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Published on: June 9, 2018
Optimal Expectations and Limited Medical Testing: Evidence from Huntington Disease: Corrigendum
Emily Oster1, Ira Shoulson2, E Ray Dorsey3
1Brown University, Providence, RI.
Insights
This study corrects Huntington Disease (HD) risk perception figures. Individuals with early symptoms accurately perceive their HD risk, while those with advanced symptoms remain overly optimistic, contrary to previous findings.
Area of Science:
- Medical Research
- Bayesian Analysis
- Risk Perception Studies
Background:
- The original study "Optimal Expectations and Limited Medical Testing: Evidence from Huntington Disease" (2013) presented Figure 4 on Huntington Disease (HD) risk perception.
- Figure 4 illustrated how individuals' perceived risk of HD changes with symptom progression.
- It compared perceived risk with calculated "actual risk" using Bayesian updating.
Purpose of the Study:
- To update and correct Figure 4 from the 2013 study on Huntington Disease (HD).
- To address inaccuracies in the calculation of "actual risk" for HD.
- To present revised data on risk perception in relation to symptom severity.
Main Methods:
- Re-analyzing data on Huntington Disease (HD) risk perception with updated information.
- Correcting a calculation error in the "actual risk" series presented in the original Figure 4.
- Utilizing improved data availability to refine Bayesian updating calculations for HD risk.
Main Results:
- The corrected figure indicates that individuals with low symptom levels accurately perceive their Huntington Disease (HD) risk.
- Individuals with more advanced symptoms exhibit overoptimism regarding their HD risk.
- The overall level of overoptimism concerning HD risk is lower than initially reported in the original study.
Conclusions:
- Risk perception accuracy for Huntington Disease (HD) varies with symptom severity.
- The findings suggest a nuanced understanding of overoptimism in HD risk assessment.
- Revised data impacts the interpretation of expectations and limited medical testing in the context of HD.
Abstract:
The purpose of this document is to update and correct Figure 4 from "Optimal Expectations and Limited Medical Testing: Evidence from Huntington Disease" (Oster, Shoulson, and Dorsey 2013). This figure documents how perceptions about the risk of HD evolve with symptoms. It compares these perceptions with the "actual risk" of HD based on a Bayesian updating calculation described in the paper. The construction of Figure 4 is correctly described in the text of the paper and the data on perceptions are documented correctly. However, the construction of the "actual risk" series is not accurate. There are two central issues. First, there were data limitations at the time of publication which have since been relaxed and the better data now available changes the picture. Second, there was an error in the construction of Figure 4 which should have been recognized at the time. We detail the issues here and include the corrected figure. The original figure showed evidence of overoptimism at all levels of motor score. The corrected figure shows that for low symptom levels individuals are correct about their risk level, whereas those with more advanced symptoms are overly optimistic. Overall, the levels of overoptimism are lower than documented originally. We will briefly discuss the implications for the theory at the end of this document.
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