Aiding Risk Information learning through Simulated Experience (ARISE): A Comparison of the Communication of Screening Test Information in Explicit and Simulated Experience Formats

Med Decis Making. 2019 Apr;39(3):196-207. doi: 10.1177/0272989X19832882. Epub 2019 Feb 28.

Abstract

Objective: To determine whether the use of Aiding Risk Information learning through Simulated Experience (ARISE) to communicate conditional probabilities about maternal serum screening results for Down syndrome promotes more accurate positive predictive value (PPV) estimates and conceptual understanding of screening, compared with explicitly providing individuals with this information via numerical summary or icon array.

Method: In experiment 1, 582 participants completed an online study in which they were asked to estimate the PPV and rate their attitudes toward a screening test when information was presented in either a description (required calculation of the PPV), explicit (PPV was provided and had to be identified), or an ARISE format (PPV was inferred through experience-based learning). In experiment 2, 316 participants estimated the PPV and rated their attitudes toward screening based on information presented in either an icon array (identify the icons that represent the PPV) or ARISE format.

Results: In experiment 1, ARISE elicited the most accurate PPV estimates compared with the description and explicit formats, and both the explicit and ARISE formats led to more unfavorable attitudes toward screening. In experiment 2, both the icon array and ARISE resulted in similar PPV estimates; however, ARISE led to more negative attitudes toward screening.

Conclusions: These findings suggest that ARISE may be superior to other formats in the communication of PPV information for screening tests. However, differences in the complexity of the formats vary and require further investigation.

Keywords: attitudes toward screening; conditional probabilities; positive predictive value; screening tests; simulated experience.

MeSH terms

  • Adolescent
  • Down Syndrome / diagnosis*
  • Down Syndrome / psychology
  • Female
  • Health Literacy / standards
  • Humans
  • Mass Screening / methods*
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Patient Education as Topic / methods
  • Patient Education as Topic / standards*
  • Probability
  • Risk Assessment / methods
  • Risk Assessment / standards
  • Young Adult