title: Belief in numbers: When and why women disbelieve tailored breast cancer risk statistics.
abstract: OBJECTIVE
  To examine when and why women disbelieve tailored information about their risk of developing breast cancer.
  
  
  METHODS
  690 women participated in an online program to learn about medications that can reduce the risk of breast cancer. The program presented tailored information about each woman's personal breast cancer risk. Half of women were told how their risk numbers were calculated, whereas the rest were not. Later, they were asked whether they believed that the program was personalized, and whether they believed their risk numbers. If a woman did not believe her risk numbers, she was asked to explain why.
  
  
  RESULTS
  Beliefs that the program was personalized were enhanced by explaining the risk calculation methods in more detail. Nonetheless, nearly 20% of women did not believe their personalized risk numbers. The most common reason for rejecting the risk estimate was a belief that it did not fully account for personal and family history.
  
  
  CONCLUSIONS
  The benefits of tailored risk statistics may be attenuated by a tendency for people to be skeptical that these risk estimates apply to them personally.
  
  
  CONCLUSIONS
  Decision aids may provide risk information that is not accepted by patients, but addressing the patients' personal circumstances may lead to greater acceptance.
authors.affiliation: VA Ann Arbor Center for Clinical Management Research, Ann Arbor, USA. schererl@missouri.edu
authors.forename: Laura D
authors.initials: LD
authors.lastname: Scherer
authors.forename: Peter A
authors.initials: PA
authors.lastname: Ubel
authors.forename: Jennifer
authors.initials: J
authors.lastname: McClure
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Greene
authors.forename: Sharon Hensley
authors.initials: SH
authors.lastname: Alford
authors.forename: Lisa
authors.initials: L
authors.lastname: Holtzman
authors.forename: Nicole
authors.initials: N
authors.lastname: Exe
authors.forename: Angela
authors.initials: A
authors.lastname: Fagerlin
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000517:prevention & control* / Q000523:psychology*; D003657:Decision Making; D005260:Female; D006801:Humans; D008875:Middle Aged; D015397:Program Evaluation; D018570:Risk Assessment; D012307:Risk Factors; D016387:Women's Health
keywords: Breast cancer; Decision aids; Risk calculator; Shared decision making