Literature DB >> 24829276

Efficacy of a web-based intelligent tutoring system for communicating genetic risk of breast cancer: a fuzzy-trace theory approach.

Christopher R Wolfe1, Valerie F Reyna2,3, Colin L Widmer1, Elizabeth M Cedillos1, Christopher R Fisher1, Priscila G Brust-Renck2, Audrey M Weil1.   

Abstract

BACKGROUND: . Many healthy women consider genetic testing for breast cancer risk, yet BRCA testing issues are complex.
OBJECTIVE: . To determine whether an intelligent tutor, BRCA Gist, grounded in fuzzy-trace theory (FTT), increases gist comprehension and knowledge about genetic testing for breast cancer risk, improving decision making.
DESIGN: . In 2 experiments, 410 healthy undergraduate women were randomly assigned to 1 of 3 groups: an online module using a Web-based tutoring system (BRCA Gist) that uses artificial intelligence technology, a second group read highly similar content from the National Cancer Institute (NCI) Web site, and a third that completed an unrelated tutorial. INTERVENTION: . BRCA Gist applied FTT and was designed to help participants develop gist comprehension of topics relevant to decisions about BRCA genetic testing, including how breast cancer spreads, inherited genetic mutations, and base rates. MEASURES: . We measured content knowledge, gist comprehension of decision-relevant information, interest in testing, and genetic risk and testing judgments.
RESULTS: . Control knowledge scores ranged from 54% to 56%, NCI improved significantly to 65% and 70%, and BRCA Gist improved significantly more to 75% and 77%, P < 0.0001. BRCA Gist scored higher on gist comprehension than NCI and control, P < 0.0001. Control genetic risk-assessment mean was 48% correct; BRCA Gist (61%) and NCI (56%) were significantly higher, P < 0.0001. BRCA Gist participants recommended less testing for women without risk factors (not good candidates; 24% and 19%) than controls (50%, both experiments) and NCI (32%), experiment 2, P < 0.0001. BRCA Gist testing interest was lower than in controls, P < 0.0001. LIMITATIONS: . BRCA Gist has not been tested with older women from diverse groups.
CONCLUSIONS: . Intelligent tutors, such as BRCA Gist, are scalable, cost-effective ways of helping people understand complex issues, improving decision making.
© The Author(s) 2014.

Entities:  

Keywords:  Fuzzy-Trace Theory; Intelligent Tutoring System; breast cancer risk; genetic testing

Mesh:

Year:  2014        PMID: 24829276      PMCID: PMC4232483          DOI: 10.1177/0272989X14535983

Source DB:  PubMed          Journal:  Med Decis Making        ISSN: 0272-989X            Impact factor:   2.583


  43 in total

Review 1.  Assessing the risk of breast cancer.

Authors:  K Armstrong; A Eisen; B Weber
Journal:  N Engl J Med       Date:  2000-02-24       Impact factor: 91.245

Review 2.  Genetic testing and medical decision making.

Authors:  V F Reyna; F J Lloyd; P Whalen
Journal:  Arch Intern Med       Date:  2001-11-12

Review 3.  Risk-reduction mastectomy: clinical issues and research needs.

Authors:  M Stefanek; L Hartmann; W Nelson
Journal:  J Natl Cancer Inst       Date:  2001-09-05       Impact factor: 13.506

Review 4.  Heuristic decision making.

Authors:  Gerd Gigerenzer; Wolfgang Gaissmaier
Journal:  Annu Rev Psychol       Date:  2011       Impact factor: 24.137

5.  Theories of medical decision making and health: an evidence-based approach.

Authors:  Valerie F Reyna
Journal:  Med Decis Making       Date:  2008 Nov-Dec       Impact factor: 2.583

6.  Explaining contradictory relations between risk perception and risk taking.

Authors:  Britain Mills; Valerie F Reyna; Steven Estrada
Journal:  Psychol Sci       Date:  2008-05

7.  A web exercise in evidence-based medicine using cognitive theory.

Authors:  F J Lloyd; V F Reyna
Journal:  J Gen Intern Med       Date:  2001-02       Impact factor: 5.128

8.  A meta-analysis of computer-tailored interventions for health behavior change.

Authors:  Paul Krebs; James O Prochaska; Joseph S Rossi
Journal:  Prev Med       Date:  2010-06-15       Impact factor: 4.018

Review 9.  Online patient education and risk assessment: project OPERA from Cancerbackup. Putting inherited breast cancer risk information into context using argumentation theory.

