Communicating risks with interactive visualisations and reflective tasks:a mixed-methods evaluation of a mammography screening decision aid

Static graphs of statistics are established visual aids in risk communication and decision support. Interactive information visualisations (InfoVis) and reflective tasks are supposed to enhance active processing, but the evidence is scarce and mixed. This mixed-methods research investigated the effectiveness and user experience of InfoVis and tasks in the context of mammography screening. In a web-based experiment prospective invitees of the screening program (N = 338; aged 30-49) tried a pre-tested web-based decision-aid with risk information either as text, static graph, or InfoVis with or without reflective tasks. The main outcomes were informed choice and risk knowledge, the latter operationalised according to the fuzzy-trace-theory. The accompanying qualitative evaluation with seven participants applied think-aloud protocols and focused interviews. There was no experimental evidence that InfoVis support risk knowledge or informed choice better than text or static graphs. There were even minor detrimental effects. The qualitative results showed problems with the InfoVis presenting risk of overdiagnosis, and negative reactions towards the tasks. InfoVis processing was easy when the underlying concept was easy. While reflective tasks seem not advisable in this target group, limited and well-considered application of InfoVis with a low cognitive load can be an alternative, attention-directing visual aid format

Visualizing risks in cancer communication:A systematic review of computer-supported visual aids

Objective: Health websites are becoming important sources for cancer information. Lay users, patients and carers seek support for critical decisions, but they are prone to common biases when quantitative information is presented. Graphical representations of risk data can facilitate comprehension, and interactive visualizations are popular. This review summarizes the evidence on computer-supported graphs that present risk data and their effects on various measures. Methods: The systematic literature search was conducted in several databases, including MEDLINE, EMBASE and CINAHL. Only studies with a controlled design were included. Relevant publications were carefully selected and critically appraised by two reviewers.Results: Thirteen studies were included. Ten studies evaluated static graphs and three dynamic formats. Most decision scenarios were hypothetical. Static graphs could improve accuracy, comprehension, and behavioural intention. But the results were heterogeneous and inconsistent among the studies. Dynamic formats were not superior or even impaired performance compared to static formats.Conclusions: Static graphs show promising but inconsistent results, while research on dynamic visualizations is scarce and must be interpreted cautiously due to methodical limitations. Practice implications: Well-designed and context specific static graphs can support web-based cancer risk communication in particular populations. The application of dynamic formats cannot be recommended and needs further research

Quantification of the health impact of environmental stressors in Germany for use in policy making: results of the VegAS project

Steckling N, Claßen T, Mekel O, et al. Quantification of the health impact of environmental stressors in Germany for use in policy making: results of the VegAS project. The Lancet. 2013;381(Suppl. 2):136