Background. To inform their health decisions, patients may seek narratives describing other patients' evaluations of their treatment experiences. Narratives can provide anti-treatment or ...pro-treatment evaluative meaning that low-numerate patients may especially struggle to derive from statistical information. Here, we examined whether anti-vaccine (v. pro-vaccine) narratives had relatively stronger effects on the perceived informativeness and judged vaccination probabilities reported among recipients with lower (v. higher) numeracy. Methods. Participants (n = 1,113) from a nationally representative US internet panel were randomly assigned to an anti-vaccine or pro-vaccine narrative, as presented by a patient discussing a personal experience, a physician discussing a patient's experience, or a physician discussing the experiences of 50 patients. Anti-vaccine narratives described flu experiences of patients who got the flu after getting vaccinated; pro-vaccine narratives described flu experiences of patients who got the flu after not getting vaccinated. Participants indicated their probability of getting vaccinated and rated the informativeness of the narratives. Results. Participants with lower numeracy generally perceived narratives as more informative. By comparison, participants with higher numeracy rated especially anti-vaccine narratives as less informative. Anti-vaccine narratives reduced the judged vaccination probabilities as compared with pro-vaccine narratives, especially among participants with lower numeracy. Mediation analyses suggested that low-numerate individuals' vaccination probabilities were reduced by anti-vaccine narratives - and, to a lesser extent, boosted by pro-vaccine narratives - because they perceived narratives to be more informative. These findings were similar for narratives provided by patients and physicians. Conclusions. Patients with lower numeracy may rely more on narrative information when making their decisions. These findings have implications for the development of health communications and decision AIDS.
One challenge that has to be addressed by the fast and frugal heuristics program is how people manage to select, from the abundance of cues that exist in the environment, those to rely on when making ...decisions. We hypothesize that causal knowledge helps people target particular cues and estimate their validities. This hypothesis was tested in three experiments. Results show that when causal information about some cues was available (Experiment 1), participants preferred to search for these cues first and to base their decisions on them. When allowed to learn cue validities in addition to causal information (Experiment 2), participants also became more frugal (i.e., they searched fewer of the available cues), made more accurate decisions, and were more precise in estimating cue validities than was a control group that did not receive causal information. These results can be attributed to the causal relation between the cues and the criterion, rather than to greater saliency of the causal cues (Experiment 3). Overall, our results support the hypothesis that causal knowledge aids in the learning of cue validities and is treated as a meta-cue for identifying highly valid cues.
Misleading information and unfair commercial practices have to be viewed against the background of what consumers otherwise do, i.e., what their purchase decisions look like when no misleading ...information or no unfair commercial practices are in place. This article provides some of this background by studying how consumers sample information when making an in-store purchase decision. This was done by an eye-tracking study which reveals to what extent consumers succeed in purchasing the products that best meet their purchase intentions when only a representative amount of misleading information is present. The study shows that decisions were suboptimal in relation to what the consumers claimed they wanted to purchase. Only in one product category did consumers in this study actually look at products that were slightly better than average, and as a result, they mainly selected products that were just as often poor as good. If the proportion of bad purchase decisions based on misleading information is small enough, perhaps it might be better to direct the authors’ attention to other ways of improving the decision environments that consumers encounter. In addition, the eye-tracking study provides some insight into how consumers sample information when making an in-store purchase decision. The present data show that consumers invested on average of less than 1 s to look at products.
Misleading information and unfair commercial practices have to be viewed against the background of what consumers otherwise do, i.e., what their purchase decisions look like when no misleading ...information or no unfair commercial practices are in place. This article provides some of this background by studying how consumers sample information when making an in-store purchase decision. This was done by an eye-tracking study which reveals to what extent consumers succeed in purchasing the products that best meet their purchase intentions when only a representative amount of misleading information is present. The study shows that decisions were suboptimal in relation to what the consumers claimed they wanted to purchase. Only in one product category did consumers in this study actually look at products that were slightly better than average, and as a result, they mainly selected products that were just as often poor as good. If the proportion of bad purchase decisions based on misleading information is small enough, perhaps it might be better to direct the authors’ attention to other ways of improving the decision environments that consumers encounter. In addition, the eye-tracking study provides some insight into how consumers sample information when making an in-store purchase decision. The present data show that consumers invested on average of less than 1 s to look at products.
