Using natural frequencies to improve diagnostic inferences.
OBJECTIVE
To test whether physician's diagnostic inferences can be improved by communicating information using natural frequencies instead of probabilities. Whereas probabilities and relative frequencies are normalized with respect to disease base rates, natural frequencies are not normalized.


METHODS
The authors asked 48 physicians in Munich and Düsseldorf to determine the positive predictive values (PPVs) of four diagnostic tests. Information presented in the four problems appeared either as probabilities (the traditional way) or as natural frequencies.


RESULTS
When the information was presented as probabilities, the physicians correctly estimated the PPVs in only 10% of cases. When the same information was presented as natural frequencies, that percentage increased to 46%.


CONCLUSIONS
Representing information in natural frequencies is a fast and effective way of facilitating diagnosis insight, which in turn helps physicians to better communicate risks to patients, and patients to better understand these risks.
Hoffrage
U
U
Max Planck Institute for Human Development, Berlin, Germany. hoffrage@mpib-berlin.mpg.de
Gigerenzer
G
G
D001499:Bayes Theorem; D001943:Breast Neoplasms / Q000000981:diagnostic imaging; D003933:Diagnosis; D005189:False Positive Reactions; D006801:Humans; D008327:Mammography; D011237:Predictive Value of Tests; D011336:Probability; D012306:Risk