Authors:  James Mackay; Peter Schulz; Sara Rubinelli; Andrea Pithers
Journal:  Patient Educ Couns       Date:  2007-06-21

10.  The role of numeracy on client knowledge in BRCA genetic counseling.

Authors:  David B Portnoy; Debra Roter; Lori H Erby
Journal:  Patient Educ Couns       Date:  2009-10-23
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  30 in total

1.  The effectiveness of argumentation in tutorial dialogues with an Intelligent Tutoring System for genetic risk of breast cancer.

Authors:  Elizabeth M Cedillos-Whynott; Christopher R Wolfe; Colin L Widmer; Priscila G Brust-Renck; Audrey Weil; Valerie F Reyna
Journal:  Behav Res Methods       Date:  2016-09

2.  The Gist of Delay of Gratification: Understanding and Predicting Problem Behaviors.

Authors:  Valerie F Reyna; Evan A Wilhelms
Journal:  J Behav Decis Mak       Date:  2016-08-10

3.  A multidisciplinary approach to designing and evaluating Electronic Medical Record portal messages that support patient self-care.

Authors:  Daniel Morrow; Mark Hasegawa-Johnson; Thomas Huang; William Schuh; Renato Ferreira Leitão Azevedo; Kuangxiao Gu; Yang Zhang; Bidisha Roy; Rocio Garcia-Retamero
Journal:  J Biomed Inform       Date:  2017-03-24       Impact factor: 6.317

4.  Understanding Genetic Breast Cancer Risk: Processing Loci of the BRCA Gist Intelligent Tutoring System.

Authors:  Christopher R Wolfe; Valerie F Reyna; Colin L Widmer; Elizabeth M Cedillos-Whynott; Priscila G Brust-Renck; Audrey M Weil; Xiangen Hu
Journal:  Learn Individ Differ       Date:  2016-07-01

5.  Using conversational agents to explain medication instructions to older adults.

Authors:  Renato F L Azevedo; Dan Morrow; James Graumlich; Ann Willemsen-Dunlap; Mark Hasegawa-Johnson; Thomas S Huang; Kuangxiao Gu; Suma Bhat; Tarek Sakakini; Victor Sadauskas; Donald J Halpin
Journal:  AMIA Annu Symp Proc       Date:  2018-12-05

6.  Germs are germs, and why not take a risk? Patients' expectations for prescribing antibiotics in an inner-city emergency department.

Authors:  David A Broniatowski; Eili Y Klein; Valerie F Reyna
Journal:  Med Decis Making       Date:  2014-10-20       Impact factor: 2.583

7.  Impact of a randomized controlled educational trial to improve physician practice behaviors around screening for inherited breast cancer.

Authors:  Robert A Bell; Haley McDermott; Tonya L Fancher; Michael J Green; Frank C Day; Michael S Wilkes
Journal:  J Gen Intern Med       Date:  2014-12-02       Impact factor: 5.128

8.  An Overview of Judgment and Decision Making Research Through the Lens of Fuzzy Trace Theory.

Authors:  Roni Setton; Evan Wilhelms; Becky Weldon; Christina Chick; Valerie Reyna
Journal:  Xin Li Ke Xue Jin Zhan       Date:  2014-12

9.  Educating Intuition: Reducing Risky Decisions Using Fuzzy-Trace Theory.

Authors:  Valerie F Reyna; Rebecca B Weldon; Michael McCormick
Journal:  Curr Dir Psychol Sci       Date:  2015-10

Review 10.  Using fuzzy-trace theory to understand and improve health judgments, decisions, and behaviors: A literature review.

Authors:  Susan J Blalock; Valerie F Reyna
Journal:  Health Psychol       Date:  2016-08       Impact factor: 4.267

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