students. Psychological Science, 2014; 25(1):76–84.
44. Reyna VF, Lloyd FJ. Physician decision making and cardiac risk: Effects of knowledge, risk perception, risk tolerance, and fuzzy processing. Journal of Experimental Psychology: Applied, 2006; 12(3):179–195.
45. Reyna VF, Estrada SM, DeMarinis JA, Myers RM, Stanisz JM, Mills BA. Neurobiological and memory models of risky decision making in adolescents versus young adults. Journal of Experimental Psychology: Learning Memory and Cognition, 2011; 37(5):1125–1142.
46. Keller C, Kreuzmair C, Leins-Hess R, Siegrist M. Numeric and graphic risk information processing of high and low numerates in the intuitive and deliberative decision modes: An eye-tracker study. Judgment and Decision Making, 2014; 9(5):420–432.
47. Hess R, Visschers V, Siegrist M. Risk communication with pictographs: The role of numeracy and graph processing. Judgment and Decision Making, 2011; 6(3):263–274.
48. Garcia-Retamero R, Cokely ET. Communicating health risks with visual aids. Current Directions in Psychological Science, 2013; 22(5):392–399.
49. Weller JA, Dieckmann NF, Tusler M, Mertz CK, Burns WJ, Peters E. Development and testing of an abbreviated numeracy scale: A Rasch analysis approach. Journal of Behavioral Decision Making, 2013; 26(2):198–212.
50. Frederick S. Cognitive reflection and decision making. Journal of Economic Perspectives, 2005; 19(4):25–42.
51. Peters E, Hibbard J, Slovic P, Dieckmann N. Numeracy skill and the communication, comprehension, and use of risk-benefit information. Health Affairs, 2007; 26(3):741–748.
52. Duchowski AT. Eye-Tracking Methodology: Theory and Practice. London: Springer Science & Business Media, 2007.
53. Just MA, Carpenter PA. A theory of reading: From eye fixations to comprehension. Psychological Review, 1980; 87(4):329–354.
54. Aiken LS, West SG. Multiple Regression: Testing and Interpreting Interactions. Thousand Oaks, CA: SAGE Publications, 1991.
55. Rubaltelli E, Dickert S, Slovic P. Response mode, compatibility, and dual-processes in the evaluation of simple gambles: An eye-tracking investigation. Judgment and Decision Making, 2012; 7(4):427–440.
56. Just MA, Carpenter PA. The role of eye-fixation research in cognitive psychology. Behavior Research Methods & Instrumentation, 1976; 8(2):139–143.
57. Reyna VF, Brainerd CJ. The origins of probability judgment: A review of data and theories. Pp. 239–272 in Wright G, Ayton P (eds). Subjective Probability. Oxford: John Wiley & Sons, 1994.
58. Fiedler S, Glöckner A. The dynamics of decision making in risky choice: An eye-tracking analysis. Frontiers in Psychology, 2012; 3.335.