People who possess greater mathematical skills (i.e., numeracy) are generally more accurate in interpreting numerical data than less numerate people. However, recent evidence has suggested that more numerate people may use their numerical skills to interpret data only if their initial interpretation conflicts with their worldview. That is, if an initial, intuitive (but incorrect) interpretation of data appears to disconfirm one’s beliefs, then numerical skills are used to further process the data and reach the correct interpretation, whereas numerical skills are not used in situations where an initial incorrect interpretation of the data appears to confirm one’s beliefs (i.e., motivated numeracy). In the present study, participants were presented with several data problems, some with correct answers confirming their political views and other disconfirming their views. The difficulty of these problems was manipulated to examine how numeracy would influence the rate of correct responses on easier vs. more difficult problems. Results indicated that participants were more likely to answer problems correctly if the correct answer confirmed rather than disconfirmed their political views, and this response pattern did not depend on problem difficulty or numerical skill. Although more numerate participants were more accurate overall, this was true both for problems in which the correct answer confirmed and disconfirmed participants’ political views.

INTRODUCTION:Anchoring bias is defined as relying too much on the initial information provided, when making our own impression.While anchoring affects our everyday lives, in times of stress and anxiety, it affects us even more.The following case illustrates, how the COVID-19 pandemic may have further contributed to this phenomenon in medical decision making. CASE PRESENTATION:A 17-year-old girl presented to the emergency department during the COVID-19 pandemic with a fiveday history of decreased appetite, vomiting, diarrhea, fever, dry cough, and shortness of breath.She denied practicing social distancing and admitted to smoking marijuana daily as well as occasional vaping.The day before presentation, she was tested for COVID-19 in a drive-up clinic, the result of which was pending.Vital signs were significant for a HR of 140 bpm, RR of 30/min, and SpO2 of 82% on ambient air.Labs showed a WBC count of 18 K/uL, CRP of 405 mg/L, LDH of 539 IU/L, ferritin of 270 ng/ mL, and D-dimer of 2.5 ug/mL.Rapid test for SARS-CoV-2 was negative.CT chest with IV contrast did not show pulmonary embolism but was notable for bilateral groundglass opacities and bibasilar consolidation.Clinical suspicion for COVID-19 remained high, especially with these typical radiographic findings.Because of her history of vomiting with possible aspiration, treatment with ceftriaxone was initiated.On hospital day 2, she had worsening hypoxia, requiring 15 L of oxygen via nonrebreather.Inflammatory markers had risen significantly.She was transferred to the intensive care unit and covered broadly for bacterial pneumonia with vancomycin, levofloxacin, and metronidazole.Prednisone was initiated due to concern for vapinginduced lung injury.On hospital day 3, mycoplasma IgM antibody test returned positive.The SARS-CoV-2 test collected prior to admission as well as a third test, 72 hours after admission, were negative.Over the next days, oxygen requirements decreased, and chest x-ray showed improvement of infiltrates.She completed a 7-day course of levofloxacin and was discharged on a slow steroid taper.DISCUSSION: During the COVID-19 pandemic, the combination of shortness of breath, cough, fever, elevated inflammatory markers and CT findings of bilateral groundglass opacities and consolidations raise high suspicion for SARS-CoV-2.However, anchoring on this diagnosis, may lead to an inappropriate exclusion of alternate diagnoses.This atypical presentation of mycoplasma pneumonia in a 17-year-old, possibly with increased inflammatory response due to vaping, demonstrates the importance of a complete workup for other infectious and non-infectious causes, even if COVID-19 is considered a possible explanation.CONCLUSIONS: Anchoring bias needs to be considered especially during the COVID-19 pandemic.Even in patients with a high pretest probability for SARS-CoV-2 infection, alternate diagnoses must remain on the differential.

The Cognitive Reflection Test (CRT) has increasingly dominated theorizing about individual differences in intuitive/reflective thinking propensities, and it is associated with many real-world beliefs and judgments, such as religiosity, paranormal beliefs, and moral judgments. The CRT triggers common incorrect responses that come to mind easily, and it is assumed that recognizing this error is tantamount to solving the problems. As a result, incorrect answers on the CRT purportedly indicate an intuitive thought process, whereas correct answers purportedly indicate a reflective thought process. It has also been argued that the CRT problems are fundamentally different from insight problems because insight problems often cause people to sit lost in thought, unable to solve the problem until they correctly reframe it. The present research tested these assumptions and found that a substantial proportion of people have difficulty solving the problems even when the “intuitive” response is unavailable to them, the correct answer is among four multiple-choice options, and they take time to reflect. Associations between the CRT and beliefs (religiosity, paranormal beliefs, moral judgments, etc.) remained even under conditions in which CRT errors appeared to result from more reflective thought than correct responses. Furthermore, multi-dimensional item response theory models indicated that the CRT loaded onto numeracy and insight problem solving ability factors rather than its own unique factor. Additionally, regression analyses indicated that numeracy and insight may account for many associations between the CRT and real-world beliefs. Broader implications for dual-process theories of reasoning and judgment are discussed.

Research that has explored public enthusiasm for cancer screening has suggested that the public may be overly enthusiastic about being screened with certain tests, and this has been attributed, in part, to lack of knowledge about the risks and benefits. In this article the authors considered the possibility that some people may be enthusiastic about screening even when they are informed and also accept that the test unquestionably does not save lives. Two studies were conducted, one that involved a nationally representative U.S. sample and another that involved an online convenience sample. All participants were asked whether they would want to receive a hypothetical screening test for breast (women) or prostate (men) cancer that does not reduce the chance of cancer death or extend the length of life. Over half of participants wanted to receive the described screening test. Many people did not believe that cancer screening might not save lives, yet screening preferences were not due to disbelief alone. Results further suggested that cancer worry, reassurance, and a desire for health information explained variance in preferences for unbeneficial screening, adjusting for beliefs about screening benefits, perceptions of screening risks, family history, perceptions of cancer risk, and demographics. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Vaccine refusal has an impact on public health, and the human pappillomavirus (HPV) vaccine is particularly underutilized. Research suggests that it may be difficult to change vaccine-related attitudes, and there is currently no good evidence to recommend any particular intervention strategy. One reason for vaccine hesitancy is lack of trust that vaccine harms are adequately documented and reported, yet few communication strategies have explicitly attempted to improve this trust. This study tested the possibility that data from the vaccine adverse event reporting system (VAERS) can be used to increase trust that vaccine harms are adequately researched and that potential harms are disclosed to the public, and thereby improve perceptions of vaccines. In the study, participants were randomly assigned to one of three communication interventions. All participants read the Centers for Disease Control (CDC) vaccine information statement (VIS) for the HPV vaccine. Two other groups were exposed to additional information about VAERS, either summary data or full detailed reports of serious adverse events from 2013. Results showed that the CDC's VIS alone significantly increased perceptions of vaccine benefits and decreased perceived risks. Participants who were also educated about VAERS and given summary data about the serious adverse events displayed more trust in the CDC and greater HPV vaccine acceptance relative to the VIS alone. However, exposure to the detailed VAERS reports significantly reduced trust in the CDC and vaccine acceptance. Hence, general information about the VAERS data slightly increased trust in the CDC and improved vaccine acceptance, but the specific VAERS reports negatively influenced both trust and acceptance. Implications for communicating about vaccines are discussed.