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Medical Decision Making, Vol. 25, No. 5, 560-570 (2005)
DOI: 10.1177/0272989X05280560
© 2005 Society for Medical Decision Making

Comparing the Standard Rating Scale and the Magnifier Scale for Assessing Risk Perceptions

Andrea D. Gurmankin, PhD, MBe

Dana-Farber Cancer Institute, 44 Binney Street, Smith 253, Boston, MA; Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts, and the Center for Community Based Research, Dana-Farber Cancer Institute, Boston, Massachusettsandrea_gurmankin{at}dfci.harvard.edu

Marie Helweg-Larsen, PhD

Department of Psychology, Dickinson College, Carlisle, Pennsylvania

Katrina Armstrong, MD, MSCE

Abramson Cancer Center, the Department of Medicine, and the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia

Stephen E. Kimmel, MD, MSCE

Department of Biostatistics & Epidemiology and the Cardiovascular Division, Department of Medicine, and the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia

Kevin G. M. Volpp, MD, PhD

Philadelphia Veterans Affairs Center for Health Equity Research and Promotion, University of Pennsylvania School of Medicine, and the Wharton School, Philadelphia, Pennsylvania

Objective. A new risk perception rating scale ("magnifier scale") was recently developed to reduce elevated perceptions of low-probability health events, but little is known about its performance. The authors tested whether the magnifier scale lowers risk perceptions for low-probability (in 0%–1% magnifying glass section of scale) but not high-probability (>1%) events compared to a standard rating scale (SRS). Method. In studies 1 (n = 463) and 2 (n = 105), undergraduates completed a survey assessing risk perceptions of high- and low-probability events in a randomized 2X 2 design: in study 1 using the magnifier scale or SRS, numeric risk information provided or not, and in study 2 using the magnifier scale or SRS, high- or low-probability event. In study 3, hypertension patients at the Philadelphia Veterans Affairs hospital completed a similar survey (n = 222) assessing risk perceptions of 2 self-relevant high-probability events—heart attack and stroke—with the magnifier scale or the SRS. Results. In study 1, when no risk information was provided, risk perceptions for both high- and low-probability events were significantly lower (P < 0.0001) when using the magnifier scale compared to the SRS, but risk perceptions were no different by scale when risk information was provided (interaction term: P = 0.003). In studies 2 and 3, risk perceptions for the high-probability events were significantly lower using the magnifier scale than the SRS (P = 0.015 and P = 0.014, respectively). Conclusions. The magnifier scale lowered risk perceptions but did so for low- and high-probability events, suggesting that the magnifier scale should not be used for assessments of risk perceptions for high-probability events.

Key Words: magnifier scale • standard rating scale • risk perceptions


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