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  1. Background

    Decision aids can help patients make medical decisions, which is especially advantageous in situations with equipoise. However, when there is no correct answer, it is difficult to assess whether a decision aid is helpful. The goal of this research is to propose and validate an objective method for measuring decision aid effectiveness by quantifying the clarity participants achieved when making decisions.

    Design

    The measure of decisional clarity was tested in a convenience sample of 131 college-aged students making hypothetical decisions about 2 treatment options for depression and anxiety. The treatments varied with respect to potential benefits and harms. Information was presented numerically or with an accompanying data visualization (an icon array) that is known to aid decision making.

    Results

    Decisional clarity was better with the icon arrays. Furthermore, the results showed that decisional clarity can be used to identify situations for which patients will be more likely to struggle making their decision. These included situations for which financial considerations were relevant to the decision and situations for which the probabilities of potential benefits were higher.

    Limitations

    The measure of decisional clarity and the situations identified as lacking clarity should be validated with a larger, more representative sample.

    Conclusions

    These findings demonstrate that decisional clarity can be used to both empirically evaluate the effectiveness of a decision aid as well as test factors that can cloud clarity and disrupt medical decision making.

    Implications

    Researchers and medical providers interested in developing decision aids for situations with equipoise can use decisional clarity as an objective measure to assess the effectiveness of their decision aid. Financial considerations and higher probabilities may also cloud judgments.

    Highlights

    An objective measure of decisional clarity is supported. Decisional clarity can be used to evaluate decision aids in the context of equipoise for which there is no objectively correct choice. Decisional clarity can also be used to identify scenarios for which patients are likely to struggle to make a medical decision.

     
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  2. While visualization can support understanding complex phenomena, their effectiveness might vary with the recipient’s familiarity with both the phenomenon and the visualization. The current study contrasted interpretations of simulated hurricane paths using student populations from a high frequency hurricane area versus no local hurricane risk. Non-expert understanding of trajectory predictions was supported via two visualizations: common cones of uncertainty and novel dynamic ensembles. General patterns of performance were similar across the two groups. Participants from the high hurricane risk area did show narrower decision thresholds, in both common and novel visualization formats. More variability was consistently considered possible when viewing the dynamic ensemble displays. Despite greater likelihood of experiences with variability of trajectories outside of forecast paths, greater familiarity tended towards narrower interpretations of the need for evacuations within the variability possible. The results suggest an advantage of dynamic ensembles in grasping uncertainty even in populations familiar with hurricanes. 
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  3. Risk communication is critically important, for both patients and providers. However, people struggle to understand risks because there are inherent biases and limitations to reasoning under uncertainty. A common strategy to enhance risk communication is the use of decision aids, such as charts or graphs, that depict the risk visually. A problem with prior research on visual decision aids is that it used a metric of performance that confounds 2 underlying constructs: precision and bias. Precision refers to a person’s sensitivity to the information, whereas bias refers to a general tendency to overestimate (or underestimate) the level of risk. A visual aid is effective for communicating risk only if it enhances precision or, once precision is suitably high, reduces bias. This article proposes a methodology for evaluating the effectiveness of visual decision aids. Empirical data further illustrate how the new methodology is a significant advancement over more traditional research designs. 
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  4. Abstract The gun embodiment effect is the consequence caused by wielding a gun on judgments of whether others are also holding a gun. This effect could be responsible for real-world instances when police officers shoot an unarmed person because of the misperception that the person had a gun. The gun embodiment effect is an instance of embodied cognition for which a person’s tool-augmented body affects their judgments. The replication crisis in psychology has raised concern about embodied cognition effects in particular, and the issue of low statistical power applies to the original research on the gun embodiment effect.Thus, the first step was to conduct a high-powered replication. We found a significant gun embodiment effect in participants’ reaction times and in their proportion of correct responses, but not in signal detection measures of bias, as had been originally reported. To help prevent the gun embodiment effect from leading to fatal encounters, it would be useful to know whether individuals with certain traits are less prone to the effect and whether certain kinds of experiences help alleviate the effect. With the new and reliable measure of the gun embodiment effect, we tested for moderation by individual differences related to prior gun experience, attitudes, personality, and factors related to emotion regulation and impulsivity. Despite the variety of these measures, there was little evidence for moderation. The results were more consistent with the idea of the gun embodiment effect being a universal, fixed effect, than being a flexible, malleable effect. 
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