1. BOOK DISCUSSION Michelle Eberle Education & Outreach Coordinator National Network of Libraries of Medicine, New England Region

2. Authors: Steven Woloshin and Lisa Schwartz  Good decisions are based on facts and a prism of values  Without facts, we can’t make good decisions  The media often uses exaggerated message/hype to generate fear or hope KNOW YOUR CHANCES: UNDERSTANDING HEALTH STATISTICS

3. Help promote a sense of:  Healthy skepticism in public  Improve decision making and how to be an informed consumer  How to look at the numbers: GOAL OF THE BOOK

4.  Please take out your handout.  Read Quick Summary P 117-119  What questions should you ask when interpreting risk?  What questions should you ask when interpreting risk reduction? LET’S REVIEW THE BOOK

5. PUTTING RISK IN PERSPECTIVE

6.  Out of how many?  Risk is calculated by numerator (people who experience the outcome)/ denominator (who it could happen to?)  Risk of 100= percentage  Scientists favor the expression that lets them use whole numbers such as 5 out of 10,000; percentage would be 0.0005  Pictographs can be helpful  To make comparisons, helps to use the same number of people each time  Converting to the “___ out of 1,000” format is helpful (Chart page 17)  Example: Number converter, page 126-127  What is another way to say 1 in 25?  “Clearly how you say things matters: some ways are just easier to understand than others.” Framing! PART 1: WHAT IS THE RISK?

7. CONVERTING TO THE “___OUT OF 1000” FORMULA

8.  Risk of What?  Getting of dying from the condition – be clear of the outcome and increasing importance to health  When?  Time frame matters. Next year? 10 year outcome? Over a lifetime?  Whose risk?  Does it apply to me? Age gender, smoking matters.  How does that compare to other health risks?  Should I be concerned? Risk charts help.  How is it framed?  2 out of 1,000 will die or 998 out of 1,000 will NOT die. Elicits different emotions/responses. Example: page 23 WHAT IS THE RISK?

9. PUTTING RISK IN PERSPECTIVE

10.  Reduced risk of what?  How big is the risk reduction?  Does the risk reasonably apply to me?  Relative risk reduction is like understanding sales. Let’s say a fancy store is having a 42% sale and it’s far away. Would you go to the store to purchase a TV? How about a pack of gum?  Starting risk = people in the placebo group  Starting risk determines how big the benefit of an action  Modified risk = risk of people with the intervention  To understand the size of risk reduction, get the change of the outcome with and without the intervention. PART 2: CAN RISK BE REDUCED?

11. PYRAMID OF RISK (PAGE 56)

12. Side effects, costs, inconvenience Useful to think of two categories of side effects Symptom side effects and life-threatening side effects Be clear of the nature of the possible side effects and get the numbers. Resources you can consult: http://druginfo.nlm.nih.gov http://medlineplus.gov http://pubmed.gov PART 3: DOES RISK REDUCTION HAVE DOWNSIDES?

13. What questions should you ask?  Can you believe the numbers?  Where are they from?  Observational studies or Randomized Controlled Trials?  Are the findings preliminary?  Such as scientific meeting reports?  Who is behind the numbers?  Is there a conflict of interest? PART 4: DEVELOPING A HEALTHY SKEPTICISM

14. What did you like most about the book? What did you not like about the book? What did you know about this subject prior to reading the book? What did you learn? DISCUSSION

15. HEALTH STATISTICS IN THE NEWS

16. Anonymous Pick one question and write your response on a note card. Responses will be shared anonymously with the group. Participation is optional. What is your major “take-away” from reading this book? Do the issues in the book affect your life? How so? Will you do anything or think differently after reading the book? What? NOTECARD ACTIVITY

17. How has the book made you interested to learn more about this topic? What? Why? Has what you learned from reading this book changed how you view news pieces about medical research findings? Would you recommend the book to a friend? SHARING

18.  The media often uses exaggerated messages and hype to generate fear or hope.  Good decisions are based on facts and a prism of values.  Without facts, we can’t make good decisions. TAKE HOME MESSAGES

19. TELL US ABOUT YOUR EXPERIENCE

20. THANK YOU! Michelle Eberle Education & Outreach Coordinator National Network of Libraries of Medicine, New England Region