Deciphering the Data: Health Numeracy and Its Impact on Decision-Making in Breast Augmentation.

[PURPOSE] Numeracy, the ability to understand numerical concepts, is a key component of health literacy. This study examines rates of innumeracy and its association with demographics to inform patient education strategies in plastic surgery.

[METHODS] A survey was distributed via Amazon Mechanical Turk. Participants rated the perceived safety of breast augmentation using a 5-point Likert scale based on fictional statistics presented as percentages, fractions, pie charts, and pictograms. They then assessed and rated their willingness to consider breast augmentation using a novel implant option compared to a traditional implant using odds ratios, absolute risk, and risk ratios.

[RESULTS] Among 578 participants (median age: 32 years), surgical safety perception varied significantly by data presentation. Positively framed statistics (e.g., "97% success rate") received higher ratings on 5-point Likert scale (mean: 3.9, SD: 0.7) than negatively framed data (e.g., "3% complication rate"; mean: 3.6, SD: 1.0). Visual formats such as pie charts (mean: 3.9, SD: 0.8) and pictograms (mean: 3.7, SD: 0.9) led to higher safety ratings than numerical representations. Only 26% of participants rated the same complication rate consistently across all formats, and just 5.4% correctly identified the safest implant. Higher income (> $100,000; p < 0.001) and postgraduate education (p = 0.037) were associated with improved numeracy. Bar graphs were the most misinterpreted format for odds ratios, with only 42.4% providing correct responses.

[CONCLUSION] Current healthcare data presentation may lead to misinterpretation. Plastic surgeons should address patient innumeracy in consultations and education. Optimizing numeracy strategies can improve patient understanding and decision-making.

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