Purpose: Paper-based patient decision aids generally present risk information using numbers and/or static images. However, limited psychological research has suggested that when people use computers to interactively graph risk information, they process the statistics more actively, making the information more available for decision making. Such interactive tools could potentially be incorporated in a new generation of web-based decision aids. But, little is known about whether interactivity improves communication of health risk information.
Method: 3,377 members of a demographically-diverse Internet panel viewed a hypothetical scenario about two hypothetical treatments for thyroid cancer. Each treatment had a chance of causing one of two side effects, but we randomly varied whether one treatment was better on both dimensions (strong dominance condition), slightly better on only one dimension (mild dominance condition), or better on one dimension but worse on the other (tradeoff condition) than the other treatment. We also varied whether respondents passively viewed the risk information in static pictograph (icon array) images or actively manipulated the information by using interactive Flash-based animations of “fill-in-the-blank” pictographs. Our primary hypothesis was that active manipulation would increase respondents’ ability to recognize dominance (when available) and choose the better treatment.
Result: The interactive risk graphic conditions had significantly worse survey completion rates (65.7% vs. 79.5%, p<0.001) than the static image conditions. In addition,respondents using interactive graphs were less likely to recognize and select the dominant treatment option (e.g.: 61.1% vs. 73.1%, p<0.001, in the strong dominance condition).
Conclusion: Interactivity, however visually appealing, can both add to respondent burden and distract people from understanding relevant statistical information. Decision aid developers need to be aware that interactive risk presentations may create worse outcomes than presentations using static risk graphic formats such as pictographs.
See more of: The 32nd Annual Meeting of the Society for Medical Decision Making