Motivated Interpretations of Survival Rates in Icon Arrays: An Issue of Frequency Format? Med Decis Making 2025 Jul;45(5):496-509
Date
04/30/2025Pubmed ID
40302242DOI
10.1177/0272989X251332315Scopus ID
2-s2.0-105004222972 (requires institutional sign-in at Scopus site)Abstract
BackgroundIcon arrays, which visually depict frequencies, are commonly recommended for communicating risk information such as survival rates. However, they have been found to be ineffective at buffering against motivated reasoning that can lead to undue optimism. To determine whether the impersonal frequency format of icon arrays (reporting a number affected out of a reference class) makes them vulnerable to motivated reasoning, a novel intervention is tested as a means for reducing undue optimism.MethodsFemale US participants from Amazon's MTurk (N = 399) imagined a scenario in which their infant would be born extremely preterm. They were presented with icon array information about the survival chances (15-in-100 or 45-in-100) of prematurely born infants with intensive care. For the key intervention, some participants were asked a reflection question immediately after seeing the icon array, which prompted them to indicate what the information meant for their own infant's percent-chance of survival (i.e., they converted a frequency about a reference class to a probability value about the personal outcome of interest). For other participants, the reflection question merely asked about frequency. The main dependent measure came next and assessed gut-level optimism.ResultsPeople's gut-level beliefs about their infant's chances of survival were optimistically biased; the intervention did not reduce this. These gut-level beliefs, rather than the objective survival rate information conveyed through icon arrays, were predictive of subsequent treatment choices.ConclusionsThe results suggest that the inability of icon arrays to buffer against motivated reasoning is not due to their frequency format. Moreover, the findings highlight the usefulness of measuring gut-level interpretations of likelihood, which can reveal significant insights into the psychological mechanisms driving patient-treatment choices.HighlightsIcon arrays, which visually depict frequencies, are commonly recommended as best-practice for communicating risk information in health contexts.However, recent work has found that they are ineffective at reducing the extent to which people engage in motivated reasoning when processing likelihood information.We find that the frequency format of icon arrays-depicting a rate for outcomes in a group of people rather than a case-specific probability-is not a primary reason why they are ineffective at reducing optimism biasWe also find that measures of gut-level beliefs of likelihood are particularly well suited for detecting optimism bias, yet also predict subsequent treatment decisions.
Author List
Strueder JD, Park I, McDonnell SM, Basir MA, Windschitl PDAuthor
Mir Abdul Basir MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultCommunication
Female
Humans
Infant, Extremely Premature
Infant, Newborn
Male
Motivation
Optimism
Survival Rate
