Physicians’ Perceptions of Patients’ Knowledge and Opinions Regarding Breast Cancer: Associations with Patient Education and Physician Numeracy

Abstract

Background: The aim of this study was to assess physicians’ perception of their patients’ knowledge and opinions regarding regular screening, and the association of their perceptions with physician numeracy and patient education level. Methods: We carried out a survey study of 240 obstetrician-gynecologists. Results: Overall, 99.6% physicians perceive that their patients know that breast cancer is hereditary, 86.5% predicted that there is a gene mutation related to breast cancer, and 79.4% predicted that most breast cancer cases occur in women aged 50 years or greater. Physicians with less educated patients thought that their patients would not know about genetic screening, and physicians with more educated patients thought that their patients would know that mammography does not reduce the risk of getting breast cancer. A total of 66.0% of obstetrician-gynecologists answered all 3 numeracy questions correctly. Less numerate physicians were more likely to indicate that their typical patient would agree with the statement about regular mammography screens than the more numerate physicians. Conclusions: Obstetrician-gynecologists expect that their patients know some things about breast cancer and not others. Some of the physicians’ perceptions about patients differ based on numeracy.

Validation of a Short, 3-Item Version of the Subjective Numeracy Scale

“…(1–6) Fagerlin et al (7, 8) developed and validated the 8-item Subjective Numeracy Scale (SNS-8), composed of self-reported numeracy abilities and preferences, as an alternative to objective measures of numeracy. Efficiency in scale design is important to limit potential burden on respondents while achieving the overall research objective and to provide a useful research tool eligible for integration into large epidemiological studies or clinical trials.…”

“…A lthough important research questions still remain, numeracy plays an fundamental role in decision making, including cognitive reasoning, understanding treatment options and risks, and the ability to convey preferences about health communication to health care providers. [1][2][3][4][5][6] Fagerlin et al 7 and Zikmund-Fisher et al 8 developed and validated the 8-item Subjective Numeracy Scale (SNS-8), composed of self-reported numeracy abilities and preferences, as an alternative to objective measures of numeracy. Efficiency in scale design is important to limit potential burden on respondents while achieving the overall research objective and to provide a useful research tool eligible for integration into large epidemiological studies or clinical trials.…”

Strengths and Gaps in Physicians’ Risk Communication: A Scenario Study of the Influence of Numeracy on Cancer Screening Communication

“…Previous research suggests that physicians may intuitively use their patients' education level to predict their patients' knowledge about cancer. 53 However, it is not known how information about the patient's numeracy influences physicians' risk communication. We expected that physicians would adapt their communication style to the patient's numeracy in accord with best practices; e.g., when talking to low numeracy patients, they would be more likely to use words and visual aids and less likely to use numbers.…”