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Ärztinnen und Ärzte in einer Sitzung

Heisenberg Chair for Medical Risk Literacy & Evidence-Based Decisions

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Heisenberg Chair for Medical Risk Literacy & Evidence-Based Decisions

Univ.-Prof. Dr. rer. nat. Dipl.-Psych. Odette Wegwarth

Heisenberg Chair for Medical Risk Literacy & Evidence-Based Decisions / Dipl.-Psychologist

CCM: Campus Charité Mitte

An evidence-based health care requires risk-savvy doctors and patients. Yet, our health care system falls short on both counts.

To illustrate the extent: In a national study of 412 U.S. primary care physicians, most physicians did not know that the 5-year survival statistic—often used to communicate the benefit of screening—is a biased metric in the context of screening. Among German gynecologists who were explicitly asked for numerical information on the benefits and harms of mammography screening, not a single one provided all information required for a patient to make an informed choice. Of 32 German HIV counselors, only one were able to correctly explain the meaning of a positive HIV test. And in a study with nearly 1,700 women from 5 European countries, the majority of women overestimated their likelihood to develop certain female cancers by orders of magnitude, whereas less than one third was aware of the fact that mammography screening can also cause harms.

Why do we have this lack of risk literacy? One frequently discussed answer assumes that people suffer from cognitive deficits that make them basically hopeless at dealing with statistics. Yet the fact that even 4th-graders can understand the positive predictive value if information is presented as natural frequencies shows that the problem can lie in how information is presented. Still, a transparent presentation of risk may not eliminate all of the observed misinterpretation of risk in medicine. When, for instance, over 400 US gynecologists were presented with an easy-to-understand summary of the current best evidence on ovarian cancer screening, about half did not revise their initial assumptions about the screening’s benefit-harm-ratio, although these assumptions were incorrect. Insights from cognitive sciences imply that people’s perception and dealing with risks does not only depend on how statistics is taught and communicated, but also on how medical risk information is transformed when travelling through social networks, and on how people initially learn about a risk (by description or by experience).

Curriculum Vitae

  • 2021 – Heisenberg chair for medical risk literacy & evidence-based decisions
  • 2015 – Habilitation and Venia legendi in Medical Sociology and Sciences of Rehabilitation, Charité – Universitätsmedizin Berlin
  • 2007 – Dissertation (Dr. rer. nat.) in Psychology, Humboldt Universität zu Berlin
  • 2003 – Diploma (Dipl.-Psych.) in Psychology, University of Potsdam

Main Focus

  • Medical risk literacy in doctors and patients
  • Evidence-based decision making
  • Fast-and-frugal decision support tools
  • Defensive decision making in medicine
  • Conflict of interests in medicine

Selected Literature

  • Wegwarth, O., Wagner, G. G., Spies, C., & Hertwig, R. (2020). Assessment of German public attitudes toward health communications with varying degrees of scientific uncertainty regarding COVID-19. JAMA Network Open, 3(12), Article e2032335. doi.org/10.1001/jamanetworkopen.2020.32335
  • Wegwarth, O., & Pashayan, N. (2019). When evidence says no: Gynecologists' reasons for (not) recommending ineffective ovarian cancer screening. BMJ Quality & Safety. Advance online publication. doi.org/10.1136/bmjqs-2019-009854
  • Wegwarth, O., & Gigerenzer, G. (2018). US gynecologists' estimates and beliefs regarding ovarian cancer screening's effectiveness 5 years after release of the PLCO evidence. Scientific Reports, 8, Article 17181. doi.org/10.1038/s41598-018-35585-z
  • Wegwarth, O., Wagner, G. G., & Gigerenzer, G. (2017). Can facts trump unconditional trust? Evidence-based information halves the influence of physicians' non-evidence-based cancer screening recommendations. PLoS ONE, 12(8), Article e0183024. doi.org/10.1371/journal.pone.0183024
  • Wegwarth, O. (2015). Cancer survival rates: The CONCORD-2 study. The Lancet, 386(9992), 429–429. doi.org/10.1016/S0140-6736(15)61442-8
  • Wegwarth, O., & Gigerenzer, G. (2013). Overdiagnosis and overtreatment: Evaluation of what physicians tell patients about screening harms. JAMA Internal Medicine, 173(22), 2086–2087. doi.org/10.1001/jamainternmed.2013.10363
  • Wegwarth, O., Schwartz, L. M., Woloshin, S., Gaissmaier, W., & Gigerenzer, G. (2012). Do physicians understand cancer screening statistics? A national survey of primary care physicians in the United States. Annals of Internal Medicine, 156(5), 340–349. doi.org/10.7326/0003-4819-156-5-201203060-00005
  • Wegwarth, O., & Gigerenzer, G. (2011). "There is nothing to worry about": Gynecologists' counseling on mammography. Patient Education and Counseling, 84(2), 251–256. doi.org/10.1016/j.pec.2010.07.025
  • Gigerenzer, G., Wegwarth, O., & Feufel, M. A. (2010). Misleading communication of risk. BMJ, 341(7777), Article 341:c4830, 791–792. doi.org/10.1136/bmj.c4830
  • Wegwarth, O., Gaissmaier, W., & Gigerenzer, G. (2009). Smart strategies for doctors and doctors-in-training: Heuristics in medicine. Medical Education, 43(8), 721–728. doi.org/10.1111/j.1365-2923.2009.03359.x

Honors and Awards

  • 2021: Invited expert at WHO Global Technical Consultation on developing metrics and indicators to quantify the burden of infodemic on health and well-being, World Health Organization, Geneva (Switzerland).
  • 2020: Granted with a Heisenberg Professorship by the Deutsche Forschungsgemeinschaft (DFG)
  • 2019: Invited expert by the Nobel Foundation, the Swedish ambassador Mr. Per Thöresson, and the Leopoldina for the Nobel Prize Dialogues “Towards Health: Equality, Responsibility, and Research,” Panel: Vaccine hesitancy, Berlin.
  • 2019 - : Appointed Experted for the WHO European Technical Consultation on Screening, World Health Organization, UN-City Kopenhagen (DK).
  • 2017: Appointed Expert by the German Chancellery for the 3rd Forum of Germany "Global health and innovation," Berlin (Germany).
  • 2016: Dr. Lothar Beyer Prize, German Society of General and Family Medicine (DEGAM), Frankfurt/Main (Germany).
  • 2013: Early Investigator Award, Society of Behavioral Medicine, San Francisco (USA).
  • 2012: Appointed Expert at the citizen dialogue "Future technologies: High tech medicine, “German Federal Ministry for Education and Research (BMBF), Berlin (Germany).
  • 2010: International Collaboration Grant, Icahn School of Medicine at Mount Sinai, New York City (USA).
  • 2009: Visiting Fellow Grant, Clinical Epidemiology Interdisciplinary Research Group, Cardiff University (UK).