Pd32-12 visual and numeric risk information reduces variation in surgeon risk perception: results from a randomized, clinical vignette experiment

You have accessJournal of UrologyCME1 Apr 2023PD32-12 VISUAL AND NUMERIC RISK INFORMATION REDUCES VARIATION IN SURGEON RISK PERCEPTION: RESULTS FROM A RANDOMIZED, CLINICAL VIGNETTE EXPERIMENT Hung-Jui Tan, David Gotz, Hillary Heiling, Allison Deal, Kara Giannone, Debra Usinger, Sue Blalock, Antonia Bennett, Matthew Nielsen, Daniel Reuland, Alex Sox-Harris, Allison Lazard, Greg Sacks, and Ethan Basch Hung-Jui TanHung-Jui Tan More articles by this author , David GotzDavid Gotz More articles by this author , Hillary HeilingHillary Heiling More articles by this author , Allison DealAllison Deal More articles by this author , Kara GiannoneKara Giannone More articles by this author , Debra UsingerDebra Usinger More articles by this author , Sue BlalockSue Blalock More articles by this author , Antonia BennettAntonia Bennett More articles by this author , Matthew NielsenMatthew Nielsen More articles by this author , Daniel ReulandDaniel Reuland More articles by this author , Alex Sox-HarrisAlex Sox-Harris More articles by this author , Allison LazardAllison Lazard More articles by this author , Greg SacksGreg Sacks More articles by this author , and Ethan BaschEthan Basch More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003325.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Differences in risk perception is a major driver of variation in surgery. Risk prediction tools aim to attenuate these differences, but only a minority of urologists use them. Because data visualization can improve engagement and information processing, we designed a visual risk display and tested its impact on surgeon risk perception. METHODS: Taking a user-centered design approach, the research team engaged a panel of urologists to identify key risk domains and design a visual risk display. From May–June 2022, we administered SUO/AUA members 6 clinical vignettes (A: favorable intermediate risk prostate cancer, B: high risk prostate cancer, C: small renal mass, D: advanced kidney cancer, E: BCG unresponsive, noninvasive bladder cancer, F: muscle-invasive bladder cancer), randomizing them to vignettes plus visual risk display, vignettes plus numeric risk information, and vignettes alone (control). Respondents estimated the risk for other-cause mortality, cancer mortality with/without surgery, serious complications, and adverse functional outcome from 0–100%. Variation was compared using Levene’s test of homogeneity in variance. RESULTS: In total, 333 urologists completed all 6 vignettes with 104 in the visual arm, 111 in the numeric arm, and 118 in the control arm. Most respondents obtained fellowship-training (71.2%) and practice in an academic setting (60.1%). Respondents had 11.7 (SD 10.6) years of experience and performed 11.2 (SD 9.7) major cases per month. As illustrated in the Figure 1, both visual and numeric risk information reduced variation in perceived risk of other-cause mortality (i.e., life expectancy) compared to control (p<0.05). Visual and numeric risk information yielded similar reductions in variation for the other risk domains. However, compared to numeric risk information only, the visual risk display only reduced variation in perceived risk for adverse functional outcomes for cases D, E, and F (p<0.05). CONCLUSIONS: Providing urologists with risk information—whether visual or numeric—reduces variation in perceived risk, particularly for life expectancy and functional outcomes. Additional research is needed to assess whether visual methods further enhance usability and risk communication in the clinical setting. Source of Funding: American Cancer Society © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e911 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hung-Jui Tan More articles by this author David Gotz More articles by this author Hillary Heiling More articles by this author Allison Deal More articles by this author Kara Giannone More articles by this author Debra Usinger More articles by this author Sue Blalock More articles by this author Antonia Bennett More articles by this author Matthew Nielsen More articles by this author Daniel Reuland More articles by this author Alex Sox-Harris More articles by this author Allison Lazard More articles by this author Greg Sacks More articles by this author Ethan Basch More articles by this author Expand All Advertisement PDF downloadLoading ...