{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T13:06:27Z","timestamp":1792242387087,"version":"4.4.0"},"reference-count":48,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2011,4,1]],"date-time":"2011-04-01T00:00:00Z","timestamp":1301616000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Patient Education and Counseling"],"published-print":{"date-parts":[[2011,4]]},"DOI":"10.1016\/j.pec.2010.04.027","type":"journal-article","created":{"date-parts":[[2010,6,8]],"date-time":"2010-06-08T08:50:44Z","timestamp":1275987044000},"page":"92-98","source":"Crossref","is-referenced-by-count":72,"title":["Health literacy, numeracy, and interpretation of graphical breast cancer risk estimates"],"prefix":"10.1016","volume":"83","author":[{"given":"Sandra M.","family":"Brown","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie O.","family":"Culver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn E.","family":"Osann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah J.","family":"MacDonald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Sand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea A.","family":"Thornton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia","family":"Grant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah J.","family":"Bowen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly A.","family":"Metcalfe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry B.","family":"Burke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark E.","family":"Robson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Friedman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey N.","family":"Weitzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.pec.2010.04.027_bib1","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1111\/j.1525-1497.2006.00544.x","article-title":"How health care systems can begin to address the challenge of limited literacy","volume":"8","author":"Paasche-Orlow","year":"2006","journal-title":"J Gen Intern Med"},{"key":"10.1016\/j.pec.2010.04.027_bib2","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1001\/jama.282.6.527","article-title":"Health literacy and numeracy","volume":"282","author":"Estrada","year":"1999","journal-title":"J Amer Med Assoc"},{"key":"10.1016\/j.pec.2010.04.027_bib3","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1177\/0272989X07303824","article-title":"Validation of the subjective numeracy scale: effects of low numeracy on comprehension of risk communications and utility elicitations","volume":"27","author":"Zikmund-Fisher","year":"2007","journal-title":"Med Decis Making"},{"key":"10.1016\/j.pec.2010.04.027_bib4","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1177\/0272989X0102100604","article-title":"Frequency or probability? A qualitative study of risk communication formats used in health care","volume":"21","author":"Schapira","year":"2001","journal-title":"Med Decis Making"},{"key":"10.1016\/j.pec.2010.04.027_bib5","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1177\/0272989X07307271","article-title":"Numeric, verbal, and visual formats of conveying health risks: suggested best practices and future recommendations","volume":"27","author":"Lipkus","year":"2007","journal-title":"Med Decis Making"},{"key":"10.1016\/j.pec.2010.04.027_bib6","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1086\/301749","article-title":"Genetic heterogeneity and penetrance analysis of the BRCA1 and BRCA2 genes in breast cancer families. The breast cancer linkage consortium","volume":"62","author":"Ford","year":"1998","journal-title":"Am J Hum Genet"},{"key":"10.1016\/j.pec.2010.04.027_bib7","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1126\/science.1088759","article-title":"Breast and ovarian cancer risks due to inherited mutations in BRCA1 and BRCA2","volume":"302","author":"King","year":"2003","journal-title":"Science"},{"key":"10.1016\/j.pec.2010.04.027_bib8","doi-asserted-by":"crossref","first-page":"2328","DOI":"10.1200\/JCO.2004.04.033","article-title":"Contralateral breast cancer in BRCA1 and BRCA2 mutation carriers","volume":"22","author":"Metcalfe","year":"2004","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.pec.2010.04.027_bib9","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.ygyno.2004.09.039","article-title":"The risk of ovarian cancer after breast cancer in BRCA1 and BRCA2 carriers","volume":"96","author":"Metcalfe","year":"2005","journal-title":"Gynecol Oncol"},{"key":"10.1016\/j.pec.2010.04.027_bib10","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1001\/jama.283.5.617","article-title":"Life expectancy gains from cancer prevention strategies for women with breast cancer and BRCA1 or BRCA2 mutations","volume":"283","author":"Schrag","year":"2000","journal-title":"J Amer Med Assoc"},{"key":"10.1016\/j.pec.2010.04.027_bib11","unstructured":"Healthy people 2010: understanding and improving health. Washington, DC: Department of Health and Human Services; January 2000."