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PSYC 4030

PSYC 4030 Study GuideSection 3 Questions over Readings and Lecture for Final ExamFall 2013 Dr MartinHelping Doctors and Patients Make Sense of Health Statistics What is collective statistical illiteracy p 54Widespread inability to understand the meaning of numbersWhat are the 3 main points in this monograph p 54Its common to patients physicianspoliticiansIts created by nontransparent framing of info that may be intentionalunintentionalIt can have serious consequences for healthWhat is the difference between absolute and relative risk What type does media tend to report p 5455Relative risk 100 higher media reports bc s seem largermore dramaticAbsolute risk 1 in 7000What is the difference between conditional probabilities and natural frequencies Which is easier to understand Why p 55Conditional probabilities includes sensitivityfalsepositive rate 1specificityNatural frequencies transparent representation that can achieve same in comparison to conditional probabilitiesoEasier to understand bc represent way humans encoded info before mathematical probabilities were inventedoTheyre simple counts that arent normalized w respect to base rateso4 natural frequencies added up to the total number of 1000 womenWhat is the key difference between survival and mortality ratesSurvival rates imagine group of ppl who are diagnosed w cancer same day Proportion of patients who are still alive after given amt of yrs To calculate take number of patients diagnosed w cancer still alive X yrs after diagnosisdivide it by the number of patients diagnosed w cancerMortality rates imagine group of ppl not defined by cancer diagnosis Proportion of ppl in group who are dead after 1 yr is mortality rate To calculate annual mortality rate take number of ppl who died from cancer over 1 yr and divide by number of ppl in groupKey difference diagnosedin formula for survival rate but not mortality rateamt of time differsWhat is the lead time bias p 56 Screening biases survival in how it affects timing of diagnosisExample group of cancer patients currently diagnosed67 yrs old all whom dieage 70 The 5yr survival of group would be 0 If group was diagnosed w cancer earlier ieage 60 and still died70their 5year survival rate would be 100 Survival rates change but time of death remains sameWhat is the overdiagnosis bias p 57Detection of pseudodisease ie detect what seems like cancer but will not progress Leads to high survival rateseven though survival rate has changed the number of ppl who died hasnt changedWhat are the 4 questions we should ask about all risks p 581Risk of whatunderstand outcome2Time frameunderstand time3How bigabsolute terms 13 out of 1000 will die by age 504Does it apply to me see if risk info is based on studies on ppl like youage gender health probsWhat are some of the potential harms of screening tests p 58Costs inconveniencefalse alarmsand in our view most important harm of overdiagnosis which leads to harm through overtreatmentDistinguish between false positive and false negative errors in screening testsFalse positivefalse alarm Test positive in ppl who dont have diseaseFalse negativemiss Test negative in someone who does have diseaseWhat is specificity and sensitivity p 59Specificityproportion of negative tests among clients wo conditionSensitivityproportion of positive tests among clients w conditionDefine the illusion of certainty p 61Emotional need for certainty when none existsAccording to Kalet Roberts and Fletcher 1994 how many patients discussed risks and benefits with their doctors during visitsIn only 1 out of 4 visits out of 160 patients only 1 in 6 was initiated by the patientdoctors usually communicated the risks w certaintyHow does this relate to peoples ability to understand basic risks p 63Ppl dont relate their risk to known factors that actually effect it badunderstanding riskAccording to research people are most likely to have a favorable evaluation of a treatment when benefits are described in what terms p 65In form of relative risk reductionEx If you have this test every 2 yrs itll reduce your chance of dying from cancer by 13 over next 10 yrsName 3 problems with the quality of press coverage of health statistics p 651Failing to report any numbers using anecdotes of miraculous healingfailure of drugtreatment2Framing numbers in nontransparent way to attract readers attention3Failing to report important cautions about study limitations How do advertisements typically discuss the benefits and potential harms of new drugs they talk about these differently p 66Benefits reported as relative risks wo reporting base rates big numbers big printoOverestimate magnitude of benefitHarms stated in way that reduces their salience fine printabsolute risks small numbers small printoReported as absolute risk small numbersName two consequences of misleading advertising p 71 Emotional manipulationImpediments to informed consentshared decisionmakingWhat is the illusion of certainty p 76Emotional need for certainty when none existsFeeling attached to test results that are taken to be absolutely certainto treatments appear to guarantee a cure Which statistics are used to communicate risk in transparent forms Which are in nontransparent forms p 77Nontransparent formsrelative risks presented wo base rate common in leading medical journalsoConditional probabilities specificitiessensitivities survival rates statements of single event that doesnt specify a reference classTransparentabsolute risksoNatural frequencies mortality rates statements concerning frequenciesWhat is mismatched framing p 78 Readers can be misled more directly than just via nontransparent framing In some cases benefitsharms of treatments are reported in different currencies benefits in large srisks in small sWhat are the authors four recommendations on probability formatting and frequency formatting very end of p 86 first full paragraph of p 901Use frequency statements not single event probabilities2Use absolute risks not relative risks3Use mortality rates not survival rates4Use natural frequencies not conditional probabilitiesBlink Gladwell 2005What was the finding of the Iowa experiment p810
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