Bayesian versus diagnostic information in physician-patient communication: Effects of direction of statistical information and presentation of visualization

Sarah Frederike Brose; Karin Binder; Martin R Fischer; Martin Reincke; Leah T Braun; Ralf Schmidmaier

doi:10.1371/journal.pone.0283947

Bayesian versus diagnostic information in physician-patient communication: Effects of direction of statistical information and presentation of visualization

PLoS One. 2023 Jun 7;18(6):e0283947. doi: 10.1371/journal.pone.0283947. eCollection 2023.

Authors

Sarah Frederike Brose^{1

2}, Karin Binder³, Martin R Fischer², Martin Reincke¹, Leah T Braun^{1

2}, Ralf Schmidmaier^{1

2}

Affiliations

¹ Department of Internal Medicine IV, University Hospital, LMU Munich, Munich, Germany.
² Institute of Medical Education, University Hospital, LMU Munich, Munich, Germany.
³ Institute of Mathematics, LMU Munich, Munich, Germany.

Abstract

Background: Communicating well with patients is a competence central to everyday clinical practice, and communicating statistical information, especially in Bayesian reasoning tasks, can be challenging. In Bayesian reasoning tasks, information can be communicated in two different ways (which we call directions of information): The direction of Bayesian information (e.g., proportion of people tested positive among those with the disease) and the direction of diagnostic information (e.g., the proportion of people having the disease among those tested positive). The purpose of this study was to analyze the impact of both the direction of the information presented and whether a visualization (frequency net) is presented with it on patient's ability to quantify a positive predictive value.

Material and methods: 109 participants completed four different medical cases (2⨯2⨯4 design) that were presented in a video; a physician communicated frequencies using different directions of information (Bayesian information vs. diagnostic information). In half of the cases for each direction, participants were given a frequency net. After watching the video, participants stated a positive predictive value. Accuracy and speed of response were analyzed.

Results: Communicating with Bayesian information led to participant performance of only 10% (without frequency net) and 37% (with frequency net) accuracy. The tasks communicated with diagnostic information but without a frequency net were correctly solved by 72% of participants, but accuracy rate decreased to 61% when participants were given a frequency net. Participants with correct responses in the Bayesian information version without visualization took longest to complete the tasks (median of 106 seconds; median of 13.5, 14.0, and 14.5 seconds in other versions).

Discussion: Communicating with diagnostic information rather than Bayesian information helps patients to understand specific information better and more quickly. Patients' understanding of the relevance of test results is strongly dependent on the way the information is presented.

Copyright: © 2023 Brose et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

MeSH terms

Bayes Theorem
Communication
Humans
Physician-Patient Relations*
Physicians*
Problem Solving

Grants and funding

This study was funded by the program RISE -Rare important syndromes in endocrinology, which is supported by the Else-Kröner-Fresenius-Stiftung (www.ekfs.de) and the Eva-Luise-und-Horst-Köhler-Stiftung (www.elhks.de). The recipient of the awards was LTB. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.