},{"key":"10.1016\/j.pec.2010.04.027_bib12","doi-asserted-by":"crossref","first-page":"3101","DOI":"10.1200\/JCO.1998.16.9.3101","article-title":"Relation between literacy, race, and stage of presentation among low-income patients with prostate cancer","volume":"16","author":"Bennett","year":"1998","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.pec.2010.04.027_bib13","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1002\/(SICI)1097-0142(19961101)78:9<1912::AID-CNCR11>3.0.CO;2-0","article-title":"Knowledge and attitude on screening mammography among low-literate, low-income women","volume":"78","author":"Davis","year":"1996","journal-title":"Cancer"},{"key":"10.1016\/j.pec.2010.04.027_bib14","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1177\/109019819802500508","article-title":"Practical assessment of adult literacy in health care","volume":"25","author":"Davis","year":"1998","journal-title":"Health Educ Behav"},{"key":"10.1016\/j.pec.2010.04.027_bib15","first-page":"383","article-title":"The role of health literacy in patient\u2013physician communication","volume":"34","author":"Williams","year":"2002","journal-title":"Fam Med"},{"key":"10.1016\/j.pec.2010.04.027_bib16","doi-asserted-by":"crossref","first-page":"134","DOI":"10.3322\/canjclin.52.3.134","article-title":"Health literacy and cancer communication","volume":"52","author":"Davis","year":"2002","journal-title":"CA: Cancer J Clin"},{"key":"10.1016\/j.pec.2010.04.027_bib17","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1081\/CNV-100000154","article-title":"The role of inadequate health literacy skills in colorectal cancer screening","volume":"19","author":"Davis","year":"2001","journal-title":"Cancer Invest"},{"key":"10.1016\/j.pec.2010.04.027_bib18","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.amepre.2005.06.012","article-title":"A definition and operational framework for health numeracy","volume":"29","author":"Golbeck","year":"2005","journal-title":"Am J Prev Med"},{"key":"10.1016\/j.pec.2010.04.027_bib19","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/j.1467-9280.2006.01720.x","article-title":"Numeracy and decision making","volume":"17","author":"Peters","year":"2006","journal-title":"Psychol Sci"},{"key":"10.1016\/j.pec.2010.04.027_bib20","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1177\/0272989X05276860","article-title":"Can patients interpret health information? An assessment of the medical data interpretation test","volume":"25","author":"Schwartz","year":"2005","journal-title":"Med Decis Making"},{"key":"10.1016\/j.pec.2010.04.027_bib21","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1007\/s11606-005-0245-7","article-title":"Patients and medical statistics. Interest, confidence, and ability","volume":"20","author":"Woloshin","year":"2005","journal-title":"J Gen Intern Med"},{"key":"10.1016\/j.pec.2010.04.027_bib22","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1177\/0272989X0202200108","article-title":"Effect of framing as gain versus loss on understanding and hypothetical treatment choices: survival and mortality curves","volume":"22","author":"Armstrong","year":"2002","journal-title":"Med Decis Making"},{"key":"10.1016\/j.pec.2010.04.027_bib23","doi-asserted-by":"crossref","first-page":"4299","DOI":"10.1200\/JCO.2003.06.025","article-title":"Adjuvant chemotherapy for breast cancer: how presentation of recurrence risk influences decision-making","volume":"21","author":"Chao","year":"2003","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.pec.2010.04.027_bib24","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1080\/10810730500526695","article-title":"Formats for improving risk communication in medical tradeoff decisions","volume":"11","author":"Waters","year":"2006","journal-title":"J Health Commun"},{"key":"10.1016\/j.pec.2010.04.027_bib25","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1093\/oxfordjournals.jncimonographs.a024192","article-title":"What does it mean to understand a risk? Evaluating risk comprehension","volume":"25","author":"Weinstein","year":"1999","journal-title":"J Natl Cancer Inst Monogr"},{"key":"10.1016\/j.pec.2010.04.027_bib26","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1177\/0272989X04265482","article-title":"The effect of numerical statements of risk on trust and comfort with hypothetical physician risk communication","volume":"24","author":"Gurmankin","year":"2004","journal-title":"Med Decis Making"},{"key":"10.1016\/j.pec.2010.04.027_bib27","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/0272989X0102100105","article-title":"General performance on a numeracy scale among highly educated samples","volume":"21","author":"Lipkus","year":"2001","journal-title":"Med Decis Making"},{"key":"10.1016\/j.pec.2010.04.027_bib28","doi-asserted-by":"crossref","first-page":"966","DOI":"10.7326\/0003-4819-127-11-199712010-00003","article-title":"The role of numeracy in understanding the benefit of screening mammography","volume":"127","author":"Schwartz","year":"1997","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.pec.2010.04.027_bib29","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1177\/0272989X0102100505","article-title":"Assessing values for health: numeracy matters","volume":"21","author":"Woloshin","year":"2001","journal-title":"Med Decis Making"},{"key":"10.1016\/j.pec.2010.04.027_bib30","first-page":"8","article-title":"Graphicacy: the fourth \u2018R\u2019?","volume":"64","author":"Aldrich","year":"2000","journal-title":"Prim Sci Rev"},{"key":"10.1016\/j.pec.2010.04.027_bib31","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1001\/jama.281.11.1037","article-title":"Perils, pitfalls, and possibilities in talking about medical risk","volume":"281","author":"Bogardus","year":"1999","journal-title":"J Amer Med Assoc"},{"key":"10.1016\/j.pec.2010.04.027_bib32","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1093\/oxfordjournals.jncimonographs.a024191","article-title":"The