Table 1 Overview of the items used for profiling basic numeracy and awareness of probability (profiling items) and the items addressing risk estimation and communication (RE&C items) a
Item | Topic | Objective | Type |
P1 | Transform a percentage into an integer value | (Profiling participants’ basic numeracy) | Num |
P2 | Transform integer values into percentages | (Profiling participants’ basic numeracy) | Num |
P3 | Give expectation for the result of the next coin flip in a sequence of coin flips | (Profiling participants’ concept of probability) | MC |
P4 | Estimate the chance of the next color being black in roulette | (Profiling participants’ concept of probability) | BA |
P5 | Rate certainty of detection methods (e.g. certainty of a DNA-test) | (Profiling participants’ awareness of uncertainty) | BA |
RE&C items | Objective | Type | |
I1 | Define five-year mortality (“In the context of a study on the mortality of a disease you are going to investigate the five-year mortality. When does the five-years interval start?”) | Interpret and explain five-year mortality | MC |
I2 | Substantiate dual formulation for risk communication (“For communicating risks to patients it is recommended to adopt “dual wording”. Which effect should be avoided by this measure?”) | Explain framing effect and its consequences | MC |
I3 | Interpret specificity of diagnostic test (“In court proceedings concerning medical malpractice it is discussed, which diagnostic tests should be accepted. Which feature would make a test unfavorable to a defendant hospital, because the test is more likely to indicate a non-existing complication than other tests?”) | Interpret and explain test characteristics | MC |
I4 | Communicate the risk of being ill, given a positive test result (“You intend to tell a patient, how likely it is to actually have a certain disease, in case that the test yields a positive result. Which of the following five formulations is NOT suitable here?”) | Communicate risks adequately | MC |
I5 | Compare absolute vs. relative risk (“You have to make a therapeutic decision. By literature research you find two relevant RCTs. The first study found out that therapy A leads to a relative risk reduction of 0.1%. The second yielded an absolute risk reduction of 1%. Which of the following statements is correct?”) | Interpret risks adequately | MC |
I6 | Interpret five-year mortality (screening context) (“The implementation of a screening program increased five-year mortality from 30% to 100%. Clinical Studies found out, that, nonetheless, there is no difference in mean life expectancy between patients included in the screening program and patients not included. What is the reason behind this discrepancy?”) | Explain benefits and harms of interventions | MC |
I7 | Calculate true positives from prevalence and sensitivity (“A given disease has 1% prevalence in standard population. The sensitivity of a diagnostic test is 85%. In how many cases out of 10,000 the test correctly indicates the disease?”) | Interpret and explain test characteristics | MC |
I8 | Calculate absolute risk given mortality of test vs. control group (“Experts discuss the implementation of a screening program, which examines the participants every three years over an interval of 10 years. Participating in the program reduces the relative risk to die from the disease by 50%. Without screening, four out of 1000 patients die from the disease. What is the correct absolute risk reduction here?”) | Interpret and communicate risks adequately | MC |
I9 | Calculate predictive values given prevalence and test characteristics (“Trisomy 21 is present in 1% of pregnancies of 40 year old women. Non-invasive tests have a sensitivity of about 90% and a specifity of about 95%. What is the probability of a trisomy 21 in case of a positive test result?”) | Understand and communicate test results | Num |