The hypothesis that human reasoning and decision-making can be roughly modeled by Expected Utility Theory has been at the core of decision science. Accumulating evidence has led researchers to modify ...the hypothesis. One of the latest additions to the field is Dual Process theory, which attempts to explain variance between participants and tasks when it comes to deviations from Expected Utility Theory. It is argued that Dual Process theories at this point cannot replace previous theories, since they, among other things, lack a firm conceptual framework, and have no means of producing independent evidence for their case.
It is difficult to overestimate Paul Meehl's influence on judgment and decision-making research. His `disturbing little book' (Meehl, 1986, p. 370) Clinical versus Statistical Prediction: A ...Theoretical Analysis and a Review of the Evidence (1954) is known as an attack on human judgment and a call for replacing clinicians with actuarial methods. More than 40 years later, fast and frugal heuristics—proposed as models of human judgment—were formalized, tested, and found to be surprisingly accurate, often more so than the actuarial models that Meehl advocated. We ask three questions: Do the findings of the two programs contradict each other? More generally, how are the programs conceptually connected? Is there anything they can learn from each other? After demonstrating that there need not be a contradiction, we show that both programs converge in their concern to develop (a) domain-specific models of judgment and (b) nonlinear process models that arise from the bounded nature of judgment. We then elaborate the differences between the programs and discuss how these differences can be viewed as mutually instructive: First, we show that the fast and frugal heuristic models can help bridge the clinical—actuarial divide, that is, they can be developed into actuarial methods that are both accurate and easy to implement by the unaided clinical judge. We then argue that Meehl's insistence on improving judgment makes clear the importance of examining the degree to which heuristics are used in the clinical domain and how acceptable they would be as actuarial tools.
The visual behaviour of consumers buying (or searching for) products in a supermarket was measured and used to analyse the stages of their decision process. Traditionally metrics used to trace ...decision-making processes are difficult to use in natural environments that often contain many options and unstructured information. Unlike previous attempts in this direction (i.e. Russo & Leclerc, 1994), our methodology reveals differences between a decision-making task and a search task. In particular the second (evaluation) stage of a decision task contains more re-dwells than the second stage of a comparable search task. This study addresses the growing concern of taking eye movement research from the laboratory into the ‘real-world’, so findings can be better generalised to natural situations.
Background: The clinical benefit of combining long-acting β2-agonists with inhaled corticosteroids rather than doubling the dose of corticosteroid has been well-documented. However, there are ...concerns that this might result in a masking of underlying airway inflammation. Objective: The aim of this study was to test the hypothesis that the addition of the long-acting β2-agonist salmeterol (SALM) to a low dose of the inhaled corticosteroid fluticasone propionate (FP) has a steroid-sparing effect and does not result in a worsening of bronchial inflammation compared to doubling the dose of inhaled corticosteroid. Methods: Fifty-six asthmatic subjects, previously not well-controlled on inhaled corticosteroids, were randomized to receive 3 months of treatment with inhaled FP 500 μg twice a day (FP 1000) or FP 200 μg twice a day plus SALM 50 μg twice a day (FP 400 + SALM). Fluticasone propionate 200 μg twice a day served as the control (FP400). Bronchial mucosal biopsy specimens, bronchial washings (BW), and bronchoalveolar lavage were obtained before and after treatment. The primary end points for the study were submucosal mast cell and eosinophil counts. Results: There was a significant improvement in FEV1 in the FP400 + SALM group compared to both the FP400 and FP1000 groups. This was accompanied by a significant improvement in peak expiratory flow in the FP400 + SALM group in both the morning and evening compared to the FP1000 group. There were no significant between treatment differences in the change in the number of submucosal mast cells or eosinophils. However, in the FP400 + SALM group there was a significant decrease in submucosal mast cells after 12 weeks of treatment. The addition of SALM to FP was not associated with any increases in airway inflammation in the biopsy specimens, bronchoalveolar lavage, or bronchial washings. Conclusion: These findings confirm that addition of SALM to FP has clinical benefits but does not mask or exacerbate airway inflammation and suggest that long-acting β2-adrenoceptor agonists might influence mast cell numbers. (J Allergy Clin Immunol 2003;112:72-8.)
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