visual communication of risk","volume":"25","author":"Lipkus","year":"1999","journal-title":"J Natl Cancer Inst Monogr"},{"key":"10.1016\/j.pec.2010.04.027_bib33","doi-asserted-by":"crossref","first-page":"6949","DOI":"10.1200\/JCO.2005.12.514","article-title":"Communicating quality of life information to cancer patients: a study of six presentation formats","volume":"23","author":"Brundage","year":"2005","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.pec.2010.04.027_bib34","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1002\/(SICI)1096-8628(20000228)90:5<361::AID-AJMG4>3.0.CO;2-8","article-title":"Genetic counseling for women with an intermediate family history of breast cancer","volume":"90","author":"Burke","year":"2000","journal-title":"Am J Med Genet"},{"key":"10.1016\/j.pec.2010.04.027_bib35","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/1472-6874-8-18","article-title":"Frequency format diagram and probability chart for breast cancer risk communication: a prospective, randomized trial","volume":"8","author":"Ghosh","year":"2008","journal-title":"BMC Womens Health"},{"key":"10.1016\/j.pec.2010.04.027_bib36","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/S0738-3991(03)00238-6","article-title":"Different formats for communicating surgical risks to patients and the effect on choice of treatment","volume":"54","author":"Timmermans","year":"2004","journal-title":"Patient Educ Couns"},{"key":"10.1016\/j.pec.2010.04.027_bib37","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.pec.2008.07.013","article-title":"Presenting health risk information in different formats: the effect on participants\u2019 cognitive and emotional evaluation and decisions","volume":"73","author":"Timmermans","year":"2008","journal-title":"Patient Educ Couns"},{"key":"10.1016\/j.pec.2010.04.027_bib38","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1080\/10810730600829916","article-title":"The influence of graphic format on breast cancer risk communication","volume":"11","author":"Schapira","year":"2006","journal-title":"J Health Commun"},{"key":"10.1016\/j.pec.2010.04.027_bib39","first-page":"391","article-title":"Rapid estimate of adult literacy in medicine: a shortened screening instrument","volume":"25","author":"Davis","year":"1993","journal-title":"Fam Med"},{"key":"10.1016\/j.pec.2010.04.027_bib40","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1111\/j.0272-4332.2004.00466.x","article-title":"Agreement between scales in the measurement of breast cancer risk perceptions","volume":"24","author":"Schapira","year":"2004","journal-title":"Risk Anal"},{"key":"10.1016\/j.pec.2010.04.027_bib41","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s12160-008-9037-8","article-title":"Clinical implications of numeracy: theory and practice","volume":"35","author":"Nelson","year":"2008","journal-title":"Ann Behav Med"},{"key":"10.1016\/j.pec.2010.04.027_bib42","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/00024665-200409000-00009","article-title":"Recruitment of research participants through the Internet","volume":"22","author":"Im","year":"2004","journal-title":"Comput Inform Nurs"},{"key":"10.1016\/j.pec.2010.04.027_bib43","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1207\/S15324796ABM2404_01","article-title":"The Internet as a research tool: worth the price of admission?","volume":"24","author":"Lenert","year":"2002","journal-title":"Ann Behav Med"},{"key":"10.1016\/j.pec.2010.04.027_bib44","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1002\/hed.10383","article-title":"Numeracy and the shortcomings of utility assessment in head and neck cancer patients","volume":"26","author":"Schwartz","year":"2004","journal-title":"Head Neck"},{"key":"10.1016\/j.pec.2010.04.027_bib45","series-title":"Income, poverty, and health insurance coverage in the United States: 2006","first-page":"P60","author":"DeNavas-Walt","year":"2007"},{"key":"10.1016\/j.pec.2010.04.027_bib46","first-page":"35","article-title":"Numeracy and the medical student's ability to interpret data","volume":"5","author":"Sheridan","year":"2002","journal-title":"Eff Clin Pract"},{"key":"10.1016\/j.pec.2010.04.027_bib47","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1472-6947-1-2","article-title":"Identifying patient preferences for communicating risk estimates: a descriptive pilot study","volume":"1","author":"Fortin","year":"2001","journal-title":"BMC Med Inform Decis Making"},{"key":"10.1016\/j.pec.2010.04.027_bib48","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1197\/jamia.M2115","article-title":"Design features of graphs in health risk communication: a systematic review","volume":"13","author":"Ancker","year":"2006","journal-title":"J Am Med Inform Assoc"}],"container-title":["Patient Education and Counseling"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0738399110002740?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0738399110002740?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T22:33:38Z","timestamp":1559169218000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0738399110002740"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,4]]},"references-count":48,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2011,4]]}},"alternative-id":["S0738399110002740"],"URL":"https:\/\/doi.org\/10.1016\/j.pec.2010.04.027","relation":{},"ISSN":["0738-3991"],"issn-type":[{"value":"0738-3991","type":"print"}],"subject":[],"published":{"date-parts":[[2011,4]]}}}